Member Handbook. Basic Membership. Membership and how to properly access them. Membership Rules / Regulations

Similar documents
SHORT-TERM MEMBERSHIP PROGRAM RULES AND REGULATIONS

REGULAR MEMBERSHIP PROGRAM RULES AND REGULATIONS

GLOBAL EMERGENCY SERVICES

DIAMOND MEMBERSHIP PROGRAM RULES AND REGULATIONS

24/7 support for travel services and emergencies

Information about International SOS

250 million beneficiaries

Virginia / North Carolina Tour: January 15-18, 2007 Jackson Preparatory School

FAQS FOR UNIVERSITY OF SOUTH FLORIDA BUSINESS TRAVELERS

Application Guidelines for KAKEHASHI Project

Summer 2018 IP Summer Contract

Welcome. Kit a 3/12

AMBULANCE SERVICES. Guideline Number: CS003.F Effective Date: January 1, 2018

2013 Morehouse College Summer China Study Abroad Program Participation terms and conditions, release, and waiver May 13, 2013 June 3, 2013

Superintendent s Regulation 4400-R Exhibit 1

FACILITIES USE POLICY

University of Georgia Emergency Response Protocol for International Education Programs

Parent Contract and Terms and Conditions

About OSHC Worldcare. Who is eligible for OSHC? What is OSHC? How long do I have to be covered? Why do international students need OSHC?

OFF-CAMPUS ACTIVITIES

Offering more than risk and retirement solutions, because we care VALUE-ADDED SERVICES

Fiscal Compliance Training Series: Charging Salaries Travel Expenses

BROOKLYN TECHNICAL HIGH SCHOOL

BON SECOURS RICHMOND NOTICE OF PRIVACY PRACTICES

SHORT-TERM MISSION TRIP APPLICATION. Please return completed applications to the church office: 6400 Sweetbay Drive, Crestwood KY 40014

MEDICAID CERTIFICATE OF COVERAGE

Wayne State College Athletic Department Financial Procedures Handbook

Partners In Ministry, Inc.

WAKE FOREST BAPTIST HEALTH NOTICE OF PRIVACY PRACTICES

Department of Surgery Resident Travel Policy

Wherever you need to be

. PROCEDURAL PROVISIONS

University of Louisiana System

paid for by them that are reasonable and directly related to the individual s service on behalf of the City

Langston University Returning Athlete Screening Form

GUIDELINES for Thailand International Postgraduate Programme (TIPP)

AN INTRODUCTION TO FINANCIAL MANAGEMENT FOR GRANT RECIPIENTS. National Historical Publications and Records Commission

Short Term Missionary Application

If you have any questions concerning the application process, do not hesitate to contact us soon.

THE COUNSELING PLACE ADULT INTAKE FORM Yearly Family Income:

Person to Contact in Case of Emergency. THE COUNSELING PLACE YOUTH INTAKE FORM Yearly Family Income:

NOTICE OF PRIVACY PRACTICES UNIVERSITY OF CALIFORNIA RIVERSIDE CAMPUS HEALTH CENTER

Notice of Health Information Privacy Practices Acknowledgement

Study Abroad Student Participation Agreement

Policy Title: Administration of Medication by School Personnel Policy No:

Patient s Bill of Rights (Revised April 2012)

Registration Form. School Name: Start Date: Grade:

COLORADO INDIGENT CARE PROGRAM

Personal Accident Claim - Doctor s Statement

PATIENT RIGHTS TO ACCESS PERSONAL MEDICAL RECORDS California Health & Safety Code Section

Attending Physician Statement Short Term Disability

12057 Jefferson Blvd LA, CA (323)

community. Welcome to the Pennsylvania UnitedHealthcare Community Plan for Kids CHIP Member Handbook CSPA15MC _001

Center for Teaching and Learning Professional Development Funding Request Packet 2015

The Act of 2 July 1999 No. 63 relating to Patients Rights (the Patients Rights Act)

JCC of Central New Jersey POLAND AND ISRAEL A Journey From Dark to Light April 22- May 2, 2017

