| This information is applicable for the following AustraLearn Programs: - Internships
- Semester or Year Abroad at University of the South Pacific, Fiji
- Summer and January Programs
- Gap Programs
Health Insurance You are required to have health insurance coverage during your study abroad program. AustraLearn has arranged the “HealthSelect Overseas” policy for student accident and sickness insurance through HTH Worldwide. HealthSelect Overseas Policy Details AustraLearn will provide you with a copy of the following and your insurance card ID via email upon confirmation of your insurance. This will occur approximately 4 weeks prior to your departure. This following contains a brief summary of the features and benefits for insured participants covered under Policy No. U-1170-A-08. Who is Eligible for the Coverage? All regular, full time or part-time Eligible Participants and Eligible Dependents of the educational organization or institution who: - Are engaged in international educational activities; and
- Are temporarily located outside his/her Home Country as a non resident alien; and
- Have not obtained permanent residency status.
When Does the Coverage Start? Coverage for an Eligible Participant and an Eligible Dependent starts at 12:00:01 a.m. on the latest of the following: - The effective date of the Policy; or
- The Participating Organization’s or Institution’s Effective Date;
- The effective date shown on the Insurance Identification Card, if any;
- The date the premium and completed enrollment form, if any, are received by the Insurer or the Administrator.
Thereafter, the insurance is effective 24 hours a day, worldwide except whenever the Covered Person is in his/her Home Country. In no event, however, will insurance start prior to the date the premium is received by the Insurer. When Does the Coverage End? Coverage for an Eligible Participant and an Eligible Dependent will automatically terminate on the earliest of the following dates: - The date the Policy terminates
- The Participating Organization’s or Institution’s Termination Date
- The date of which the Eligible Participant or the Eligible Dependent ceases to meet the Individual Eligibility Requirements
- The end of the term of coverage specified in the Eligible Participant’s or Dependent’s enrollment form, if any, including any requested extension
- The date the Eligible Participant or Eligible Dependent leaves the Country of Assignment for his/her or her Home Country
- The date the Eligible Participant or Eligible Dependent requests cancellation of coverage (the request must be in writing); or
- The premium due date for which the required premium has not been paid, subject to the Grace Period provision.
What to do in Case of an Emergency? All Eligible Participants are entitled to Global Assistance Services while traveling outside of the United States. In the event of an emergency, they should go immediately to the nearest physician or hospital without delay and then contact HTH Worldwide. HTH Worldwide will then take the appropirate action to assist and monitor the medical care until the situation is resolved. To contact HTH Worldwide in the event of an emergency, call 1.800.257.4823 or collect to +1.610.254.8771. Coordination of Benefits The Insurer will reduce the amount payable under the Policy to the extent expenses are covered under any Other Plan. The Insurer will determine the amount of benefits provided by Other Plans without reference to any coordination of benefits, non duplication of benefits, or other similar provisions. The amount from Other Plans includes any amount to which the Covered Person is entitled, whether or not a claim is made for the benefits. The Policy is secondary coverage to all other policies. hthstudents.com Once Eligible Participants receive their Medical Insurance ID card from HTH Worldwide, they should visit hthstudents.com, and using the certificate number on the front of the card, sign in to the site for comprehensive information and services relating to this plan. Participants can track claims, search for a doctor, view plan information, download claim forms and read health and security information. Claims Submission Claims are to be submitted to HTH Worldwide, Attn: International Claims, One Radnor Corporate Center, Suite 100, Radnor PA 19087, USA. See the hthstudents.com website for claim forms and instructions on how to file. What is Covered by the Plan? Schedule of Benefits – Table 1 Medical Expenses | Limits – Covered Person | | Lifetime Maximum Benefit | $1,000,000 | | Policy Year Maximum Benefits | $100,000 | | Maximum Benefit per Injury or Sicknesses | $100,000 | | Deductible | $0 per Injury or Sickness | | Accidental Death & Dismemberment | Maximum Benefit: Principal Sum up to $10,000 for Participant; up to $5,000 for Spouse; up to $1,000 for Dependent | | Repatriation Of Remains | Maximum Benefit up to $25,000 | | Medical Evacuation | Maximum Lifetime Benefit up to $100,000 | | Bedside Visit | Up to a maximum benefit of $1,500 | Schedule of Benefits – Table 2 – Medical Expenses | | Indemnity Plan Limits | | Physician Office Visits | 100% of Reasonable Expenses | | Inpatient Hospital Services | 100% of Reasonable Expenses | | Hospital and Physician Outpatient Services | 100% of Reasonable Expenses | Schedule of Benefits – Medical Expense Benefits Benefits listed below are subject