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Results from search: http://travel.state.gov/medical.html
Medical Information for Americans Abroad
Medical Information for Americans Traveling Abroad
U.S. Department of State
Bureau of Consular Affairs
If an American citizen becomes seriously ill or injured abroad, a U. S. consular officer can assist in
locating appropriate medical services and informing family or friends. If necessary, a consular
officer can also assist in the transfer of funds from the United States. However, payment of
hospital and other expenses is the responsibility of the traveler.
Before going abroad, learn what medical services your health insurance will cover overseas. If
your health insurance policy provides coverage outside the United States, REMEMBER to carry
both your insurance policy identity card as proof of such insurance and a claim form. Although
many health insurance companies will pay "customary and reasonable" hospital costs abroad, very
few will pay for your medical evacuation back to the United States. Medical evacuation can
easily cost $10,000 and up, depending on your location and medical condition.
THE SOCIAL SECURITY MEDICARE PROGRAM DOES NOT PROVIDE COVERAGE
FOR HOSPITAL OR MEDICAL COSTS OUTSIDE THE U.S.A.
Senior citizens may wish to contact the American Association of Retired Persons for information
about foreign medical care coverage with Medicare supplement plans.
To facilitate identification in case of an accident, complete the information page on the inside of
your passport providing the name, address and telephone number of someone to be contacted in
an emergency.
A traveler going abroad with any preexisting medical problems should carry a letter from the
attending physician, describing the medical condition and any prescription medications, including
the generic name of prescribed drugs. Any medications being carried overseas should be left in
their original containers and be clearly labeled. Travelers should check with the foreign embassy
of the country they are visiting to make sure any required medications are not considered to be
illegal narcotics.
A listing of addresses and telephone numbers of U.S. embassies and consulates
abroad is contained in Key Officers of Foreign Service Posts .
This publication may be obtained through the Superintendent of Documents, U.S.
Government Printing Office, Washington, DC 20402. Also available from the Government
Printing Office is Health
Information for International Travel by the Centers for Disease Control
and Prevention (CDC). This contains a global rundown of disease and immunization
advice and other health guidance, including risks in particular countries. For
additional health information, the CDC maintains the international travelers
hotline at 1-877-FYI-TRIP (1-877-394-8747), an automated faxback service at
1-888-CDC-FAXX (1-888-232-3299) and a home page on the Internet at http://www.cdc.gov .
For detailed information on physicians abroad, the authoritative reference is The Official ABMS Directory of
Board Certified Medical Specialists published for the American Board of Medical Specialists and its certifying
member boards. This publication should be available in your local library. U.S. embassies and
consulates abroad maintain lists of hospitals and physicians. Major credit card companies also can
provide the names of local doctors and hospitals abroad.
Some countries require foreign visitors to have inoculations or medical tests before entering.
Before traveling, check the latest entry requirements with the foreign embassy of the country to
be visited.
Several private organizations will provide medical information and insurance for overseas
travelers. Most charge a fee for this service. The following is provided FOR
INFORMATIONAL PURPOSES ONLY and in no way constitutes an endorsement, expressed
or implied, by the Department of State.
AIR AMBULANCE / MED-EVAC
U.S.-based Companies
ACADIAN AMBULANCE & AIR MED SERVICE, INC.
Lafayette, LA
800-259-3333
ADVANCED AIR AMBULANCE
Miami, FL
800-633-3590 / 305-232-7700
AAA - AIR AMBULANCE AMERICA
Austin, TX
800-222-3564 / 512-479-8000
AIR AMBULANCE CARE FLIGHT INTERNATIONAL,
INC.
Clearwater, FL
800-282-6878 / 1-727-530-7972 (international)
AIR AMBULANCE NETWORK
Sarasota, FL
800-327-1966
AIR AMBULANCE PROFESSIONALS
Fort Lauderdale, FL
800-752-4195 / 954-491-0555
AirEvac
Phoenix, AZ
800-421-6111
AIR MEDIC - AIR AMBULANCE OF AMERICA
Washington, PA
800-245-9987
AIRescue INTERNATIONAL
Van Nuys, CA
800-922-4911 / 818-994-0911
AIR RESPONSE
Orlando, FL
800-631-6565 / 303-858-9967
AIR STAR INTERNATIONAL
Thermal, CA
877-570-0911 / 800-991-2869
e-mail: AirStar1@aol.com
AMERICAN CARE, INC.
San Diego, CA
800-941-2582 / 619-486-8844
AMERICAN JET AIR MEDICAL
Houston, TX
888-I-FLY-AJI / 713-641-9700
CRITICAL AIR MEDICINE
San Diego, CA
800-247-8326 / 619-571-0482
CRITICAL CARE MEDFLIGHT
Lawrenceville, GA
800-426-6557
GLOBAL CARE / MEDPASS
Alpharetta, GA
800-860-1111
INFLIGHT MEDICAL SERVICES INTERNATIONAL INC.
Naples, FL
800-432-4177 / 941-594-0800
INTERNATIONAL SOS ASSISTANCE
Philadelphia, PA
800-523-8930 / 215-244-1500
Also provides travel insurance services.
MED ESCORT INTERNATIONAL INC.
Allentown, PA
800-255-7182 / 610-791-3111
MEDEX ASSISTANCE CORPORATION
Timonium, MD
888-MEDEX-00 / 410-453-6300 (call collect)
(Also provides travel insurance services.)
