Plan Administrator: International Medical Group | AM Best Rating: A "Excellent" | Underwriter: Sirius International
Complete details are given in certificate of insurance.
Complete details are given in certificate of insurance.
SUDDEN AND UNEXPECTED RECURRENCE
For those up to age 65 with a primary health plan, Outreach International will pay the Usual, Reasonable and Customary charges of a sudden and unexpected recurrence of a Pre-existing Condition up to the plan maximum. For those without a primary health plan, Outreach International will pay up to a $20,000 lifetime maximum. For those age 65 and older, with or without a primary health plan, Outreach International will pay up to a $2,500 lifetime maximum. The primary health plan must have existed prior to the effective date and during coverage of the Outreach plan, and the Pre-existing Condition must be covered under the primary health plan.
(Acute Onset of Pre-existing Condition means a sudden and unexpected outbreak or recurrence of a pre-existing condition(s) which occurs spontaneously and without advance warning either in the form of physician recommendations or symptoms, is of short duration, is rapidly progressive, and requires urgent care.)
You may seek treatment with the hospital or the doctor of your choice. Preferred Provider Organization (PPO) contracted by IMG, a separately organized network of approximately 475,000 physicians and 4,500 privately owned and operated hospitals.
If your Outreach plan is purchased for a minimum of one month, coverage may be renewed (unless there is a break in coverage) for a total of up to two years. Renewals are available in whole month or daily increments and may be completed online or by using a paper application, however, renewals of less than one month are available only online. For each renewal of less than one month completed online, you will be charged an additional $5 processing fee. Each insured person must only satisfy one deductible and coinsurance within each 12 month coverage period. Please note: Renewal rates may differ from initial rates.
You will be required to pay a $50 cancellation fee and Only full month premiums will be considered for refunds (e.g., if you choose to cancel your coverage two months and two weeks prior to the date your coverage ends, IMG will only consider the two full months for a refund). If you have filed claims, your premium is non-refundable.
Each proposed hospital admission, in-patient or out-patient surgery, and other procedures as noted in the Certificate of Insurance must be Precertified for medical necessity, which means the insured person or their attending physician must communicate with an IMG representative at the number listed on the IMG identification card prior to admission to a hospital or performance of a surgery. In case of an emergency admission, the Precertification call must be made within 48 hours of the admission, or as soon as reasonably possible. If a hospital admission or a surgery is not Precertified, eligible claims and expenses will be reduced by 50%. It is important to note that Precertification is only a determination of medical necessity, not an assurance of coverage, verification of benefits or a guarantee of payment. All medical expenses eligible for reimbursement must be medically necessary and will be paid or reimbursed at usual, reasonable, and customary rates.