On Call International
It Could Happen to You!TM
Terms & Conditions
The following Terms and Conditions apply to the program provided by
On Call International
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COVERED SERVICES
MEDICAL ASSISTANCE
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Pre-Trip Plan
ON CALL shall provide up-to-date information either by e-mail, fax or
over the phone regarding required vaccinations, health risks, travel
restrictions and weather conditions for global destinations worldwide.
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Medical Monitoring
ON CALL shall, via telephone, monitor the Member's conditions when
hospitalized and provide ongoing updates to the Member's
family. Depending upon the medical and/or geographical situations, ON
CALL may retain the services of consulting physicians/nurses and/or
other medical professionals with relevant areas of expertise to assist
in the monitoring of the Member's condition. ON CALL does not provide
or control the provision of medical services to Members. The attending
medical practitioner and/or the Member or their representative makes
all decisions regarding medical services. The parties understand and
agree that the rendering of medical services to a Member and the
result thereof are solely within the control of medical practitioners
and/or other providers of the services and advice. ON CALL and
performance of its obligations shall not constitute any undertaking to
render any medical services, to assume or guarantee the result of
medical services provided on behalf of Members, or to guarantee that
the medical services performed by others will be rendered in
accordance with generally accepted standards or procedures.
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24 Hour Nurse Help Line
ON CALL shall provide Members with clinical assessment, education and
general health information. This service shall be performed by a
registered Nurse counselor to assist in identifying the appropriate
level and source(s) of care for Members (based on symptoms reported
and/or health care questions asked by or on behalf of Members). Nurses
shall not diagnose Member's ailments.
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Medical, Dental and Pharmacy Referrals
ON CALL shall provide, at the Member's request, referrals to medical,
dental professionals and pharmacies in the given geographic area
locations of western style medical facilities and English speaking
doctors, dentists and other health care providers in an area served by
ON CALL to the extent possible.
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Deposits, Advances and Guarantees
Deposits, advances and guarantees will be provided for, but not
limited to, medical facilities, hotels, airlines, ground and air
ambulances and other like providers to secure service for Member. Any
advances of funds on behalf of the Member shall be charged to the
Member's credit card at the time of service.
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Dispatch of Medicine
ON CALL shall dispatch to the Member prescription medicine, when not
locally available and legally permissible, upon the written
authorization of Member's Primary Physician. The Member is
responsible for any expenses incurred in this regard, including but
not limited to, the cost of the pharmaceuticals, shipping cost, taxes
or other import/export duties. These expenses will be billed to the
Member's credit card prior to shipping.
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Dispatch of Physician/Nurse
When a Member is away from home, ON CALL may, at its sole discretion,
dispatch to the Member's location a physician or other health care
professional to assist in determining the medical condition and
suitability to travel to a Member who has been hospitalized.
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Unlimited Emergency Medical Transportation (Evacuation/Repatriation)
If a Member is away from his/her permanent residence and is involved in an
accident or suffers sudden illness which requires transportation to another
facility for immediate medical treatment, ON CALL will make arrangements and
pay to transfer the Member to the nearest facility of their choice capable of
providing adequate care. Coverage, Limits and Exceptions for these expenses
are defined in Section (B) Terms and Conditions.
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Medically Supervised Repatriation
If a Member is away from his/her permanent residence and is hospitalized as
the result of an accident or sudden illness and the remaining in-patient
hospital stay can be completed at a hospital of the Member's choice near
their permanent residence and the Member is unable to travel without a medical
escort, ON CALL will make arrangements and pay to transfer the Member to the
facility of their choice capable of providing adequate care. Coverage, Limits
and Exceptions for these expenses are defined in Section (B) Terms and
Conditions.
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Unsupervised Repatriation
If a Member must return home for further treatment after being hospitalized as
the result of an accident or sudden illness occurring while away from his/her
permanent residence and the Member is able to travel home without a medical
escort, ON CALL will make arrangements and pay to transfer the Member via
commercial air to the facility of their choice near their permanent residence,
or to their permanent residence for continuing care. Coverage, Limits and
Exceptions for these expenses are defined in Section (B) Terms and Conditions.
