What Are The Pre-Notification Requirements?
All Hospitalizations, Surgeries, Pregnancies, Emergency Medical Evacuations, Emergency Reunions, Repatriation of Remains, Computerized Tomography (CAT Scan), and Magnetic Resonance Imaging (MRI) must be Pre-notified. Simply call, or have your Physician call, MultiNational Underwriters® with all information relative to your claim. You may also pre-notify by submitting details through Student Zone. Be sure to have your ID number available.
If you do not Pre-notify, medical expenses will be reduced by 50% and all other expenses will be forfeited.
Acute Onset Of Pre-Existing Condition
If your Pre-existing Conditions have been fully disclosed on your Application and the conditions are not excluded or restricted by any other provision of your Certificate, you are covered for an Acute Onset of Pre-existing Condition up to $1,000 during the first 12 months of coverage and up to $2,500 during the second 12 months of coverage hereunder.
An Acute Onset of a Pre-existing Condition is a sudden, unexpected outbreak or recurrence of a Pre-existing Condition, which occurs spontaneously and without advance warning, either in the form of Physician recommendations or symptoms which would have caused a prudent person to seek medical attention prior to the outbreak or recurrence. Treatment must be obtained within 24 hours of the sudden and unexpected outbreak or recurrence.
What Is Covered?
Medical Expenses
- Inpatient and Outpatient charges made by a Hospital.
- Charges made by a Physician, surgeon, radiologist, anesthesiologist, and any other Medical Specialist to whom the Physician has referred the case.
- Charges made for dressings, sutures, casts or other supplies prescribed by the attending Physician or Medical Specialist, but excluding nebulizers, oxygen tanks, diabetic supplies and all devices for repeat use at home.
- Charges for diagnostic testing using radiology, ultrasonographic or laboratory services.
- Charges for oxygen and other gases and anesthetics and their administration.
- Charges for prescription drugs for treatment of a covered Injury or Illness, but not for the replacement of lost, stolen, damaged, expired or otherwise compromised drugs.
- Charges made by a licensed Extended Care Facility upon direct transfer from an Acute Care Hospital.
- Emergency Local Ambulance transport incurred in connection with Injury or Illness resulting in Inpatient hospitalization.
Pre-Existing Conditions
After 12 months of continuous coverage, StudentSecure SM will provide benefits for Pre-existing Conditions. A Pre-existing Condition is any Injury or Illness which, within the 12 months prior to the Effective Date of Coverage, manifested itself, exhibited symptoms, or required medical treatment or medication, or for which a Physician was consulted.
Maternity & Newborn Care
When conception occurs after the Effective Date of Coverage, StudentSecure SM provides Maternity benefits, including but not limited to pre-natal, delivery, and post-natal care as well as expenses for miscarriage and complications of pregnancy. Routine Nursery Care of Newborns is also covered, subject to the maximum shown in the Schedule of Benefits and Limits.
Organized Sports Activities
Medical expenses for Injuries or Illnesses sustained while participating in intercollegiate, interscholastic, intramural, or club sports are covered by the StudentSecure SM plan up to a maximum of $5,000 per Injury or Illness. Covered organized sports are: basketball, baseball, cross country, dance team, football, golf, kickball, soccer, softball, swimming, tennis, track, volleyball, weight training, and wrestling.
Mental Health Disorders
StudentSecure SM provides benefits for Mental Health Disorders. Outpatient treatment is covered to a maximum of $50 per day, with a $500 Lifetime Maximum. Usual, Reasonable, and Customary expenses are covered for Inpatient treatment to a $10,000 Lifetime Maximum. Treatment for Mental Health Disorders is covered only if not obtained from a Student Health Center.
Emergency Medical Evacuation
If recommended by your attending Physician, who certifies that Evacuation is necessary to safeguard your life and that Medically Necessary treatment is not available locally, and if approved in advance and coordinated by MultiNational Underwriters®, StudentSecure SM will provide the following benefits: Emergency air and/or ground transportation to the nearest Hospital that is qualified to provide the Medically Necessary treatment.
Emergency Reunion
StudentSecure SM will provide benefits, up to the maximum indicated in the Schedule of Benefits and Limits, for the cost of an economy round-trip air and/or ground transportation ticket for one of your relatives (parent, spouse, sibling or child age 18 or older) for transportation to the area where you are hospitalized and for reasonable expenses for lodging and meals for your relative for a period not to exceed 15 days in either of the following situations:
- Following a covered Emergency Medical Evacuation; or
- You are hospitalized due to a life-threatening Injury or Illness for more than five days.