MEDJET ASSISTANCE
Birmingham, AL
1-800-963-3538
MEDJET INTERNATIONAL, INC.
Birmingham, AL
800-356-2161 / 205-592-4460
MEDWAY AIR AMBULANCE
Lawrenceville, GA
800-233-0655
MERCY MEDICAL AIRLIFT
Manassas, VA
800-296-1217
(Service area: Caribbean and part of Canada only. If necessary, will
meet commercial incoming patients at JFK, Miami and other airports.)
NATIONAL AIR AMBULANCE
Ft. Lauderdale, FL
800-327-3710 / 305-525-5538
SMARTRAVEL
Alexandria, VA
800-730-3170 / 703-379-8645
Provides a range of travel medicine services.
TRAVEL CARE INTERNATIONAL, INC.
Eagle River, WI
800-524-7633 / 715-479-8881
TRAVELERS EMERGENCY NETWORK
Tierra Verde, FL
800-ASK-4-TEN
e-mail: ten@intrex.net
Foreign-based Companies
AEA INTERNATIONAL
Singapore
U.S. Phone: 800-468-5232
Service worldwide, also provides travel insurance services
AUSTRIAN AIR AMBULANCE
Vienna, Austria
43-1-40-144
EURO-FLITE LTD.
Helsinki International Airport
Vantaa, Finland
358-9-870-2544
EUROPASSISTANCE
Johannesburg, South Africa
27-11-315-3999
GERMAN AIR RESCUE (DRF)
Filderstadt, Germany
49-0711-7007-0
e-mail: alarmzentrale@drf.de
MEDIC'AIR
Paris, France
331-41-72-14-14
TYROL AIR AMBULANCE
Innsbruck, Austria
43-512-22422
TRAVEL INSURANCE COMPANIES
ACCESS AMERICA, INC.
Richmond, VA
866-807-3982
AIGAssist
American International Group, Inc.
New York, NY
800-382-6986
ASA, INC.
International Health Insurance
Phoenix, AZ
888-ASA-8288
AXA ASSISTANCE
Bethesda, MD
301-214-8200
CLEMENTS INTERNATIONAL
Washington, DC
800-872-0067 / 202-872-0060
http://www.clements.com
e-mail: info@clements.com
GATEWAY
Seabury & Smith
Washington, DC
800-282-4495 / 202-457-7707
e-mail: gateway.dc@seabury.com
HEALTH CARE GLOBAL
(also known as MEDHELP or WALLACH & COMPANY or HEALTHCARE ABROAD)
Middleburg, VA
800-237-6615 / 540-687-3166
HIGHWAY TO HEALTH
Fairfax, VA
703-322-1515
(Also provides destination-based travel health information for cities worldwide.)
INTERNATIONAL MEDICAL GROUP (IMG)
Indianapolis, IN
800-628-4664 / 317-655-4500
MultiNational Underwriters, Inc.
Indianapolis, IN
800-605-2282
e-mail: insurance@mnui.com
MUTUAL OF OMAHA
Tele-Trip Company
Omaha, NE
800-228-9792
PETERSEN INTERNATIONAL UNDERWRITERS, INC.
Valencia, CA
800-345-8816
e-mail: piu@piu.org
TRAVELEX
Omaha, NE
800-228-9792
TRAVEL GUARD
Stevens Point, WI
800-826-4919
TRAVEL INSURED INTERNATIONAL
E. Hartford, CT
800-243-3174
TRAVEL INSURANCE SERVICES
InterMedical Division
Walnut Creek, CA
800-937-1387/925-932-1387
TRIPGUARD PLUS
Northridge, CA
800-423-3632
UNICARD TRAVEL ASSOCIATION
Overland Park, KS
800-501-0352
UNIVERSAL SERVICE AND ASSISTANCE
Alexandria, VA
800-770-9111 / 703-370-7800
WORLDWIDE ASSISTANCE
Washington, DC
800-777-8710 ext. 417
EXECUTIVE MEDICAL SERVICES
AMERICAN MEDICAL CENTERS
Moscow, Russia
Offices in Moscow, St. Petersburg, Kiev, Prague, Warsaw, Istanbul
(7-095) 933-77-00 (Moscow)
HEALTH QUEST TRAVEL INC.
Wexford, PA
888-899-3633
e-mail: HQT@HealthQuestTravel.com
WORLD CLINIC
Burlington, MA
800-636-9186
Return to Travel Publications Page
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Medical Insurance Information for Senior Citizens
Medical Insurance Information for Senior Citizens
Here we will post information on medical insurance and help in processing health insurance claims.
If you would like to submit information regarding these subjects please e-mail us.
Seniors' Forum -- a place for senior citizens to air greivances regarding medical insurance.
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Information
Results from search: http://www.hlth.gov.bc.ca/msp/
Medical Services Plan Home Page
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Medical Services Plan of B.C.
The Medical Services Plan (MSP) insures medically required services provided by general practitioners, specialists and supplementary health care practitioners, laboratory services and diagnostic procedures.
Important Notice! MSP Reception Offices Closed March 28, 2002.
The MSP Burnaby and Victoria reception offices closed permanently on March 28, 2002. For information on other ways to correspond with MSP, see How to Contact MSP .
