Premier Coverage includes all the benefits of Standard Coverage and coverage for pre-existing conditions. This policy when purchased would cover life threatening emergency situations due to any pre existing medical condition.
Premier Plan DOES NOT COVER maintenance of pre existing problems such as prescriptions, lab tests, x-rays or doctor consultations or any outpatient services. If you have non-emergency nature of sickness, you may make use of India Network Foundation Consult a Doctor program.
The program is sickness- and injury-based, and for each sickness, or injury, the chosen deductible is to be paid by policy holder. The usual and customary charges are paid by the insurance as outlined in the Schedule of Benefits located on the web page after meeting the deductible.
The pre existing coverage offered by India Network Plan is the highest available in the USA. Pre existing coverage of $25,000 is available for 70 plus members with $100,000 policy and a pre existing deductible of $5,000. Alternatively, if the visitor elects the $1,000 Pre Existing Deductible, the Pre Existing Maximum Coverage is $15,000.
For example, your mom is suddenly sick and rushed to the emergency room. She is treated and stabilized. The emergency visit is related to pre existing high blood pressure problem. The insurance will pay U&C charges as given in benefits schedule. The Insurance will pay for services related to the visit until it reaches $25,000 for this sickness (subject to $5,000 deductible with the $100,000 policy) for the visitor age 70 plus. IT IS NOT TEN PERCENT OF THE BILLS. ALL BILLS WILL BE SETTLED AS PER THE POLICY UNTIL THE AMOUNT REACHES $25,000 in this example.
Keep in mind, if an accident or sickness occurs unrelated to the pre existing condition, the standard deductible and standard maximum coverage applies.
Premier Coverage provides a maximum of $50,000 coverage with $150K policy and with a deductible of $5,000 for 2-69 Year old and $25,000 to 70 Plus members with $100K policy and with a deductible of $5,000. The pre-existing coverage offered by India Network Plan is the highest available in the USA. Premier Coverage is NOT available with $50,000 program. For example, a member purchases the Premier Coverage plan with $150,000 policy for parents. Mom got suddenly sick and rushed to emergency room. She was treated and stabilized. The emergency visit is related to pre-existing high blood pressure problem. The insurance will pay U&C charges as given in benefits schedule. The Insurance will pay to services related to the visit until it reaches $50,000 for this sickness (subject to $5,000 deductible) . IT IS NOT TEN PERCENT OF THE BILLS. ALL BILLS WILL BE SETTLED AS PER THE POLICY UNTIL THE AMOUNT REACHES $50,000 (with 150K policy).
A health or medical condition is categorized as pre-existing condition if that condition is known to the insured, a Physician was consulted, or for which treatment or medication was prescribed prior to the effective date of an Insured Person's coverage. Diabetes, blood pressure, chronic back pain, high cholesterol, kidney stones, skin problems are some examples of pre existing conditions.
For example, say someone has blood pressure problem which is under control with medication. Suddenly the insured become sick with brain hemorrhage and rushed to hospital. This would be a scenario where the Premier policy would be of help. If the visitor wants to see either a specialist or a family physician to checkup blood pressure problem under ordinary circumstances, the doctor visit is not covered by the Premier plan. The India Network Program also offers Medical Evacuation benefit and Repatriation benefit (see program link for details).
The minimum duration is one month and maximum duration allowed is twelve months at a time, 15 days and few days coverage is available at the time of renewal. Please choose the duration carefully as no changes can be made after the policy starts.
India Network Foundation is pleased to send $2,500 to a visiting Indian family to help in its medical emergency. Foundation members and matching funds were made available in January 2011 to assist with expenses incurred from a vehicle accident in Central Florida.
The Standard Plans do not require a network physician or facility. The India Network plan is a national program valid in the US and extends to visits to incident countries such as Canada, Mexico and the Bahamas. You may visit any provider closest to your location (see yellow pages in your phone book). All you have to do is present them with your Insurance ID card. Claims processing will settle the claims with the provider directly if the provider bill for covered services as per your program chosen or to you (the insured) if you file claim. On-line Claims are filed from Members Area.
If you are enrolled in a Network based Comprehensive Plan, to participate at the 80%/20% co-insurance for the first $5,000 of medical expenses, please refer to the MultiPlan Provider Network search for a list of doctors and facilities.