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Up to $2,500 for Family Reunion
If a Member is away from home and will be hospitalized for more than seven (7)
days, at the Member's request, ON CALL shall make and pay for economy travel
arrangements for a parent or family member to join the Member. On Call shall
also make suitable hotel arrangements and pay for hotel and meals up to the
limit of coverage. Coverage, Limits and Exceptions for these expenses are
defined in Section (B) Terms and Conditions.
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Up to $10,000 Repatriation of Deceased Remains
In the event of a Member's death away from home, ON CALL will render every
assistance possible to obtain necessary clearances and make arrangements for
the return of deceased remains and pay such reasonable expenses associated with
the return. Coverage, Limits and Exceptions for these expenses are defined in
Section (B) Terms and Conditions.
*All coverages are subject to Section B-Limitations, Terms and Conditions.
Travel Assistance
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Travel Assistance
At the Member's request, ON CALL shall assist Member once a trip has
started with changing airline, hotel or car rental reservations.
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Translation and Interpreters
ON CALL will provide foreign language assistance over the telephone,
or up to one-page translations submitted via fax. ON CALL will also
provide referrals to local translators and interpreters. Fees for
these types of translators are the responsibility of the Member.
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Emergency Cash Advance Assistance
ON CALL shall provide assistance to Members by arranging for the
forwarding of funds from Member's credit cards or family members. Any
fees associated with the transfer of funds will be the responsibility
of the Member.
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Replacement of Lost Traveling Documents Assistance
ON CALL shall provide assistance to Members by arranging for the
replacement of passports, airline documents, birth certificates and
other travel-related documents. Any fees required for the acquisition
or forwarding of these documents is the responsibility of the Member.
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Emergency Message Forwarding Assistance
In the event a Member is unable to reach an employer, family member or
traveling companion, ON CALL shall forward a message via telephone or
fax to the intended party.
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Lost Luggage Assistance
ON CALL shall assist the Member with the tracking of luggage lost in transit.
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Legal Referral
If a Member is away from home and is arrested, or requires the
services of an attorney, ON CALL shall arrange for an initial
telephone consultation with an attorney without charge to Member. If
needed, a Member will be referred to an attorney in the appropriate
geographical area. Fees and costs charged by the referred attorney
shall be the responsibility of Member.
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COVERAGE LIMITATIONS, TERMS AND CONDITIONS FOR MEMBERS
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Participation
A participant of this Program is defined as a Member who has enrolled in and
paid for this Program prior to their departure on a covered trip. A Member
may also enroll their Dependents for coverage under this Program. An enrolled
Dependent shall also be known as a Member.
Dependent shall mean: A spouse who is legally married to the Member, or
unmarried children of a Member who is over 30 days and under 19 years of age,
or under 25 years of age if they are attending an accredited institution of
higher learning on a regular full-time basis and/or wholly dependent upon the
Member for maintenance and support.
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The Following Medical/Travel Benefits will be paid up to the Maximum Combined
Single Limit per event per Member:
Combined Single Limit of $2,500 for one (1) economy fare, round-trip airline
ticket and accommodations and meals not to exceed $150 per day subject to a
maximum of five (5) days for a family member to join hospitalized Member.
Return of Deceased Remains up to $10,000
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The Following Expenses Are Not Covered
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Services other than those indicated herein.
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SERVICES RENDERED WITHOUT THE AUTHORIZATION AND/OR INTERVENTION OF ON CALL.
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Intentionally self-inflicted injuries, suicide, or any attempted
threat (in Missouri, suicide or any attempted threat, while sane)
except when hospitalized as an inpatient.
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Services provided for a Member for which no charge is normally made.
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Expenses incurred if the original or ancillary purpose of the
Member's trip is to obtain medical treatment.