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Changes to MSP Telephone Service (effective March 4, 2002)
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Increase in MSP Premiums (effective May 1, 2002)
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Changes to Premium Assistance Program (effective May 1, 2002)
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Changes to Supplementary Benefits Program (effective May 1, 2002)
MSP for B.C. Residents
MSP Forms and Online Services To apply for MSP coverage, or to notify MSP of your change of address, or to obtain a new MSP CareCard.
Electronic Banking for Paying Premiums To find out about paying your MSP premiums by electronic banking (E-banking).
MSP for Group Plan Administrators
New Company Information To obtain information and a Third Party Registration form for establishing a group billing plan.
MSP Direct To register for online electronic business service for MSP group accounts.
MSP for Medical and Health Care Practitioners
Eye Exams (PDF 10Kb) Changes in criteria for insured eye examinations for beneficiaries between ages 19 - 64.
MSP Tutor A self-directed learning site for physicians and medical office assistants. Test your knowledge about billing claims to MSP!
Clinical Practice Guidelines and Protocols To view guidelines and protocols developed by the B.C. Guidelines and Protocols Advisory Committee.
Billing Procedures for Physicians Includes online MSC Payment Schedule, ICD9 codes and detailed information on billing claims for general practice and specialty services.
MSC Payment Schedule Includes detailed information on billing claims for general practice and specialty services.
Billing Procedures for Supplementary Benefit Practitioners Note: see changes effective January 1, 2002 .
Please note: All information in this site is subject to change in accordance with the provisions of the Medicare Protection Act and Regulations and the Hospital Insurance Act and Regulations. If a discrepancy exists between the information on this web site and the legislation, the legislation will prevail.
Last Revised: May 03, 2002
Results from search: http://www.iii.org/media/hottopics/
III - Hot Topics & Insurance Issues
HOT TOPICS & INSURANCE ISSUES
HOT TOPICS: Joint Industry Forum Leaders of the property and casualty insurance industry believe that profitability in both commercial and personal lines will improve in 2002 compared with last year, according to a survey conducted by the Insurance Information Institute (I.I.I.) at its sixth annual Property/Casualty Insurance Joint Industry Forum. 2002 Outlook for Auto and Homeowners Insurance Rates - The cost of auto and
homeowners insurance will rise for many consumers in 2002 following several
years of flat to decreasing prices. This outlook article discusses the major cost
drivers in auto and homeowners insurance today and offers customers
money-saving tips that can help them offset these costs. Mold - Concern about the health and property damage consequences of mold contamination has become the subject of much discussion. The implications of mold for the insurance industry are coming up as well. Credit Scoring - Insurers for many years have used factors such as a person's driving record, years of driving experience, and the age and construction of a home to make these decisions. Today some insurance companies supplement these factors with another factor found to be a highly accurate predictor of risk: insurance scores based on credit information.
Asbestos - Just when it seemed that the wave of asbestos claims was over, during the last few years, insurers have had to pay out increasing amounts on asbestos.
Auto Rates Rising-Video Play with RealPlayer Play with Windows MediaPlayer
INSURANCE ISSUES: Arson Asbestos Liability Auto Safety and Crashworthiness Auto Theft Captives and Other Risk-Financing Options Catastrophes: Insurance Issues Cell Phones and Driving Compulsory Auto Insurance Controlling Medical Care Costs in Property/Casualty Insurance Crop Insurance Drunk Driving Earthquakes: Risk and Insurance Issues Environmental Pollution: Insurance Issues Financial Services Financial and Market Conditions Generic Auto Crash Parts Insolvencies/ Guaranty Funds Insurance Fraud Liability System Medical Malpractice Mold and the Insurance Industry: Truth and Consequences No-Fault Auto Insurance No-Fault Auto Insurance Fraud in New York State: Problems & Solutions Older Drivers Optional Federal Charter Privacy: Impacts and Implications for the Insurance Industry Rate Regulation and Other Regulatory Issues Reinsurance Residual Markets Teen Drivers The Long Shadow of September 11: Terrorism & Its Impacts on Insurance and Reinsurance Markets Urban Insurance Issues Who Wants to be a Millionaire? No-Fault Auto Insurance Fraud in New York Workers Compensation
Results from search: http://www.bc.edu/bc_org/avp/enmgt/stserv/fin/medins.html
Boston College Medical Insurance Information
Boston College Financial Services
Student Medical Insurance Information 2002-2003
LOCATION: Student Services -> Financial Services Home -> Medical Insurance Information
This link will take you to Medical Insurance Waivers, Applications, Enrollment and Claim Forms.
Table of Contents
Boston College Student Accident and Sickness Insurance 2002-2003
Eligibility
Dates of Coverage
Withdrawals
Policy Term and Premium
Definition of Coverage
Accident and Sickness Coverage Description of Benefits
Part A--In-Patient Benefits
Part B--Surgical Benefits
Part C--Convalescent Facility Benefit
Part D--Out-Patient Accident and Sickness Benefits
Part E -- Miscellaneous Out-Patient Services
Part F--Mental Health, Alcoholism and Substance Abuse Services
Part G--Intercollegiate Sports Benefit
Part H-1--Preparation and Transportation of Remains
Part H-2--Medical Evacuation
Part I--Pre-Existing Accident and Sickness Benefit
Part J--Mandated Benefits
Part K--Wellness Program
Part L--Extension of Benefits
LI> Specialty Providers
Limitation and Reductions
Exclusions
Termination
Claim Procedure
Consumer's Right to Claim Review
Notice of Information Privacy Practices
Boston Mutual Insurance Company Authorization to obtain Information for Insurance Claims Purposes Form (PDF document)
Full-time students at Boston College or students enrolled at least 75%
of full-time, are required by state law to be covered under this plan,
unless the student submits the required Waiver Information. This information must provide proof of coverage by a comparable health insurance plan, and must be completed by the student or the policyholder if student is under age 18.