MNU must be notified in advance of the travel of the relative in order for Emergency Reunion benefits to be payable. Emergency Reunion benefits that are not related to an Emergency Medical Evacuation will be paid only following the end of the Inpatient hospitalization.
Terrorism
StudentSecure SM provides Medical coverage for Injuries and Illnesses resulting from an Act of Terrorism, subject to a $50,000 Lifetime Maximum, provided all of the following conditions are met:
- The Injury or Illness does not result from chemical, nuclear or biological weapons or events.
- You have no direct or indirect involvement in the Act of Terrorism.
- The Act of Terrorism is not in a country or location where the United States government has issued a travel advisory that has been in effect within the 6 months prior to your date of arrival.
- You have not unreasonably failed or refused to depart a country or location following the date an advisory to leave that country or location is issued by the United States government.
An Act of Terrorism is defined as: an act, including but not limited to, the use of force or violence and/or the threat thereof, of any person or group(s) of persons, whether acting alone or on behalf of or in connection with any organization(s) or government(s) committed for political, religious, ideological or similar purposes including the intention to influence any government and/or to put the public, or any section of the public, in fear.
For additional benefits covering Acts of Terrorism, including high limit AD&D and Permanent Total Disability coverage, review the MultiNational Accident Plan (MAP).
International Citizen Assistance Services
All Assistance Services are available to you 24 hours a day, 7 days a week while your International Citizen Plan is in effect.
A) Pre-Trip Health And Safety Advisories
Call MNU for current passport, visa, inoculation and vaccine requirements, as well as up-to-date travel safety advisories.
B) Livetravel Services
MNU will make emergency travel and itinerary changes for you including rebooking flights, hotel reservations and ground transportation arrangements.
C) Bagtrak
MNU are the industry leaders in tracking lost checked baggage. MNU will help you locate your lost checked baggage and deliver it to you anywhere in the world.
D) Emergency Message Relay
MNU will relay messages to your family, friends and co-workers, helping you to maintain contact during an emergency.
E) Emergency Cash Transfers
MNU will assist you in arranging and obtaining cash transfers anywhere in the world.
F) International Citizen Assistance Services Also Include:
- Medical referrals
- Up-to-the-minute travel medical advisories
- Assistance with prescription drug replacement
- Dispatch of a doctor or specialist
- Emergency travel arrangements for family members
- Lost passport or travel documents assistance
- Embassy and consulate referrals
- Legal and accounting referrals
- Bail bond assistance
- Translation and interpretation assistance
StudentSecure SM Assistance Services are not insurance benefits, and provision of any Assistance Service is not a guarantee of any other benefit under StudentSecure SM.
Accidental Death and Dismemberment
In the event of your Accidental Death or Dismemberment resulting from a covered Injury, StudentSecure SM will provide the following benefit:
- Accidental Death - Principal Sum to the Beneficiary designated on your Application
- Loss of Sight in both eyes or loss of two or more Limbs - Principal Sum to you
- Loss of Sight in one eye or loss of one Limb - One-half of the Principal Sum to you
Loss of Sight is defined as total and irrevocable loss of sight. Loss of Limb is defined as complete and permanent severance of a hand at or above the wrist, or a foot at or above the ankle.
The Accidental Death and Dismemberment benefit is not available for losses resulting from an Act of Terrorism.
Repatriation Of Remains
In the event of a covered Injury or Illness resulting in your death, StudentSecure SM will provide the following benefit: Air and/or ground transportation of bodily remains or ashes to the area of your Principal Residence, and reasonable costs of preparation of your remains necessary for transportation.
Emergency Dental
The following Emergency Dental expenses are covered:
- Emergency Dental treatment and Dental surgery necessary to restore or replace sound natural teeth lost or damaged in an Accident which is covered under this insurance subject to a maximum of $250 per tooth and $500 Certificate Period Maximum; and
- Emergency Dental treatment necessary to resolve acute, spontaneous and unexpected onset of pain subject to a maximum benefit of $100 per Certificate Period.
Does StudentSecure Provide any Home Country Coverage?
StudentSecure SM offers limited Home Country coverage. Medical expenses only can be covered during one incidental visit of up to 15 days. The member must return abroad, either to the Host Country or another country en route to the Host Country, no more than 15 days after the return to the Home Country in order to be eligible for this benefit.
Return to the Home Country must not be taken for the purpose of obtaining treatment for an Injury or Illness that began outside of the Home Country.
Benefit Period
If you are hospitalized as Inpatient on your coverage Termination Date, StudentSecure SM will provide a Benefit Period of 60 days for that condition only. The Benefit Period begins on the first date that you receive diagnosis or treatment for the condition and continues for 60 days, regardless of whether you are abroad or return to your Home Country.