Relocation Guide. Intern INDIA

GUEST TERMS OF AGREEMENT

The Prague Program. Department of Business. Dr. Sean Melvin Hoover Phone:

Immersions & Overseas/Interstate Tours Policy

THE RULES OF THE UNION JACK CLUB (Adopted on 10 th May 2011 and revised 08 th May 2018)

NOTICE OF PRIVACY PRACTICES

Joseph Bikowski, M.D., Associates

Chapter 3. Covered Services

Practice Limited to Infants, Children, & Adolescents

YMCA PRIMETIME PARENT/GUARDIAN:

Scope of Regulation Excerpt from Business and Professions Code Division 2, Chapter 6, Article 2

Non-Emergency Medical Transportation

PATIENT INFORMATION Please Print

Nicaragua Mission Trip: April 15-24, 2016

SPOUSE/GUARDIAN (If patient is married, give spouse information. If patient is a child, give parent information.)

SWEET HOME SCHOOL DISTRICT FAMILY AND MEDICAL LEAVE HANDBOOK

Aetna Fixed Indemnity Plan Helps pay for the costs of everyday medical expenses

Welcome Plan. Basic health insurance for temporary, new and returning Canadian residents

Scope of Service Transportation (Specialized Transportation)

Nebraska pays for telepsychiatry + a separate transmission fee ($.08/minute).

WELCOME TO THE MEDICAL ASSISTANCE TRANSPORTATION PROGRAM! (MATP)

Early and Periodic Screening, Diagnosis, and Treatment Program EPSDT Florida - Sunshine Health Annual Training

9 Calculating the fee for persons covered by statutory health insurance and those entitled to medical care 8

Your leave will be counted against your 12 weeks per calendar year FMLA leave entitlement.

Non-Emergency Medical Transportation

NOTICE OF PRIVACY PRACTICES

INNOSPEC INC GIFTS, HOSPITALITY, CHARITABLE CONTRIBUTIONS AND SPONSORSHIPS POLICY

First Name: Last Name: address: Cell Phone: Birth Date (MM/DD/YY): / / 991. Year: Major(s): Emergency Contact: Relationship: Phone 1: Phone 2:

RESIDENT PHYSICIAN AGREEMENT THIS RESIDENT PHYSICIAN AGREEMENT (the Agreement ) is made by and between Wheaton Franciscan Inc., a Wisconsin nonprofit

SUMMER CAMP OCOEE RETREAT CENTER JULY 20-23, 2016

2018 CAMP Registration Packet. Boyertown YMCA PHILADELPHIA FREEDOM VALLEY YMCA

Nursing Act 8 of 2004 section 59

Purpose 3. Scope 3. Responsibilities 4. Annual Leave 4. Commissioner Leave 5. Sick Leave 5. Bereavement/tangihanga Leave 6

Great Grocery Giveaway B-I-G-Y-2-5 Dice Roll Challenge OFFICIAL RULES

ASSISTING STUDENTS WITH MEDICATIONS

Happy Nursery Day Terms & Conditions

NURSING HOMES OPERATION REGULATION

Orthopedic Specialty Clinic, Ltd. Updated 05/2014

ALL HANDS ON EVEREST, ISLAND PEAK REGISTRATION

The Upgrade Your Date Contest on 92Q.com

Rio Norte Junior High School Music Department Rio Norte Drive, Valencia, CA PH X 1505

Regional User Transportation Policy in the Nunavik Region

Club Tours and Event Policy

MOTHER BEAR CHARITABLE FOUNDATION, INC. CHARITABLE GRANT AGREEMENT. This Charitable Grant Agreement (this or the Agreement ) is entered into as of the

Transcription:

Member Handbook Basic Membership This Handbook helps Members fully understand the benefits and limitations of the On Call Membership and how to properly access them. Membership Rules / Regulations Eligibility and Participation The On Call Basic Membership is available to residents of the United States and Canada up to and including age 76. Individuals age 77 through age 85 must be enrolled in the On Call Mature Plan. Membership must be activated and fee paid prior to or on the day of departure from member s home address as listed on the membership enrollment form. Membership fees are non-refundable unless membership is cancelled prior to departure. An Individual Membership is defined as any individual who has enrolled in and paid for this Program and includes the primary member only. A Family Membership shall include the primary member and his or her spouse, domestic partner of the same or opposite sex and up to eight (8) unmarried dependent children (includes step, foster or legally adopted children) who is over 30 days and under 19 years of age, or up to and including 26 years of age if they are attending an accredited institution of higher learning on a regular full-time basis and/or wholly dependent upon the Member for maintenance and support. Membership cards will be sent to the primary member, their spouse or domestic partner and dependent children over the age of 16 as listed on the member s enrollment form. Additional membership cards are available for a fee upon request.

Membership Benefits Medical Assistance Pre-Trip Planning Upon request On Call will provide up-to-date global destination information regarding required vaccinations, health risks, travel restrictions and weather conditions either by email, fax or telephone. Medical Monitoring If a member is hospitalized, On Call s medical team will monitor the Member s condition to ensure appropriate care and will provide regular updates to the member s authorized family members or emergency contacts. If necessary, On Call may retain the services of consulting physicians/nurses and/or other medical professionals with relevant areas of expertise to assist in the monitoring of the Member s condition. 24 Hour Nurse Help Line On Call will provide members with clinical assessment, education and general health information by Registered Nurse Counselors who will assist in identifying the appropriate level and source(s) of care for Members (based on symptoms reported and/or health care questions asked by or on behalf of members). Nurses cannot however diagnose member s ailments. Medical, Dental and Pharmacy Referrals At the Member s request On Call will provide referrals to medical and dental professionals and pharmacies in the given geographic area, that provide western style medical facilities, English speaking doctors, dentists and other health professionals to the extent possible. Deposits, Advances and Guarantees Deposits, advances and guarantees will be provided for, but not limited to, medical facilities, hotels, airlines, ground and air ambulances and other like providers to secure service for members. Any advance of funds on behalf of the member shall be charged to the member s credit card at the time of service. Prescription Replacement Assistance Should Member s prescription medication become lost or damaged, On Call will assist the Member in obtaining a replacement locally. On Call will assist with dispatching prescription medication to the member, when medication is not available locally, where legally permissible with written authorization of the member s primary physician. Members are responsible for the expense of such services including but not limited to, the cost of the pharmaceuticals,

shipping costs, taxes or other import/export duties. These expenses will be billed to the member s credit card prior to shipping. Dispatch of Physician or Nurse When a member is away from home, On Call may, at it sole discretion, dispatch to the member s location a physician or other healthcare professional to assist in determining the medical condition and suitability to travel to a member who has been hospitalized. Members are responsible for the expense of such services including but not limited to, the cost of the medical professional s fees and transportation. These expenses will be billed to the member s credit card. Medical Transport & Related Benefits Unlimited Emergency Medical Transportation via Private Air Ambulance Coordinated if a member is hospitalized due to sudden illness or injury while traveling 50 miles or more from their primary residence as listed on the member s enrollment form, AND a. The remaining hospital stay can be continued at a hospital of the member s choice closer to the primary residence b. The member is unable to return by commercial airline with or without a medical escort On Call will make arrangements and pay for air medical transfer of the patient via private air ambulance to the member s hospital of choice closest to their home. If a member s condition is critical or life threatening, and the facility they are in cannot provide appropriate care, On Call will provide initial medical transfer to the closest appropriate hospital of the member s choice that is capable of providing appropriate and immediate emergent medical care. After stabilization On Call will arrange and pay for continued transfer to the member s home hospital or place of residence as listed on the member s enrollment form. If the member wishes to be evacuated to a hospital outside the home area, On Call will transport the member as long as the transfer does not exceed the cost to evacuate to the home area by 50%. Medically Supervised Evacuation via Commercial Airline If a member is hospitalized due to sudden illness or injury while traveling 50 miles or more from their primary residence as listed on the member s enrollment form, AND a. The remaining hospital stay can be continued at a hospital of the member s choice closer to the primary residence b. The member is able to return by commercial airline with a medical escort On Call will make arrangements and pay for air medical transfer of the patient via commercial airline with a medical escort. On Call will make the determination of the type and number of escorts needed.