For insurance purposes graduate students registering at the credit levels listed below will be automatically charged and enrolled in the BC medical plan unless waiver information is submitted.
Arts and Sciences--7 or more
CAS--9 or more
Education--7 or more
Management--9 or more
Nursing--7 or more
Social Work--9 or more
Students who wish to waive the Boston College Insurance Plan electronically may do so by accessing the University Web Services Page .
Students may begin waiving the insurance for 2002-2003 on April 17, 2002.
Please Note: If the student is under the age of 18, the student may not use the automated system. A written waiver is required and must be signed by the parent or guardian. Click here if you need to download and print a copy of the waiver form.
If you wish to review the Boston College Student Insurance Plan, an outline of the policy is described below:
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Boston College Student Accident and Sickness Insurance 2002-2003
The following is an outline of the insurance which is provided under a
blanket policy issued to Boston College. The policy is underwritten by
Boston Mutual Life insurance Company of Canton, Massachusetts and is
administered by the Student Benefit Division of Walter W. Sussenguth and
Associates of Canton, Massachusetts. The following is a brief digest of
the coverage of the policy. It is not the policy. Only the actual
provisions of the policy which will be in the possession of the College
will apply.
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Eligibility
Full-time students at Boston College or students enrolled at least 75%
of full-time, are required by state law to be covered under this plan,
unless the student submits the required Waiver information.
Part-time students below 75% of full-time who submit a part-time
enrollment form must be in a degree granting program if they wish to
be enrolled in the student plan. Covered students may also enroll
their spouse and unmarried dependent children, under age 19, in this
plan. The Dependent and Part-Time Enrollment Forms can be obtained
at the Boston College Health Services Office (Cushing Hall 140), or
by calling Walter W. Sussenguth and Associates. The Dependent and
Part-Time Enrollment Forms must be completed and submitted to Walter
W. Sussenguth and Associates along with the amount indicated on the
form for the term of coverage selected.
Part-time student and dependent coverage begins on the later of the
following;
Beginning date of the semester policy term, or
The date payment is received.
Last date of enrollment is October 4, 2002 for fall semester and
February 7, 2003 for spring semester.
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Dates of Coverage
Your coverage under the policy will begin on August 15, 2002 and
terminates on January 14, 2003 for fall semester participants.
Coverage for the spring semester will begin on January 15, 2003 and
terminates on August 14, 2003.
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Withdrawals
If you withdraw from Boston College before semester classes begin,
you will receive a full cancellation of this insurance premium. If
you withdraw from Boston College after the first day of classes of the
semester, your coverage will remain in effect until the end of the
period for which you have paid a premium. In this instance you will not
receive a cancellation of the insurance premium.
All full-time student premium cancellations will be generated by the
Office of Student Services at Boston College.
Part-time student and dependent refunds will be generated by Walter W.
Sussenguth and Associates upon receipt of written request on a pro-rata
basis.
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Policy Term and Premium
1st Semester 2nd Semester
August 15, 2002
through
January 14, 2003 January 15, 2003
through
August 14, 2003
Student Only $240.00 $340.00
Spouse $561.00 $776.00
First Child $292.00 $407.00
Add'l Child $147.00 $204.00
Students will be billed the "Student Only" amount unless a Waiver
has been completed before the semester billing.
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Definition of Coverage
You are insured against loss resulting from hospital or medical
treatment due to:
Accidental bodily injury (except as provided in Part I)
if it is:
Sustained while your insurance is in effect; and a direct
result of an accident.
Sickness which first manifests itself (except as provided
in Part I) and causes loss that occurs:
After your effective date of coverage; and while your
insurance is in force.
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Accident and Sickness Coverage
Description of Benefits
If an accidental injury or sickness requires an insured person to
seek medical treatment, the Company will pay the following expenses
actually incurred by you during the term of the policy not to exceed
an aggregate payment of $100,000 for any one accident or any one
sickness except as provided herein under Part I.
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Part A--In-Patient Benefits
The following benefits are payable when the insured Person is confined as a resident patient in a licensed hospital:
Hospital Room and Board-
The Company will pay 80% of the reasonable and customary charges
for the use of semi-private or intensive care unit expense incurred.
Hospital Services-
The Company will pay 80% of the reasonable and customary charge for
expenses incurred for X-ray examination, laboratory tests, anesthetic,
use of operating room, medicines and other necessary hospital treatment, except personal services.
Physician's Benefit-
The company will pay 80% of the reasonable and customary charge for
expenses incurred for medical treatment (other than surgery) by a
physician while confined as a bed patient in a hospital.
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Part B--Surgical Benefits
Surgical Benefit (In-Patient or Out-Patient)-
The Company will pay 80% of the reasonable and customary charge
made by a physician for each surgical operation, but not to exceed
$5,000.
Assistant Surgeon Benefit-
The Company will pay the actual expense incurred up to 30% of the
payment made under the Surgical Benefit.
Anesthetist Benefit-
The Company will pay the actual expense incurred up to 30% of
the payment made under the Surgical Benefit.
