Travel Coverage FAQs

What if something happens and I get admitted to the hospital or have to have surgery while traveling? • If it’s an urgent or emergency situation, we’ll still cover your claims at the in-network level anywhere you go. • Once you’re stabilized, we ask that you return to in-network providers to ensure we can coordinate your recovery.

What happens if I need routine care (like diabetes blood checks) while staying out of network for an extended period of time? • An HMO plan doesn’t cover this.

What if I need to see a specialist while out of network?

• You’ll need to receive prior authorization from Simplete for your claims to be covered. • If the specialist is in the Simplete network, we don’t require a referral or prior authorization to go to that provider. The specialist may request that you get a referral from your primary care provider (PCP), but that’s the specialist’s policy, not a Simplete policy.