to Table 1 Lifetime Maximums, Annual Maximums, Maximums per Injury and Sickness, Co-Insurance; and Table 2 Plan Type Limits | Medical Expense | Limits – Covered Person | | Maternity Care for a Covered Pregnancy | Reasonable Expenses | | Inpatient treatment of mental and nervous disorders including drug or alcohol abuse | Reasonable Expenses up to $2,500 Maximum per lifetime for a maximum period of 30 days per lifetime | | Outpatient treatment of mental and nervous disorders including drug or alcohol abuse | Reasonable Expenses up to $500 Maximum per lifetime | | Treatment of specified therapies, including acupuncture and Physiotherapy | Reasonable Expenses up to $5,000 Maximum combined total for Inpatient and Outpatient care, up to 30 days immediately following the attending Physician’s release for rehabilitation following a covered Hospital confinement or surgery per Policy Year | | Therapeutic termination of pregnancy | Reasonable Expenses up to $500 Maximum per Policy Year | | Routine nursery care of a newborn child of a covered pregnancy | 100% of Reasonable Expenses up to $500 per Policy Year maximum | | Repairs to sound, natural teeth required due to an Injury | 100% of Reasonable Expenses up to $500 per Policy Year maximum | | Outpatient prescription drugs including oral contraceptives | 80% of actual charge | Pre-Existing Condition Limitation The Insurer does pay benefits for loss due to a Pre-Existing Condition. What is NOT Covered? Unless specifically provided for elsewhere under the Policy, the Policy does not cover loss caused by or resulting from, nor is any premium charged for, any of the following: - Preventative medicines, routine physical examinations, or any other examination where there are no objective indications of impairment in normal health.
- Services and supplies not Medically Necessary for the diagnosis or treatment of a Sickness or Injury.
- Surgery for the correction of refractive error and services and prescriptions for eye examinations, eye glasses, contact lenses or hearing aids, except when Medically Necessary for the Treatment of an Injury.
- Plastic or cosmetic surgery, unless they result directly from an Injury which necessitated medical treatment within 24 hours of the Accident.
- For diagnostic investigation or medical treatment for infertility, fertility, or birth control.
- Expenses incurred in excess of Reasonable Expenses.
- Expenses incurred for Injury resulting from the Covered Person’s being legally intoxicated or under the influence of alcohol as defined by the jurisdiction in which the Accident occurs. This exclusion does not apply to the Medical Evacuation Benefit, to the Repatriation of Remains Benefit and to the Bedside Visit Benefit.
- Voluntarily using any drug, narcotic or controlled substance, unless as prescribed by a Physician. This exclusion does not apply to the Medical Evacuation Benefit, to the Repatriation of Remains Benefit and to the Bedside Visit Benefit.
- Organ or tissue transplant.
- Participating in an illegal occupation or committing or attempting to commit a felony.
- For treatment, services, supplies, or Confinement in a Hospital owned or operated by a national government or its agencies. (This does not apply to charges the law requires the Covered Person to pay.)
- While traveling against the advice of a Physician, while on a waiting list for a specific treatment, or when traveling for the purpose of obtaining medical treatment.
- The diagnosis or treatment of Congenital Conditions, except for a newborn child insured under the Policy.
- Expenses incurred within the Covered Person’s Home Country.
- Treatment to the teeth, gums, jaw or structures directly supporting the teeth, including surgical extraction’s of teeth, TMJ dysfunction or skeletal irregularities of one or both jaws including orthognathia and mandibular retrognathia.
- Expenses incurred in connection with weak, strained or flat feet, corns or calluses.
- Diagnosis and treatment of acne and sebaceous cyst.
- Outpatient treatment for specified therapies including, but not limited to, Physiotherapy and acupuncture which does not follow a covered Hospital Confinement or surgery.
- Deviated nasal septum, including submucous resection and/or surgical correction, unless treatment is due to or arises from an Injury.
- Self inflicted Injuries while sane or insane; suicide, or any attempt thereat while sane or insane. This exclusion does not apply to the Medical Evacuation Benefit, to the Repatriation of Remains Benefit and to the Bedside Visit Benefit.
- Loss due to war, declared or undeclared; service in the armed forces of any country or international authority; riot; or civil commotion.
- Riding in any aircraft, except as a passenger on a regularly scheduled airline or charter flight.
- Elective termination of pregnancy.
- Loss arising from participation in professional sports, scuba diving, hang gliding, parachuting or bungee jumping.
- Medical Treatment Benefits provision for loss due to or arising from a motor vehicle Accident if the Covered Person operated the vehicle without a proper license in the jurisdiction where the Accident occurred.
- Under the Accidental Death and Dismemberment provision, for loss of life or dismemberment for or arising from an Accident in the Covered Person’s Home Country.
- Expenses incurred as a result of pregnancy that is not covered.
|