Second Surgical Opinion Benefit (Consultation Only)-
The Company will pay up to $200 for a second written surgical
opinion as to the necessity of a surgical procedure.
Out-Patient Hospital Services For Surgical Day Care-
The Company will pay 80% of the reasonable and customary charges
to a maximum of $5000, for examination, laboratory tests, x-rays,
anesthesia, use of operating room, medicines, and any other
necessary hospital treatment (except personal services) while
being treated as an out-patient surgical patient.
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Part C--Convalescent Facility Benefit
The Company will pay up to $75 per day for up to ten (10) days
for confinement as an in-patient in a nursing home or rehabilitation facility per accident or sickness following a period
of hospitalization. Payment for confinement in the Boston College Infirmary will not require a prior period of hospitalization.
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Part D--Out-Patient Accident and Sickness Benefits
The following services will be covered up to a combined maximum
benefit of $1,500 for each accident or sickness.
Out-Patient Accident and Sickness Benefit-
Once you have paid the required deductible the Company will pay
80% of the reasonable and customary charge incurred up to $1,500
for the treatment of an accidental injury or sickness. Covered
charges also include required laboratory tests or x-rays for the
diagnosis or treatment of any one accident or any one sickness.
Physician's Office Visit-
If treated in a physician's office, the Insured Person is
responsible for paying a $10 deductible per visit.
Hospital Emergency Room-
If treated in the Emergency Room, the Insured Person is
responsible for paying a $50 deductible per visit.
If treated in a Hospital Out-Patient Department, the Insured
Person is responsible for paying a $35 deductible per visit.
High Cost Procedure Benefit--
In addition to the benefits described above (which include coverage
for procedures costing up to $200) specific outpatient procedures
costing over $200 but not limited to CT Scan, MRI, Laser, Radiation and
Chemotherapy are covered at 80% of the usual and customary charges
up to a maximum of $5000.
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Part E--Miscellaneous Out-Patient Services
Dental Benefit--
The Company will pay 80% of the reasonable and customary charge
up to a maximum of $300 per tooth for dental treatment as a
result of accidental injury to sound natural teeth.
The Company will pay 80% of the reasonable and customary charge
up to a maximum of $100 per tooth for the surgical removal of
an impacted wisdom tooth. No other benefits will be paid under
this plan for impacted teeth.
Physical Therapy--
The Company will pay 80% of the reasonable and customary charge
for physical therapy by a registered physical therapist, subject to a
maximum of $500, when prescribed by the attending physician.
Ambulance Benefit--
The Company will pay the actual expense incurred in excess of $25
up to $225 per injury or sickness for the use of an ambulance to
or from the hospital.
Prescription Drug Benefit--
After a $5.00 copayment for each Generic or $15.00 copayment for each Brand Name Prescription Drug, all covered medicines will be paid up to a maximum of $1000 per policy year at Brooks Pharmacies or Eaton Apothecary. Medications not covered by this benefit include, but are not limited to, contraceptives, smoking deterrents, drugs whose sole purpose is to promote or stimulate hair growth and appetite suppressants.
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Part F--Mental Disorders Benefits
Benefits shall be provided on the same basis as any other sickness for insured persons for the diagnosis and treatment of the following biologically-based mental disorders, as described in the most recent edition of the Diagnostic and Statistical Manual of the American Psychiatric Association, referred to in this benefit as the "DSM": schizophrenia; schizoaffective disorder; major depressive disorder; bipolar disorder; paranoia and other psychotic disorders; obsessive-compulsive disorder; panic disorder; delirium and dementia; affective disorders; and any biologically-based disorders appearing in the DSM that are scientifically recognized and approved by the Commissioner of the Department of Mental Health in consultation with the Commissioner of the Division of Insurance.
Rape Related --Benefits shall be provided on the same basis as any other sickness for insured persons for the diagnosis and treatment of rape-related mental or emotional disorders to victims of a rape or victims of an assault with an intent to rape, as defined by sections 22 and 24 of chapter 265, whenever the costs of such diagnosis and treatment exceed the maximum compensation awarded to such victims pursuant to paragraph (c) of paragraph (2) of subsection (b) of section 3 of chapter 258c.
Benefit shall be provided on the same basis as an other sickness for insured persons for medically necessary treatment for the diagnosis and treatment of all other mental disorder not otherwise provided for in this section and which are described in the most recent edition of DSM during each 12 month period on the following basis: up to 60 days of inpatient treatment; and up to 24 outpatient visits.
Such benefits shall include inpatient, intermediate, and outpatient services that are medically necessary and active and noncustodial treatment for such mental disorders to take place in the least restrictive clinically appropriate setting. For purposes of this benefit, inpatient services may be provided in a general hospital licensed to provide such services, in a facility under the direction and supervision of the Department of Mental Health, in a private mental hospital licensed by the Department of Mental Health, or in a substance abuse facility licensed by the Department of Public Health. Intermediate services shall include, but limited to, Level III community-based detoxification, acute residential treatment, partial hospitalization, day treatment and crisis stabilization licensed or approved by the Department of Public Health or the Department of Mental Health. Outpatient services may be provided in a licensed hospital, a mental health or substance abuse clinic licensed by the Department of Public Health, a public community mental health center, a professional office, or home-based services, provided, however, services delivered in such offices or settings are rendered by a licensed mental health professional acting within the scope of their license.
Benefits shall be provided on the same basis as any other sickness for insured persons for medically necessary psychopharmacological service and neuropsychological assesment services.
