Frequently asked questions

Can a Medical Referral Abroad request be rejected?

Yes, the SZV Medical Advisors will not approve a medical referral abroad for specific reasons, amongst others are:

• If the treating doctor requesting a medical referral abroad does not provide a complete medical report with all the information stipulated by SZV. If this information is missing, SZV will notify the treating doctor and he/she will have 10 working days to submit the necessary information. If the information is not received within the specified time, the medical referral abroad request will be rejected.
• The requested treatment or specialist is available on Sint Maarten.
• The requested treatment is not covered by the Insured's SZV insurance package.
• The individual is not SZV insured.

What does the Insured do if their medical request abroad is rejected?

SZV will notify the Insured by phone if the medical referral abroad request is rejected/not approved. A letter confirming the rejection is sent to the treating doctor who has requested the referral, within 7 working days. The insured should visit the treating doctor that referred him/her to discuss other medical treatment options as well as to receive a copy of the rejection letter.

Can the Insured or the referring doctor choose where the insured would like to be treated?

No, SZV has established selection guidelines for the designated countries in which the Insured is referred to abroad. At times the treating doctor referring the Insured may suggest a designated country, however this is merely a suggestion. SZV decides in which designated country the Insured will be treated based on their knowledge of the quality of care, available services and promptness of care. For example, the treating doctor who is referring you may suggest you go to Aruba for Orthopedic treatment of your hip. However, SZV knows that there is specialized orthopedic care in Aruba, the orthopedic specialist does not provide hip treatment. Therefore SZV will not send the Insured to Aruba.  Also, the treating doctor referring the Insured may suggest treatment in the Dominican Republic, however SZV knows that all the treatment the Insured needs is not available in the Dominican Republic or that there is a long waiting time for that specialty in the Dominican Republic so SZV will designate Colombia as the country to be treated in. Because of these and other issues SZV has the final word on the designated country where treatment will be done.

What happens if the specialist abroad recommends the Insured follows up?

Depending on the follow up treatment recommended by the specialist the insured can receive follow up care on Sint Maarten.  If the care is not available on the Island the Insured should be re-evaluated by the treating doctor who referred him/her abroad in the first place. The treating doctor will request a follow-up medical referral abroad and submit a new medical report on the Insured's current condition.