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International Major Medical Insurance | FAQ's

Who is the insurer?

The Global Medical plan is insured by Sirius International Insurance Corporation. Sirius offers financial security and a worldwide reputation, This well-established insurance company is rated 'A' (Excellent) by A.M. Best Company and 'A-' by Standard & Poor's.

What's the difference between the Bronze, Silver, Gold, Gold Plus and Platinum level of the Global Medical?

The Global Medical plan is available in five levels so that you can choose the coverage level that’s right for you.

  • Platinum - The Platinum level is the most comprehensive offering medical coverage, dental, vision, wellness, political evacuation, remote transportation, and maternity coverage. The Platinum provides $8 million lifetime coverage per insured and is consider to be the “Cadillac” insurance plan due to it’s comprehensive benefit structure.
  • Gold Plus - The Gold Plus is the second most comprehensive health insurance plan offering $5 million lifetime coverage per insured person. The plan covers doctor visits, hospitalization, prescription medication, medical evacuation, repatriation, mental health, wellness, and more. This plan is excellent for those individuals needing 3 years or more.
  • Gold - The Gold level is a comprehensive health insurance plan similar to the Gold Plus for the first three years of coverage. After three years, this plan drops in benefits to a capped benefit policy meaning it will cover up to a specific limit. This plan is excellent for those individuals needing 3 years or less.
  • Silver - The Silver level is a capped benefit plan offering an affordable option for those concerned about their budget, but also wanting international coverage. This plan is well designed for those individuals traveling to countries with affordable health treatment.
  • Bronze - The Bronze level is also a capped benefit plan offering the most economical pricing of the five plan levels. This plan also provides worldwide coverage to meet the tightest budgets and is designed to cover accidents and illnesses that happen on your plan.

Which coverage is right for me?

The Global Medical Plan is available in five different levels - Bronze, Silver, Gold, Gold Plus, and Premium - all of which offers two areas of coverage: including or excluding the US, Canada, China, Hong Kong, Japan, Macau, Singapore and Taiwan. If you do not need coverage in these countries, you may obtain lower premiums by selecting the "Worldwide Excluding" option.

Am I eligible for the Global Medical insurance plan?

The Global Medical plan is available to individuals and families from around the world who are at least age 14 days and not over age 74 and meet the following requirements:

  • US citizens: Must be outside or anticipate to be outside of the US for at least 6 months out of the next 12 months
  • Non-US citizens: Eligible for new business and renewal if considered a non-resident alien or has an exempted Visa type (A, F, G, J, M, R, Q)
  • Non-US citizens: Not eligible for new business or renewal if they meet the substantial presence test or if resident alien with non-exempted Visa.

The following is a link to information regarding the substantial presence test:
http://www.irs.gov/Individuals/International-Taxpayers/Substantial-Presence-Test

Is coverage under the Global Medical Plan renewable?

Yes. Global Medical products are annually renewable. There are no medical questions at renewal. Renewal is subject to your continued eligibility and timely payment of premiums and there is a 9% premium increase upon renewal. To ensure continuous coverage, all plans with a 2018 or later effective date will automatically renew on an annual basis beginning in 2019. Members will receive a renewal notice via email 45 days prior to their anniversary date.

Global Senior Plan

Eligibility for the standard Global Medical plan ends at age 75, but for those members who joined before age 65 and have maintained coverage for at least 10 years, the Global Senior Plan is available with no medical questions. The Global Senior Plan offers many of the same benefits and limits as the standard Global Medical plan. The Senior Plan has a deductible of $5,000 and offers an Overall Maximum Limit of $100,000 per year, up to a $1 million Lifetime Maximum.

What should I expect during the underwriting process?

The Global Medical is a medically underwritten plan, which means that your family's medical status and history will be used to determine your eligibility for coverage. Once you have submitted your application it will be reviewed within 5 business days by an underwriter. Within that period you will hear back from the underwriters and they will either:

  • Issue coverage and complete your application
  • Request further documentation regarding your past medical history
  • Apply a rider to your coverage that limits or excludes certain medical conditions
  • Apply a premium increase due to your medical and/or family history
  • Deny coverage

You will be notified on the status of your application once complete or if further information is needed. If a rider or premium increase is added to your plan you will be notified. If you are issued a rider you will be provided with a 30 day ‘free look’ period. If you do not like our counter offer, you can simply cancel coverage within the 30 day free look and we’ll refund 100% of your premium.

Preferred Provider Network (PPO) & Medical Concierge

The Global Medical plan uses UnitedHealthcare PPO inside the USA where you can receive treatment. If you go to one of these providers, your will need to pay your deductible first, and then your coinsurance will be waived. These providers have also agreed to accept direct payment from the insurance company.

Simply present your identification card at the provider's office so that they may contact us to verify benefits and billing information. For your convenience, there is also an international network and both networks are searchable through the Student Zone, which is accessible with your Certificate number and date of birth once coverage has been approved.