What Are The Exclusions And Limitations?
The following charges, treatments, surgeries, medications, conditions and circumstances are excluded:
- Pre-existing Conditions - Charges resulting directly or indirectly from any Pre-existing Condition are excluded from this insurance during the first 12 months of coverage. A Pre-existing Condition is any Injury or Illness which, within the 12 months prior to the Effective Date of Coverage, manifested itself, exhibited symptoms, or required medical treatment or medication, or for which a Physician was consulted.
- Treatment for or related to any congenital condition, except for a newborn child insured under the Policy.
- Pre-natal, delivery, post-natal, and newborn care, unless related to a Covered Pregnancy.
- Birth control, artificial insemination, infertility, impotency or sexual dysfunction, sterilization or reversal thereof.
- Substance Abuse.
- Charges which are not incurred during the Certificate Period or the applicable Benefit Period, and charges which are not presented to Underwriters for payment within 60 days from the end of the Certificate Period or the applicable Benefit Period.
- Charges for use of Emergency Room for treatment of Illness within the United States unless the patient is directly admitted to the Hospital as Inpatient for further treatment of that Illness.
- Services that are not Medically Necessary and administered or ordered by a Physician or Medical Specialist, and services that are provided at no cost, by a family member, or by a person who ordinarily resides with you, or which are attributable to or recoverable from any other party including government-sponsored plans.
- Charges which exceed Usual, Reasonable and Customary.
- Investigational, Experimental or for Research purposes.
- Venereal Disease, AIDS or ARC.
- Treatment by a Chiropractor unless ordered in advance by a Physician.
- Physical therapy and treatment for Mental Health Disorders if treatment is obtained at a Student Health Center.
- Diseases of the skin.
- Dental treatment, including treatment of the temporomandibular joint, except for Emergency Dental treatment for the relief of acute, spontaneous and unexpected onset of pain.
- Eyeglasses, vision exams, contact lenses, hearing tests, hearing aids, hearing implants, eye refraction, visual therapy, orthoptics or visual eye training or eye surgery (including cataract surgery and radial keratotomy) or for any examination or fitting related to these devices or procedures.
- Immunizations and Routine Physical Exams.
- Expenses in excess of $5,000 for Injury or Illness sustained while taking part in intercollegiate, interscholastic, intramural, or club sports, and all expenses for any Injury or Illness sustained while taking part in any other Amateur Athletics. Amateur Athletics is defined as sports or other athletic activities that are organized and/or sanctioned, involving regular or scheduled practices and/or regular or scheduled games. This definition does not include athletic activities that are non-contact and engaged in by a Member solely for recreational, entertainment or fitness purposes and not for wage, reward or profit.
- Injury sustained while taking part in: professional sports; mountaineering where ropes or guides are normally used or at elevations of 4,500 meters or higher; aviation, except when traveling solely as a passenger in a commercial aircraft; hang gliding, sky diving, parachuting, or bungee jumping; snow skiing or snowboarding, except for recreational downhill and/or cross-country snow skiing or snowboarding (no cover provided whilst skiing away from prepared and marked in-bound territories and/or against the advice of the local ski school or local authoritative body); racing by any animal or motorized vehicle; spelunking; subaqua pursuits involving underwater breathing apparatus unless NAUI/PADI certified, accompanied by a certified instructor, and at depths of less than 10 meters; jet skiing; and any other sport or athletic activity which is undertaken for thrill seeking and exposes you to abnormal or extreme risk of injury.
- Injury sustained while under the influence of or due wholly or partly to the effects of intoxicating liquor or drugs other than drugs taken in accordance with treatment prescribed and directed by a Physician but not for the treatment of Substance Abuse.
- Willfully self-inflicted Injury or Illness and/or any complications or consequences thereof.
- The Deductible, Coinsurance and charges which are not included as Eligible Expenses as described in the Master Policy, and charges which exceed the limits set forth in the Schedule of Benefits and Limits.
- Treatment required as a result of complications or consequences of a treatment or condition not covered hereunder.
- Charges for travel or accommodations, except as provided for in the Local Ambulance, Emergency Medical Evacuation, Repatriation of Remains, and Emergency Reunion sections of this insurance.
- Treatment incurred as a result of exposure to non-medical nuclear radiation and/or radioactive material(s).
- Organ or tissue transplants or related services.
- Acts of Terrorism, except as provided for herein, war, insurrection, riot or any variation thereof.
This is a summary of exclusions. For more details, or for a complete copy of the Master Policy, contact MultiNational Underwriters®.
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