Licensed mental health professional-- means a physician who specializes in the practice of psychiatry, a licensed psychologist, a licensed independent clinical social worker, a licensed mental health counselor, or a licensed nurse mental health clinical specialist.
Claims-- when necessary for administration of claims under this benefit section, consent to the disclosure of information regarding services for mental disorders will be required on the same basis as disclosure of information for other sickness or injury.
Exclusions-- benefits will not be payable for mental health benefits or services: which are provided to a person who is incarcerated, confined or committed to a jail, house of correction or prison, or custodial facility in the department of youth services within the Commonwealth or one of the political subdivisions; which constitute educational services required to be provided by a school committee pursuant to section 5 of chapter 71B; or which constitute services provided by the Department of Mental Health.
Alcoholism --Benefits shall be provided on the same basis as any other sickness for insured persons for medically necessary treatment of alcoholism or chemical dependency when said treatment is rendered in conjunction with treatment for mental disorders.
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Part G--Intercollegiate Sports Benefit
If an Insured Person sustains an accidental injury while participating
in the play or practice of an intercollegiate sport sponsored by Boston
College, the Company will pay up to a maximum of $1,000 for medical
or surgical treatment or hospitalization, except that injury to sound
natural teeth is limited to $500 for any one accident. This plan also
provides up to $1,000 for Accidental Death and Dismemberment and Loss
of Sight Benefit as a result of injury sustained while participating in
the play or practice of an intercollegiate sport sponsored by Boston
College. All varsity athletic injuries must be reported immediately
to the Boston College Athletic Trainer.
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Part H-1--Preparation and Transportation of Remains
In the event of the death of an Insured Person, while insured under
the policy, the Insurance will pay necessary reasonable and customary
expenses for preparation and transportation of the remains to the
Insured Person's place of residence in his or her home country, but
such expenses shall not exceed the aggregate maximum of $7,500.
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Part H-2--Medical Evacuation
If an Insured Person is unable to continue their academic program due
to a covered injury or sickness, the insurance will pay necessary,
reasonable and customary expenses for evacuation to another medical
facility, or the Insured Participant's home country, but not to exceed
$10,000 in aggregate. a medical evacuation would be considered only
if medically necessary, and after a hospitalization of at least five (5)
days.
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Part I--Pre-Existing Accident and Sickness Benefit
Pre-existing Condition means any condition, which originates, is diagnosed, treated or recommended for treatment with six months immediately prior to the effective date under this policy.
If the Insured had prior comparable coverage in effect to a date not more than thirty days prior to the effective date under this policy, then the Pre-existing Condition will be covered under this policy on the same terms as any other illness or accident.
If the Insured had NO prior comparable coverage in effect to a date not more than thirty days prior to the effective date under this policy, then, coverage for a Pre-existing Condition for the first six months of this policy will be limited to a maximum of $2,500. After the expiration of six months the Pre-existing Condition will be covered under this policy as any other illness or accident.
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Part J--Mandated Benefits
The Company will pay in accordance with the benefits mandated by the Commonwealth of Massachusetts Insurance Law for such expense actually incurred during the policy period for such mandated benefit. Current mandated benefits are:
a. Women's Health Benefit Expenses-- Covered medical expenses include an annual Cytologic Screening (Pap Smear) for women age 18 and older and are payable on the same basis as any outpatient Benefits. The plan also includes one baseline mammogram for women between the ages of 35 and 40. For women age 40 and older the plan provides for an annual mammogram.
b. Initial Prosthetic Device and Reconstructive Surgery Benefit-- Benefits will be provided for the surgical procedure known as a mastectomy and the initial prosthetic device or reconstructive surgery incident to the mastectomy. Benefits shall be provided for the charges of reconstructive surgery on a nondiseased breast to produce a symmetrical appearance. Reconstructive surgery includes, but is not limited to, augmentation mammoplasty, reduction mammoplasty and mastopexy. When a mastectomy is performed and there is no evidence of malignancy, benefits will be limited to the cost of the prosthesis or reconstructive surgery to within 2 years after the date of the mastectomy.
c. Home Health Care-- Covered medical expenses include services provided by a public or private home health agency in the patient's residence. Such service include, but are not limited to nursing and physical therapy. Additional services such as occupational therapy, speech therapy, medical social work, nutritional consultation, the services of a home health aide and the use of durable medical equipment may be provided to the extent the services are determined to be medically necessary component of the nursing and physical therapy. The services must be medically necessary and provided in conjunction with a physician approved home health service plan.
d. Hospice Care Expenses-- Covered medical expenses include Hospice care for terminally ill individuals with a life expectancy of six months or less.
e. Cardiac Rehabilitation Expenses-- Cardiac rehabilitation is defined as multidisciplinary, medically necessary treatment of persons with documented cardiovascular disease, which shall be provided in either a hospital or other setting and which shall meet standards promulgated by the Commissioner of Health. Covered medical expenses include cardiac rehabilitation expenses for treatment rendered in connection with documented cardiovascular disease. Treatment includes, but is not limited to, outpatient treatment which is initiated within 26 weeks after diagnosis of cardiovascular disease.
f. Bone Marrow Transplant for Treatment of Breast Cancer-- Covered medical expenses includes coverage for bone marrow transplants for persons who have been diagnosed with breast cancer that has progressed to metastic disease, provided that such person meets the criteria established by the Department of Public Health.