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Participation in a declared or undeclared act of war, civil
disturbance, or insurrection, or an accident occurring while the
Member is serving on full-time or active duty in the Armed Forces of
any country.
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Participation in an international authority flight in aircraft being
used for experimental purpose, or in military aircraft (except the
Military Aircraft Command of the United States or similar air
transport Services Account of other), or while serving as a member of
the crew of any aircraft.
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Use of any alcohol or drug, unless prescribed by a physician, or
except if hospitalized as an inpatient.
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Any services provided to an injured person where the Member is
entitled to receive reimbursement for such expenses under any group
insurance program maintained by the Member's insurance company or
employer.
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Routine or non-disabling medical problems, such as simple fractures,
or sickness, which can be treated by local doctors and do not prevent
the injured person from continuing the trip or returning home.
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Any treatment or expense related to childbirth, miscarriage or
pregnancy except for any abnormal pregnancy or vital complication of
pregnancy which endangers the life of the mother and/or unborn child
during the first twenty-four (24) weeks of pregnancy.
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Transportation for an organ transplant when a Member was on an organ
transplant list prior to enrollment.
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Any expenses incurred while traveling within 50 miles of an eligible
Member's primary place of residence.
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Limitations
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All legal actions arising under this Agreement shall be barred unless
written notice thereof is received by ON CALL within one year from the
date of event giving rise to such legal action.
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ON CALL cannot be held responsible for failure to provide services or
for delays caused by strikes or conditions beyond its control,
including but not limited to, flight conditions, or where rendering of
service is prohibited by local laws or regulatory agencies.
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Member may be required to release ON CALL or any health care provider
from liability during emergency evacuation and/or repatriation.
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Without limiting the foregoing, ON CALL's actions and obligations
under this Agreement are ministerial in nature, and all medical care
is provided by medical professionals ultimately selected by a Member
and in no event is the responsibility of ON CALL. ON CALL is not
liable for any malpractice performed by a local doctor, health care
provider or attorney.
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ON CALL retains the medical discretion to limit two separate flights
per Member, per year and to limit one emergency evacuation and or
repatriation attributable to any single medical condition of a Member.
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Transport to hospital of patient's choice must be to home area
hospital. If patient requests transport to hospital outside home area
and the cost does not exceed home destination costs by 50%,
arrangements will be made. Patient acknowledges that coverage ends
once patient is transported to hospital of choice.
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ON CALL, at its sole discretion, will assist Members on a fee for
service basis for interventions falling under the Limitations and
Uncovered Services. ON CALL reserves the right, at its sole
discretion, to request additional financial guarantees or pre-payment
or indemnification from the Member prior to rendering such service on
a fee for service basis.
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Eligibility
This plan is available to residents of the U.S. and Canada, age 76 and under.
Only the person designated as a Member on the Application, who is undertaking a
Covered Trip shall be eligible for services under the Plan. The Covered Trip
day limit does not apply to full-time students. Membership continues only for
the period the subscription fee has been paid. A Covered Trip shall be
defined as anytime the covered Member is more than 50 miles from their primary
place of residence. The maximum length of a Covered Trip is defined in the
Member's chosen plan as outlined on the Membership Card.
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Standard Plan:
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Covered Trip not to exceed 90 consecutive days
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Extended Stay Plans:
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180 Day Plan: Not to exceed 180 consecutive days
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270 Day Plan: Not to exceed 270 consecutive days
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365 Day Plan: Not to exceed 365 consecutive days
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Payment of Subscription Fees and Reimbursements
All initial and supplemental fees are due and payable on or before the
departure date of the covered trip. ON CALL shall have no obligation
to render services hereunder unless and until subscription fees have
been paid in full. Subscription fees and Reimbursement are net of any
applicable taxes.
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Refunds
Refunds will only be given if covered trip is cancelled prior to
departure.
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Membership Cards
Membership card will be sent to the primary Member. Additional
Membership cards are available upon request.
Underwritten by Virginia Surety Company, Inc.
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