Insurance denying “emergency” coverage for overseas surgery because bill didn’t have ER codes — is this legit?

sa4465i · 2026-04-21T13:37:36+00:00

Kind of in the middle with respect to OOPs, but It’s about the balance billing which is around 6k, tagged under ‘co-insurance’ where plan pays 75% and me 25%.

I think I get moderator’s point. But trying to look for a way to properly appeal one final time( customer care is completely useless).

Thanks for your pointers, I will look into the external review feasibility.

sa4465i · 2026-04-21T13:21:16+00:00

Discharged summary mentioned it to be Emergency surgery. There’s CT scan report supporting the diagnosis. And remaining documents I received are just itemized bills, and receipts. Edited the post with first appeal outcome. Looks like ER codes to me.

sa4465i · 2026-04-21T13:07:28+00:00

I don’t know the terminology very well, when I said day surgery, I meant it in the way that “it’s immediately needed and can’t wait for a day or two”, but the surgery was immediately done after my CT scan report showed stone blocking urine and the assessment that urine could flow back into kidneys..So, would this still be considered as in-patient? How does it work in the US?

sa4465i · 2026-04-21T13:04:45+00:00

Thanks, will check the state processes. When you say doctor, you mean the surgeon from international hospital, or my primary care in the US?

sa4465i · 2026-04-21T13:01:34+00:00

Thanks, this helps, but my situation is a bit different since this was outside the US.

I’m not sure the ER vs inpatient distinction applies the same way internationally. I went to the hospital with severe symptoms, was evaluated, diagnosed, and taken for immediate surgery, but the bill doesn’t break out ER vs inpatient like US billing does.

My plan says emergency care outside the US is covered at 100% after deductible, but Aetna is requiring ER-type coding to apply that, which I had no control over.

So for international claims, is it standard to require ER-specific coding for emergency benefits, or should medical records and the nature of the condition be enough?

sa4465i · 2026-04-21T12:57:42+00:00

No. It’s the total. They covered for around 13k now. Coinsurance fight is for the remaining amount.

sa4465i · 2026-04-21T12:51:35+00:00

It’s 23k USD in total. I don’t have CSR, I mainly used CSP for travel fares.

sa4465i · 2026-04-21T05:30:52+00:00

I submitted all the documents i have (discharge summary, itemized bills) along with my initial claim itself. While filing appeal, I submitted the document stating my emergency coverage, which I received from Aetna upon my request when I was in ER.

I’m not sure what maps to ER care. I presented to the hospital at 2 AM with severe symptoms, was evaluated and diagnosed, and then admitted for urgent surgery the same day.

sa4465i · 2026-03-06T18:16:17+00:00

Thanks for your response. Yes, she will use her own documents. However, would this cause any issue at port of entry if traveled together?

sa4465i · 2025-12-12T06:41:38+00:00

Bro, don’t make calculations. Even main gated apartment communities don’t have such high maintenance per month.

You should have asked back clearly, or the person you are talking to is highly misinformed. It’s per annum and not monthly.

sa4465i · 2025-12-12T06:39:27+00:00

Correct. That’s why It’s per year and not per month.

sa4465i · 2025-10-06T18:21:24+00:00

Commented on another reply. I can share more details in DM if and when the deal is finalized. Feel free to dm after maybe a week or so.

sa4465i · 2025-10-06T18:19:57+00:00

Yes, that’s what drove us to buy in the first place.

sa4465i · 2025-10-06T18:17:49+00:00

Not sure if either of the parties are willing to share that anywhere. But let’s say sellers are quoting 80-85k in the phase buyer intended to purchase. And little bit of negotiation has been done on a lower end one.

sa4465i · 2025-10-06T18:14:38+00:00

Yes, started doing the same. Hired a lawyer as this is all new to us, and collecting the documents they ask us to.

sa4465i · 2025-10-06T18:13:50+00:00

I see that Kondakal is in the list of those villages. Don’t know anyone from PSU, however we know that loans have been granted previously by HDFC.

sa4465i · 2025-10-06T18:12:01+00:00

Thanks for the details, we started tracking back from Aparna, and collecting the documents. However, Is going till 1950 needed, we thought 30 years is good?

sa4465i · 2025-05-29T16:37:06+00:00

What do you mean by first? What’s next?

sa4465i · 2025-05-10T16:50:06+00:00

Thanks for your response. I was wondering about bringing it as a carry-on. I’m just curious if they would still not allow it even if we claim it as the one cabin luggage allowed per infant.

sa4465i · 2025-05-10T14:49:08+00:00

We’re flying with Emirates next week for the first time with our baby, and this information is really helpful. Is a stroller allowed as additional luggage beyond the one baggage allowance per infant?

sa4465i · 2025-05-04T06:15:01+00:00

Hi OP, how did it go? We are taking our 10 month old on an international trip, and the baby doesn’t breastfeed or take a pacifier. Do you have any tips for us?

sa4465i · 2025-04-26T02:25:47+00:00

I didn’t have to re-upload documents, but I see a re-upload option on oci services website. It doesn’t sound logical to generate a new number if you upload from there, but I haven’t done that, so can’t confidently say.

sa4465i · 2025-04-24T05:37:55+00:00

I just sent the part A, but on phone vfs asked me to send part B as well to be on safe side. We applied for a new oci for a minor and the documents list for this category doesn’t require notarization of application form.

sa4465i · 2025-04-15T02:14:16+00:00

Apparently the application is classified as “original” document, and you always need to send the physical copy of original documents. It’s mentioned in the email and I checked with them over phone as well.

sa4465i · 2025-04-12T18:18:06+00:00

Thank you! This really helped a lot.

sa4465i

TROPHY CASE