g. Diabetes-Related Services and Supplies-- Covered expenses include items which are medically necessary for the diagnosis or treatment of insulin-dependent, insulin-using, gestational and non-insulin-dependent diabetes: blood glucose monitors; blood glucose monitoring strips for home use; voice synthesizers for blood glucose monitors for use by the legally blind; visual magnifying aids for use by the legally blind; urine glucose strips; ketone strips; lancets; insulin; insulin syringes; prescribed oral diabetes medication that influence blood sugar levels; laboratory tests including glycosylated hemoglobin, or HbAlc, tests; urinary protein/microalbumin and lipid profiles; insulin pumps and insulin pump supplies; insulin pens; therapeutic/molded shoes and inserts that have been certified by the treating doctor and prescribed by a podiatrist or other qualified doctor and furnished by a podiatrist, orthotist, prosthetist or pedorthist; supplies and equipment approved by the Federal Drug Administration for the purposes for which they have been prescribed and diabetes outpatient self-management training and education, including medical nutrition therapy.
h. Human Leukocyte Antigen-- Covered medical expenses include the cost of human leukocyte antigen testing or histocompatibility locus antigen testing that is necessary to establish bone marrow transplant donor suitability. The coverage covers the cost of testing for A, B or DR antigens, or any combination thereof, consistent with rules, regulations and criteria established by the Department of Public Health.
i. Infertility, Pregnancy-Related Benefits-- Covered medical expenses includes coverage for medically necessary expenses of diagnosis and treatment of infertility. Infertility means the condition of a presumably health individual who is unable to conceive or produce conception during a period of one year. Benefit will include, but are not limited to, the following Non-experimental Infertility Procedures: artificial insemination; in vitro fertilization and embryo placement; gamete intra-fallopian transfer; sperm, egg and/or inseminated egg procurement, processing and banking, to the extent such costs are not covered by the donor's insurer, if any; intracytoplasmic sperm injection for the treatment of male factor infertility; and zygote intrafallopian transfer.
j. Non prescription Enteral Formulas-- Covered medical expenses includes coverage for nonprescription enteral formulas for home use for which a physician has issued a written order and which are medically necessary for the treatment of malabsorption caused by Crohn's disease, ulcerative colitis, gastroesphageal reflux, gastrointestinal motility, chronic intestinal pseudobstruction, and inherited disease of amino acids and organic acids. Coverage for inherited diseases of amino acids and organic acids shall include food products modified to be low protein in an amount not to exceed $2,500 in the policy period.
k. Maternity Health Care-- Covered medical expenses include prenatal care, childbirth and post partum care to the same extent as provided for medical conditions not related to pregnancy. Coverage is provided for a minimum of 48 hours of in-patient care following a vaginal delivery and a minimum of 96 hours of in-patient care following a caesarean section for the mother and her newly born child. Any decision to shorten such minimum shall be made by the attending physician in consultation with the mother. Any such decision shall be made in accordance with rules and regulations promulgated by the Department of Public Health and the mother is entitled to a minimum of one home visit. Post delivery care shall include, but is not limited to, home visits, parent education, assistance and training in breast or bottle feeding and the performance of any necessary and appropriate clinical tests.
l. Off-Label uses of Prescription Drugs to Treat Cancer-- Prescription Medicines also include coverage for any off-label drug used for the treatment of cancer provided such drug is recognized for treatment of such indication in one of the standard reference compendia, or in the medical literature or by the commissioner.
m. Off-Label uses of Prescription Drugs to Treat HIV/AIDS-- Prescription Medicines also includes off-label drugs for HIV/AIDS treatment if such drug is recognized for treatment in one of the standard reference compendia, or in the medical literature or by the commissioner.
n. Scalp Hair Prosthesis for Cancer Patients-- Covered medical expenses includes coverage for expenses for scalp hair prosthesis worn for loss of hair suffered as a result of the treatment of any form of cancer or leukemia; subject to a statement by the treating physician that the scalp hair prosthesis is medically necessary. Scalp hair prosthesis is subject a maximum amount of $350 within the policy period.
o. Speech, Hearing and Language Disorders-- Covered medical expenses include the expenses incurred in the medically necessary diagnosis and treatment of speech, hearing and language disorders by individuals licensed as speech-language pathologists or audiologists regardless of whether the services are provided in a hospital, clinic or a private office.
p. Alcoholism-- Benefits are payable for the treatment of alcoholism on the following basis:
Inpatient-- Benefits will be paid on the same basis as an other medical condition; but benefits will not exceed 30 days per calendar year in an accredited or licensed hospital or in any public or private facility licensed by the Department of Public Health and providing detoxification or rehabilitation services, or in a residential alcohol treatment program.
Outpatient-- Benefits shall not exceed a maximum of $500 over a 12 month period for services furnished by an accredited or licensed hospital or by any public or private facility or portion thereof providing rehabilitation services and licensed by the Department of Public Health.
q. Dependent Coverage-- If you have selected Dependent coverage, covered medical expenses include:
Early Intervention:
1. Early Intervention Services--These services include: occupational therapy; physical therapy; speech therapy; nursing care; and psychological counseling. The maximum benefit for these services is limited to $3,200 per child per policy period with a lifetime maximum of $9,600. Services must be provided by person's licensed and working in early intervention programs approved by the Department of Public Health. Coverage is available to insured, dependent children from birth until their third birthday
r. Specialty Providers
Services for covered medical expenses when provided by podiatrists; chiropractors; optometrists; certified registered nurse anesthetist; nurse practitioner; or certified nurse midwife will be covered when the provider performs such service within the lawful scope of their license.