Unsupervised Evacuation via Commercial Airline If a member must return home for further treatment after being hospitalized as a result of an accident or sudden illness occurring while away from his/her permanent residence and the Member is able to travel home without a medical escort, On Call will make arrangements and pay to transfer the member via commercial air to the facility of their choice near their permanent residence, or to their permanent residence for continuing care. Family Reunion Benefit If a member is alone and hospitalized while traveling 50 miles or more from home, and his/her medical condition leaves them incapable of a medical transport even in an air ambulance, or the member desires to remain in the hospital where they are, and the hospital stay is anticipated to be seven (7) days or more, at the member s request, On Call will make and pay for economy travel arrangements up to $2,500 for a family member or companion to join the member. On Call shall also make suitable hotel arrangements and pay for hotel and meals up to the limit of the benefit. Return of Dependent Children If a member is hospitalized while traveling 50 miles or more from home, and his/her medical condition leaves them incapable of a medical transport even in an air ambulance, or the member desires to remain in the hospital where they are, and the hospital stay in anticipated to be seven (7) days or more, at the member s request, On Call will return the member s minor children who are under 18 years of age and accompanying member on the trip, to their home, with an attendant if necessary, up to $2,500. Return / Repatriation of Deceased Remains In the event of a member s death while 50 miles or more from home, On Call will render every assistance possible to obtain necessary clearances and make arrangements for the return of deceased remains and pay such reasonable expenses, up to $15,000, associated with the return. Travel Assistance Concierge Services At the member s request, On Call shall assist member once a trip has started with changing airline, hotel or car rental reservations.

Translation & Interpreters On Call will provide foreign language assistance over the telephone, or up to one-page translations submitted via fax or email. On Call will also provide referrals to local translators and interpreters. Fees may apply for these types of translators and are the responsibility of the member. Emergency Cash Advance Assistance On Call shall provide assistance to members by arranging for the forwarding of funds from member s credit cards or family members. Any fees associated with the transfer of funds will be the responsibility of the member. Replacement of Lost Traveling Documents Assistance On Call shall provide assistance to members by arranging for the replacement of passports, airline documents, birth certificates and other travel-related documents. Any fees required for the acquisition or forwarding of these documents is the responsibility of the member. Emergency Message Forwarding Assistance In the event a member is unable to reach an employer, family member or traveling companion, On Call shall forward a message via telephone, fax or email to the intended party. Lost Luggage Assistance On Call shall assist the member with the tracking of luggage lost or delayed in transit. Legal Consultation & Referral If a member is away from home and is arrested, or requires the services of an attorney, On Call shall arrange for an initial telephone consultation with an experienced international attorney without charge to the member. If needed, a member will be referred to an attorney in the appropriate geographical area. Fees and costs charged by the referred attorney shall be the responsibility of the member. Membership Limitations/Exclusions In order to receive any type of Medical Transport Benefits, members must be hospitalized as an inpatient. If a member is medically discharged from the hospital or leaves against medical advice and physically able to travel under his/her own power, without the assistance of either a medical or non-medical escort, member will no longer be eligible for medical transfer benefits. All arrangements for medical evacuation and repatriation must be made by On Call at the time of the incident. On Call is a membership program, not an insurance plan, therefore any

