Systems and Methods for Cross Border Health Insurance

A system for providing healthcare insurance services to a beneficiary outside of a home boundary of the beneficiary, the system comprising:

• a computer system comprising at least one processor and an operably connected data storage medium, wherein the at least one processor is configured for receiving a request to provide healthcare insurance services for healthcare services provided, or to be provided, to a beneficiary from a healthcare provider at a first location,
• wherein the at least one processor is further configured for:
• determining whether the first location of the healthcare provider is within or outside of the home boundary of the beneficiary;
• and
• if the first location is outside of the home boundary of the beneficiary:
• determining an eligibility of the beneficiary based on at least the healthcare provider and the first location of the healthcare provider;
• and
• providing an insurance coverage amount to the healthcare provider at the first location based on the determination of the eligibility of the beneficiary.

A method for providing healthcare insurance services to a beneficiary outside of a home country of the beneficiary, the method comprising:

• receiving, by a computing system including a processor and a data storage medium, a request to provide healthcare insurance services for healthcare service provided, or to be provided, to a beneficiary from a healthcare provider in a first country;
• determining, by the computing system, whether the first country of the healthcare provider is within or outside of the home country of the beneficiary;
• and
• if the first country is outside of the home country of the beneficiary:
• determining, by the computing system, an eligibility of the beneficiary based on at least the healthcare provider and the first country of the healthcare provider;
• and
• providing, by the computing system, an insurance coverage amount to the healthcare provider at the first country based on the determination of the eligibility of the beneficiary,
• wherein providing the insurance coverage amount comprises determining, by the computing system, at least one of a legal structure of the first country, a regulatory structure of the first country, a taxation structure in the first country, and a type of healthcare services provided, or to be provided, to the beneficiary.