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Global Medical U.S.A.

Frequently Asked Questions & Policy Definitions

“Sickness” means an illness, disease or condition of the covered person that causes a loss for which the covered person incurs medical expenses while covered under the Policy. All related conditions and recurrent symptoms of the same or similar condition will be considered one Sickness.

“Injury” means accidental bodily harm sustained by a covered person that results directly and independently from all other causes from a covered accident. The Injury must be caused solely through external and accidental means. All injuries sustained by one person in any one accident, including all related conditions and recurrent symptoms of these injuries, are considered a single Injury.

“Medically Necessary” means a treatment, service or supply that is: 1) required to treat an Injury or Sickness; prescribed or ordered by a doctor, or furnished by a Hospital; 2) performed in the least costly setting required by the covered person’s condition; and 3) consistent with the medical and surgical practices prevailing in the area for treatment of the condition at the time rendered. A service or supply may not be Medically Necessary if a less intensive or more appropriate diagnostic or treatment alternative could have been used. The Company may, at its discretion, consider the cost of the alternative to be the Covered Expense.

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Q. What expenses are covered?
A. For a list of covered expenses click here.

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Q. Will the Plan pay medical providers directly or do I need to pay first and then be reimbursed?
A. The answer is spelled out in more detail under the general instructions in the Claims section of our web site, however there honestly is no easy answer. This is simply due to the need to respond to the individual billing practices of medical providers both outside and inside of the USA. Many will accept an assignment of benefits and when they do the Plan will pay the provider directly. You should indicate that you are assigning benefits in such a manner on the claim form (also available in the Claims section). For relatively small claims it may be necessary for you to pay first and then be reimbursed. Payment for large claims such as for Emergency Medical Evacuation will be arranged directly through the Assistance Company, which must be contacted and be involved in making all arrangements. In addition, payment guarantees may be arranged via the Assistance Company in special circumstances where eligibility of the claim is clear.

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Q. How soon must I enroll before coverage may begin?
A. Coverage may be issued with an effective date in the future. The earliest effective date is 12:01am on the day after enrollment. If you are enrolling by mail, it is best to give us reasonable time to process your enrollment and mail you back your confirmation materials.

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Q. May I prorate my premiums for short or odd numbers of days or weeks?
A. Under the Global Medical plans there is a 15 day rate which may be used together with the monthly rates to figure the correct time periods.

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Q. What about Non USA citizens or permanent residents traveling to the USA?
A. Global Medical USA is for these individuals, for work or for pleasure.

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Q. May I "charge" my premium?
A. Yes, Master or Visa, check the enrollment form for details.

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Q. I am planning on traveling to the USA and while on the trip will be traveling for a brief time to another country, will the Global Medical USA plan cover me when I am not in the USA as well?
A. Yes, the Global Medical USA plan is designed for foreign nationals traveling to the USA and coverage continues on side trips to other countries outside of your Home Country.

Policy terms and conditions are briefly outlined in this Description of Insurance. Complete provisions pertaining to this insurance plan are contained in the Master Policy which is on file with the Policyholder, Trustee of ACE USA Accident & Health Insurance Trust in the District of Columbia. In the event of any conflict between this Description of Coverage and the Master Policy, the Master Policy will govern. ACE USA is a division of ACE Corporation. Insurance products and services are provided by ACE insurance underwriting companies and not by the corporation itself. This Plan may not be available in all states. 08/07 ©CMI 2007

Personal Information Notification: All verification or changes for an Enrolled Person's information must be submitted to CMI Insurance in writing at 1447 York Road, Lutherville, MD 21093. The Enrolled Person will receive a letter to either verify current information or to acknowledge the changes made within 30 days from receipt of the letter.