What are Usual, Customary and Reasonable (UCR) Charges?

The visitors insurance experience is different for everybody-- from varying needs when purchasing a policy to how the insurance is eventually used, there are a wide variety of factors that come into play.

When it comes to reimbursement from an insurance company after filing a claim, usual, customary and reasonable (UCR) charges can affect how much you are reimbursed.

UCR is the amount that most providers in a particular geographic area tend to charge for certain medical services. The UCR varies from one area to another.

UCR charges are the maximum amount a travel insurance provider will reimburse a policy holder for a particular medical service or procedure in a certain geographical area, based on the average cost for that service.

For example, if 90 percent of medical facilities in a specific geographical area charge $100 for an x-ray, the travel insurance provider may establish the UCR as $100 for an x-ray in that area. That means, if you get an x-ray at a facility that charges $150 for an x-ray in that same area, you may be responsible for paying the additional $50 because it exceeds the $100 x-ray UCR for that area.

UCR charges vary by area and insurance company, so it is important to do your research before you embark on your trip so you don’t end up paying out of pocket for a medical service or treatment.

Unfortunately, there is no one source that provides all UCR charges by geographical area. Most insurance companies gather this data from doctors and hospitals and compile it for their records. If you are unsure what the UCR charges might be for your destination, you can call your insurance company and request that information.

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