expenses incurred by a member related to any benefits mentioned in this program will not be reimbursed to members. On Call maintains the right to determine the urgency of the case, the most appropriate type of aircraft used, the timing and routing of such flights after consultation with the local attending physician. Exclusions Any services other than those indicated and described within this document will not be provided. Other exclusions include: Any service rendered without the authorization and/or intervention of On Call. Intentionally self-inflicted injuries, suicide, or any attempted threat (in Missouri, suicide or any attempted threat while sane) except when hospitalized as an inpatient. Participation in a declared or undeclared act of war, civil disturbance, or insurrection, or an accident occurring while the member is serving on full-time or active duty in the Armed Forces of any country. If the sole purpose of the member s trip is to obtain medical treatment. Participation in an international authority flight in aircraft being used for experimental purpose, or in military aircraft (except the Military Aircraft Command of the United States or similar air transport Services Account of other), or while serving as a member of the crew of any aircraft. Routine or non-disabling medical problems such as simple fractures, or sickness, which can be treated by local doctors and do not prevent the member from continuing his/her trip or returning home. Any treatment or expense related to childbirth, miscarriage or pregnancy except for any abnormal pregnancy or vital complication of pregnancy which endangers the life of the mother and/or unborn child during the first twenty-four (24) weeks of pregnancy. Medical evacuation benefits will not be provided to members hospitalized as a direct result of the use or abuse of non-prescription, illegal drugs or alcohol. Adverse reactions to prescribed drugs either requiring hospitalization or while hospitalized do not apply to this exclusion, and medical evacuation benefits will apply in such cases.

Transportation for an organ transplant when a member was on an organ transplant list prior to enrollment. While traveling within 50 miles of an eligible member s primary place of residence. Limitations All legal actions arising under this Agreement shall be barred unless written notice thereof is received by On Call within one year from the date of event giving rise to such legal action. On Call cannot be held responsible for failure to provide services or for delays caused by strikes or conditions beyond its control, including but not limited to, flight conditions, or where rendering of service is prohibited by local laws or regulatory agencies. Member may be required to release On Call or any health care provider from liability during emergency evacuation and/or repatriation. Without limiting the foregoing, On Call s actions and obligations under this Agreement are ministerial in nature, and all medical care is provided by medical professional ultimately selected by a Member and in no event is the responsibility of On Call. On Call cannot provide or control the provision of medical services to the member in another country. Decisions regarding medical services provided is the sole responsibility of the member, their medical practitioner or designated representative. On Call cannot guarantee the quality of medical services performed by others outside the control or direction of On Call. On Call is not liable for any malpractice performed by a local doctor, health care provider or attorney. A member traveling or living outside the U.S. for an uninterrupted period in excess of 90 days is not eligible for membership benefits unless enrolled in an Extended Stay membership. This limitation applies to international travel only; domestic travel is not limited to 90 days maximum per trip. Medical transports, whether emergency initial evacuation or subsequent medical transport are limited to two (2) separate transports per membership per year, except for transports involving multiple family members requiring simultaneous air medical transport. Under such circumstances, each family member will receive one transfer. Medical transports to hospital of patient s choice must be to home area hospital. If member requests transport to hospital outside home area and the cost does not exceed home

destination costs by 50% arrangements will be made. Patient acknowledges that benefits ends once member is transported to their hospital of choice. On Call will assist members on a fee for service basis for interventions falling under the Limitations and Uncovered Services. On Call reserves the right at its sole discretion, to request additional financial guarantees or pre-payment or indemnification from the member prior to rendering such service on a fee for service basis. On Call reserves the right to recover expenses paid on behalf of the member where the member is entitled to receive reimbursement for such expenses under any group insurance program maintained by the member s insurance company or employer. Related to the Family Reunion Benefit, On Call shall pay up to $2,500 for one (1) economy fare, round-trip airline ticket and accommodations and meals up to $150 per day subject to a maximum of five (5) days for a family member to join a hospitalized member. How To Contact On Call On Call members are able to call for assistance while traveling 24 hours a day, 365 days a year whether traveling within the United States or internationally by calling the numbers shown below. Toll Free (USA & Canada) 800-575-5014 Call Collect (International) 603-328-1926 Fax: 603-898-9172 Email: mail@oncallinternational.com On Call Corporate Office and Global Assistance Center is located at: 11 Manor Parkway Salem, New Hampshire 03079 For more detailed information, please visit our website at www.oncallinternational.com