Preventive and Primary Care Services for Children:
The following services from the date of birth through six years of age:
1. Physical examination, history, measurements, sensory screening, neuropsychiatric evaluation and development screening and assessments at the following intervals: six times a year during the child's first year after birth, three times during the next year, and annually until age six.
2. Coverage for newborn hearing screening test.
3. Hereditary and metabolic screening at birth; appropriate immunizations; tuberculin tests, hematocrit, hemoglobin or other appropriate blood tests and urinalysis, as recommended by the physician and lead screening.
4. Coverage of injury and sickness including necessary care and treatment of medically diagnosed congenital defects and birth abnormalities or premature birth.
5. Special medical formulas approved by the Department of Public Health Commissioner, prescribed by a physician and that are medically necessary.
Newborn or Adopted Children--
Newborn infants and newborn infants of a dependent are covered from the moment of birth and adopted children from the date of placement in the home, or, if a foster child, from the date of the filing of the petition to adopt.
Mental Disorders--
Benefits shall be provided on the same basis as any other sickness for insured dependent children under the age of 19 for the diagnosis and treatment of non-biologically-based mental, behavioral or emotional disorders, as described in the most recent edition of the DSM, which substantially interfere with or substantially limit the functioning and social interactions of such child provided, that such interference or limitation is documented by and to the referral for said diagnosis and treatment is made by a physician, or is evidenced by conduct, including but not limited to: an inability to attend school as a result of such a disorder; the need to hospitalize such child as a result of such a disorder; or a pattern of conduct or behavior caused by such a disorder which poses a serious danger to self or others. Such benefits to a child who is engaged in an ongoing course of treatment shall continue beyond the dependent's nineteenth birthday until said course of treatment, as specified in such child's treatment plan, is completed and while the policy under which such benefits first became available remains in effect, or subject to a subsequent policy which is in effect.
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Part K--Wellness Program
When examinations, immunizations and tests are recommended by the Boston College Health Services for the prevention of disease, reimbursement will be made up to a maximum of $60.00 per policy year.
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Part L--Extension of Benefits
If an Insured Person is under treatment for a condition on the date his
or her insurance terminates, expenses incurred after such termination
date and during the continuance shall be payable in accordance with the
terms of the policy, but only while they are incurred during the 90 day
period following such termination of insurance.
CONFORMITY WITH STATE STATUTES:
Any provision of this brochure which is in conflict with the statutes of the state in which the applicable policy is issued, is hereby amended to conform to the requirements of such statutes.
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Limitation and Reductions
Any hospital, medical or surgical charges incurred to the extent that
they are payable by any other hospital or insurance plan are not covered
under the Policy, but such charges in excess thereof shall be covered
as otherwise provided.
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Exclusions
No payment shall be made under the policy for:
Eyeglasses, contact lenses, hearing aids or prescriptions
thereof;
Dental treatment, except as provided under the Dental Benefit;
Cosmetic surgery except made necessary by an injury occurring
while insured;
Loss caused by war or any enemy action;
Loss resulting from having been in or on an aircraft unless
riding as a fare-paying passenger in a passenger aircraft
operated by an incorporated carrier;
Participating in the play or practice of intercollegiate
sports, except as provided under the Intercollegiate Sports
Benefits;
Injury or sickness arising out of employment for compensation,
profit or gain;
Medical expenses resulting from a motor vehicle accident if such
expense is recoverable under valid and collectible medical
insurance or third party liability;
Any treatment, supplies or medical services provided by the
Policyholder. (This Exclusion does not apply to graduate
students who are using the Boston College Health Services on
a fee for service basis.);
Elective surgery, voluntary termination of pregnancy, health
treatment or examinations where no injury or sickness is
involved, except as mandated by Massachusetts state law or as
provided herein under Park K;
Prescription drugs, except as provided herein or when hospital confined;
Any expense incurred after the date of termination of
your insurance except as provided under Part L.
Any treatment for a pre-existing accident or sickness, except
as provided under Part I.
Expense incurred for:learning disabilities;
and preventive medicines.
Treatment of Temporomandibular Joint (TMJ) disorders
involving the installation of crowns, pontics, bridges or
abutments or the installation, maintenance or removal of
orthodontic or occlusal appliances or equilibration therapy.
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Termination
Your coverage under the policy will terminate on the earliest to
occur of these dates:
The date the policy ceases to be in force;
The end of the period for which you have paid premium.
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Claim Procedure
In the event of an accident or sickness, claims should be reported by the student directly to:
John T. Riley Insurance Agency, Inc.
P.O. Box 356
West Boylston, MA 01583
(508) 835-3106
(800) 541-1101
within 30 days from the date of accident or inception of illness. Medical bills must be submitted within 90 days from date of treatment.
Claim forms may be obtained online (PDF form) or from Walter W. Sussenguth and Associates at 120 Royall Street, Canton, MA 02021, 800-669-2668, ext. 445.
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Consumer's Right to Claim Review
You are entitled to a full and fair review of any claim. Please direct questions to the address above. When writing, please include that you are a Boston College student and provide your telephone number.
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Last updated on 4/4/02.
Student Services
Lyons Hall
617-552-3300
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