Abstract: A system and method for guarantor computing system to provide cross-border healthcare services to an adherent. The guarantor computing system may be configured to receive an eligibility request from a first computing system, determine that the policy is associated with a different territory/location, determine a disease-related condition (DRC), generate and send a proxy eligibility request and the DRC to a second computing system in a second territory/location, receive a proxy healthcare approval confirmation message from the second computing system, and generate a healthcare approval message based on a combination of the information included in the proxy healthcare approval confirmation message, the information included in the service eligibility request, and information stored in a memory coupled to the computing system. The computing system may send the generated healthcare approval message to the first computing system to cause the first computing system to approve the provision of the healthcare service.

Abstract: A system and method for providing healthcare insurance services to a beneficiary outside of a home boundary of the beneficiary, that includes: receiving a request to provide healthcare insurance services to a beneficiary from a healthcare provider at a first location; 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 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.