In addition to the extensive PPO network in the US, the Global Medical plan offers an International Provider Access network of over 17,000 physicians, clinics, and hospitals worldwide. These providers have agreed to accept direct payment to make it easier for you so that you don’t have to pay upfront.

The Global Medical plan also allows you to take advantage of the Medical Concierge program in the United States to assist you with finding providers and to give you more information on provider ratings, past outcomes and general costs in the area where you plan to seek treatment. By utilizing the Medical Concierge services, your deductible will be 50% waived (to a maximum of $2,500) and your coinsurance will be waived.

Simply present your identification card at the provider's office so that they may contact us to verify benefits and billing information. For your convenience, there is also an international network and both networks are searchable through the Student Zone, which is accessible with your Certificate number and date of birth once coverage has been approved.

In addition to the extensive PPO network in the US, the Global Medical plan offers an International Provider Access network of over 17,000 physicians, clinics, and hospitals worldwide. These providers have agreed to accept direct payment to make it easier for you so that you don’t have to pay upfront.

How do I file a claim?

Filing a claim is easy. Once your Application is accepted, you will receive a kit which contains Claimant's Statement and Authorization forms. Complete this Claimant's Statement and Authorization form, attach original, itemized bills, and forward them for processing. Be sure to complete your Claimant's Statement entirely and sign it. If you have already paid certain expenses, attach copies of your payment receipts. You will be reimbursed for eligible medical or dental expenses. In many cases, payments will be made directly to the hospital or physician that treated you. Remember, you are responsible for the deductible, coinsurance, and any ineligible charges.

Is there a waiting period for maternity?

Maternity benefits are only available on the Platinum level of the Global Medical plan with a waiting period of 10 months. Coverage on the Platinum level includes prenatal, delivery, postnatal, child wellness, congenital disorders, etc. There is an additional $2,500 deductible per pregnancy and the plan will cover maternity up to a lifetime maximum of $50,000. Please note that you cannot be pregnant at the time of application.

What other optional coverage can I get with this plan?

There are five optional coverage options that you can add to your Global Medical plan and they include:

  • Global Term Life Insurance (Amounts shown are the Principal Sums per unit)
    • Age 31 days - 18 years: $5,000
    • Age 19-29 years: $75,000
    • Age 30-39 years: $50,000
    • Age 40-44 years: $35,000
    • Age 45-49 years: $25,000
    • Age 50-54 years: $20,000
    • Age 55-59 years: $15,000
    • Age 60-64 years: $10,000
    • Age 65-69 years: $7,500
  • Accidental Death & Dismemberment (AD&D) – Included with Global Term Life Insurance
    • Accidental Loss of Life: Principal Sum*
    • Accidental Total Loss of 2 Members**: Principal Sum*
    • Accidental Total Loss of 1 Member**: 50% of Principal Sum
      (*Benefit based on age at time of death; **Member means hand, foot, or eye)
  • Dental & Vision (available on the Bronze, Silver, Gold, and Gold Plus plan options) - Dental is covered up to $750 lifetime maximum with a $50 deductible (max. 2 per family) after a 6 month waiting period. Routine Services – 90% (deductible is waived); Minor restorative – 70%; Major restorative – 50%. Vision will cover routine eye exams up to $100 per 24 month; Materials covered up to $150 per 24 months.
  • Terrorism Rider (available on the Platinum only) - If injured as a result of an act of Terrorism, and the insured person has no direct or indirect participation in the act, the plan will reimburse eligible medical claims subject to a $50,000 lifetime maximum. This benefit does not cover an act of Terrorism in the event that an advisory to leave a certain country or location is issued by the United States government after the insured person's arrival date, and the insured person unreasonably fails or refuses to depart the country or location.
  • Sports Rider (available on the Gold Plus and Platinum only) - Provides up to $10,000 lifetime maximum for amateur athletics
    • Adventure Sports:
      • Through age 49 years: $50,000 lifetime maximum
      • Age 50 through 59 years: $30,000 lifetime maximum
      • Age 60 through 64 years: $15,000 lifetime maximum

For more information about these riders, please see the Global Medical Brochure.

How can I pay for this plan?

The Global Medical plan can be purchased online using a credit card or debit card. When applying for the plan, you will be able to choose your frequency of payment from paying annually, semi-annually, quarterly, or monthly. Keep in mind that there are higher administrative costs the more frequent the payment. While your payment details are required to be included on your online application, your card will not be charged until the underwriting review process has been completed.

What does Usual Reasonable and Customary (URC) mean?

Usual Reasonable and Customary is a term that insurance companies use to describe a limitation on their responsibility to pay for eligible medical expenses. Basically, URC refers to the fee typically charged by a provider for a specific procedure in a specific geographic area. So if a particular procedure typically costs $5,000 in the New York City area, and most providers customarily charge about $5,000 for that procedure, the insurance company will not pay your provider in New York City $10,000 for the same exact procedure. Instead, they will limit their payment amount to "Usual Reasonable and Customary" - in this example, $5,000.


Plan Overview Video

Find out if this plan is right for you in this short one minute video!