Plan Administrator: Venbrook Insurance Services | Underwriter: Crum & Forster SPC | AM Best Rating: A (Excellent)
Complete details are given in certificate of insurance.
|
COVERED TREATMENT OR SERVICE |
MAXIMUM BENEFIT |
|
HOSPITAL ROOM AND BOARD EXPENSES |
The average semi-private room rate |
|
PHYSICIAN’S NON-SURGICAL VISITS |
To the selected Policy Maximum |
|
OUTPATIENT MEDICAL EXPENSES |
To the selected Policy Maximum |
|
PHYSICIANS VISITS |
To the selected Policy Maximum |
|
PRESCRIPTION DRUGS |
To the selected Policy Maximum or $250,000, whichever is lower. Subject to a 60 day maximum supply per prescription. |
|
AMBULANCE SERVICE BENEFITS |
To the selected Policy Maximum |
An extension notice will be sent to the Covered Person before the Policy Period ends and includes links to extend prior to the Termination Date. The Covered Person is subject to the following rules at extension: In order to extend, the Policy Period must be initially purchased for a minimum of 5 days. If available, an extension period can be purchased; 1.at the premium rate in force at the time of the extension; 2. for a minimum of 5 days; 3. for up to a maximum of 364 days, provided the Covered Person’s Policy Period does not exceed 364 days in total. There are no grace periods for extension. Once the Policy has lapsed, reapplication is required. Please note, upon application for a new Policy, the Pre-Existing Condition exclusion, deductible and co-insurance start over.
|
COVERED TREATMENT OR SERVICE |
MAXIMUM BENEFIT |
| ACUTE ONSET OF PRE- EXISTING CONDITIONS |
For ages up to and including 69 the limit is up to the selected Policy Maximum purchased per Policy Period; subject to: 1) any sub-limit or restriction as outlined here in the Policy; 2) a maximum of $25,000 for any Cardiovascular Event for ages 65 to 69. Upon attaining age 70 Acute Onset of Pre-existing Condition benefits are not available. |
| EMERGENCY MEDICAL EVACUATION* | Limit of $25,000 Maximum per Policy Period for any condition covered under Acute Onset of a Pre-existing Condition Benefit |
Full cancellation and refund will only be considered if We receive written request prior to or on the Effective Date of the coverage. If We receive a written request for cancellation and refund after the Effective Date of coverage, a partial cancellation and refund may be allowed. The following conditions apply: a) If any claims have been filed with Us, the premium is fully earned and is non-refundable; b) If no claims have been filed with the Company, then (i) a cancellation fee of US $25 will be charged; and (ii) only unused days premiums will be considered as refundable; and c) If after a refund is made, it is determined that a claim was presented to Us on a Covered Person’s behalf, the Covered Person will be fully responsible for that claim in its entirety.
A claimant must give Us or Our authorized representative written (or authorized electronic or telephonic) notice of claim within 90 days after any loss covered by the Policy occurs. If the claimant or Covered Person is incapacitated within the 90 days after the loss, must be given as soon as reasonably possible. This notice should identify the Covered Person and the Policy Number. All claims must be submitted within 90 days from date of incident, or they will be denied. Circumstances may exist in which this is not always possible. Any submissions after 90 days will be considered based on those circumstances.