Hutong School Insurance Plan Information

Transcription

1 Territory Hutong School Insurance Plan Information Policy Number: G China Policy Maximum per injury / illness $37,500,000 Deductible/ Excess Students and Interns Deductible/ Excess Employees ER Misuse Deductible Medical Expense Prescriptions Ambulance Dental Emergency Medical Evacuation/ Repatriation $50 per injury/illness $500 per injury/illness $250 for illness and not admitted Does not apply to injuries Up to Policy Maximum $1,000 per condition 100% of charges $1,500 for emergency treatment or following an accident only Up to policy maximum Repatriation of Remains $25,000 Emergency Reunion -Relative travel life threatening illness/ death Hotel expense per day Hotel charges after discharge Sports Coverage Death Permanent Total Disablement Disfigurement $5,000 One economy round-trip ticket $150/ day up to benefit max $90 per day (5 days) Non-contact, leisure, recreational, fitness sports $50,000 $120,000 $20,000 Outward Journey Cancellation $5,000 Trip Interruption $4,000 Maternity Complications during first 26 weeks Emergency Cash for Bail $1,000 Travel Delay $1,000 Baggage Delay $450 for 24 hours Personal Liability $1,000,000 Lost Luggage $2,000 Loss of documents $150 Personal Security Expenses $10,000 Political and Natural Disaster Evacuation $25,000 Search and Rescue $25,000 Medical and Loss of Documents Assistance Included Dream Au Pair is a proud member of the International Services (IASIS) which serves to promote healthy exchange experiences supported by stable insurance arrangements. Your insurance plan provided by Dream Au Pair is an IASIS 1

2 Contact Information Emergency Assistance Services This plan provides 24-hour worldwide assistance services for emergencies anywhere in the World through APRIL Assistance. The following are some services included with this coverage: Medical Assistance Medical, Dental, and Pharmacy Referrals Medical Monitoring Emergency Medical Payments Emergency Medical Evacuation Emergency Reunion To obtain emergency assistance, contact APRIL Assistance at the following numbers: If you speak Chinese: 如果说中文 电话 (Tel): Your call will be answered as either Kang Rei or An Yuan Any other language 24/7: Tel: +66 (0) Fax: +66 (0) Assistance can also be requested by sending an to with details of the emergency and telephone numbers where the insured person can be reached. Who to contact for Emergency Security Assistance: To obtain assistance, please call the following number: - Ijet international Inc. Tel: Non- Emergency Claims For non-emergency medical claims, please submit claims information via or mail to APRIL Assistance offices in Thailand: APRIL Assistance [Thailand] Co., Ltd. Maneeya Center North, 10th Floor, 518/3 Ploenchit Road, Lumpini, Pathumwan, Bangkok Thailand Tel: +66 (0) Fax: +66 (0) ops@april.in.th Claim forms can be found online at: 2

3 Frequently Asked Questions What is the insurance company that underwrites this plan? This plan is underwritten by Inter Hannover which is one of the leading insurers in the marketplace. Wholly owned by Hannover Re, they specialize in chosen markets such as student, youth exchange, and travel. Is there a deductible? A deductible is the amount of money that you are responsible for paying to a medical provider before the insurance company will pay. If you are a student or an intern, please note that your deductible/excess is $50 per injury/illness. For an employee of the Hutong School your deductible/excess is $500 per injury/illness. Additionally, there is a $250 ER Misuse Deductible as a part of this plan. You are responsible for paying a deductible of $250 should you visit an emergency room and you are not admitted to the hospital. What do I do if I m sick or injured? You are free to visit any doctor or medical facility for an appointment. You can ask local contacts for a referral to a physician or medical provider or you can contact APRIL Assistance for a referral to a local doctor. If your medical condition is an emergency, please visit the nearest appropriate medical facility. How can I find a doctor or specific medical provider? Insureds may contact APRIL Assistance with any questions about locating a doctor or provider although insureds are free to visit any licensed medical provider for a covered injury or illness. What do I do if I require treatment and I don t have my insurance ID card? Even though you may not have your ID card, you can still seek treatment. Please remember that for nonemergency medical claims, the standard procedure is to visit the doctor, pay for the visit and any necessary medications, and then submit a claim for reimbursement. Is pre-certification required for medical procedures? Pre-certification is not required for general office visits to a medical doctor. Simply visit a doctor, pay the required fee, and submit a claim for reimbursement. Pre-certification is required for the following procedures: Inpatient care Any surgery or surgical procedure Care in an extended care facility Home nursing care Durable medical equipment and artificial limbs CAT scans and MRI To comply with precertification requirements, you must contact APRIL Assistance at the number listed above before the expense is to be incurred and comply with all instructions provided by APRIL Assistance. Is a direct payment to a medical provider option available? The typical procedure when visiting a doctor for an office visit is to simply visit the doctor, pay the required fee, and then submit a claim for reimbursement. If you would like to request a direct payment option, you may contact APRIL Assistance to see if this can be arranged. Please understand this cannot be arranged for all office visits. For pre-scheduled surgeries and procedures, direct payment will most often be arranged during the pre-certification process. 3

4 What is covered under my travel insurance policy? Travel insurance is designed to cover the cost of medical expenses resulting from unexpected or unforeseen accidents and illnesses. Where am I covered under my travel insurance policy? Is travel outside of China covered? This policy also covers incidental leisure travel outside of China for up to 14 days to the following countries: Japan, South Korea, Mongolia, Philippines, Vietnam, Thailand, Laos, Myanmar, Hong Kong, Macao, Taiwan, Malaysia, Singapore, Indonesia, India, Nepal, and Russia (East of the Urals). What is not covered under my policy? It is important to read your policy carefully to understand the exclusions. The following is a list of some items that are excluded from coverage. For a full list of exclusions, please refer to your insurance policy. Pre-existing Conditions Routine medical or dental examinations Treatment for mental health Eyeglasses, contact lenses, hearing aids, hearing implants, eye refraction, visual therapy Mountaineering where ropes or guides are normally used or at elevations of 4,500 meters or higher Treatment by a chiropractor Hang gliding, sky diving, parachuting or bungee jumping Self-inflicted injuries Where can I find a claim form? Claim forms can be found online at: What information do I need to provide when filing a claim? You must mail or the following items to your Claim Administrator: Completed claim form including your name, address, identification number, and name of your affiliated organization. All itemized medical and hospital bills including procedures and/or diagnosis codes. Copies of receipts if the bill has been paid and you are to be reimbursed. Be sure to keep a copy of all claims documents for your own records. How do I file a claim? APRIL Assistance should be notified within 30 days after the occurrence or commencement of any accident or illness, or as soon thereafter as is reasonably possible. Return the completed claim form and all supporting documentation (itemized medical and hospital bills and any copies of receipts) to: Asia Assistance Partners (Thailand) Co., Ltd. APRIL Assistance [Thailand] Co., Ltd. Maneeya Center North, 10th Floor, 518/3 Ploenchit Road, Lumpini, Pathumwan, Bangkok Thailand Tel: +66 (0) Fax: +66 (0) ops@april.in.th 4

5 How can I check the status of a claim? Pending or processed claims information can be obtained by contacting APRIL Assistance s claims customer service. 5