Aetna
Global Benefits
Global Personal Health Plan
(for groups only)
Global Medical Benefits
Our Global Personal Health Plan offers a unique range of medical benefits
for global Members, including:
Continuous Worldwide Coverage
Global Personal Health provides you and your dependents with continuous
worldwide coverage that remains with you virtually anywhere you may travel
or be located while residing overseas.
Coverage for you and your dependents
All international travelers and/or residents and their dependent spouse/children
are eligible for coverage under Global Personal Health, except for those
residing in the United States, Puerto Rico, the U.S. Virgin Island, Bermuda,
or U.S. embargo countries. Coverage for individuals over age 70 is also
available for non U.S. citizens after they have been an AGB member over
10 years.
No lifetime Maximum
With our Global Personal Health Plan, there is no lifetime maximum in
terms of coverage. Without a lifetime maximum, you are free to obtain
the care you need, without fear of exceeding an imposed coverage limit.
Access to U.S. Care
With an Open Choice Personal Health Plan
Should you or your dependents chose to sees care within the U.S. our Open
Choice Plans provide access to a nationwide network of doctors and hospitals
through an agreement with Aetna U.S. Healthcare, Aetna's U.S. benefits
company. Aetna's network of credentialed providers is the largest in the
U.S., today, with over 380,000 providers, including 2,400 participating
hospitals. Aetna's pre-negotiated discounts with these providers are extremely
competitive because of Aetna's continually growing U.S. membership. Today,
Aetna is the largest provider of health care in the world with over 20
million health members globally. We encourage you and your dependents
to seek care through these providers while in the U.S., though we do not
require you to do so. Some key advantages of utilizing of utilizing Aetna's
Preferred Providers include:
· Reduction in health care costs and lower out-of-pocket expenses.
· Higher level of benefits.
· Elimination of claims filing.
· Access to quality medical programs and providers that offer the
latest, most efficient and effective treatments.
Emergency Evacuation and Medical Assistance
AGB works with Baltimore, MD bases MEDEX Assistance Corporation to offer
you and your dependents access to emergency medical evacuation and other
assistance services 24 hours a day, 365 days a year. Emergency assistance
services include:
· Medically Necessary Emergency Evacuations.
· Medical Referrals.
· Access to worldwide network of providers.
· Transportation after initial evacuation.
· Confinement Visitation.
· Return of dependent children.
· Emergency medication, vaccine and Blood Transfers.
· Hospital deposit and emergency cash advance.
· Repatriation of mortal remains.
· Legal referral assistance.
· Translation services.
· Emergency message transmittal.
· Assistance with lost or stolen passports
· Assistance in obtaining necessary specialists.
Wellness Program
The Global Personal Health Plan includes the Aetna Wellness Program. This
Program provides coverage for several types of annual exams, which help
monitor and maintain the overall health and well-being of both you and
your dependents. Annual exams covered under our Wellness Program include:
· Annual physical check for all Members.
· Annual mammography screening at age 40 and over ("Well Women
Program").
· Annual physical check-up and vaccinations for babies ("Well
Baby Program")
· Annual prostate check-up for men as needed.
Reimbursement for Prescription Drugs Purchased Overseas
Outside the U.S., we realize that the term "prescription drug"
may apply to drugs that might not be FDA approved, or might be considered
over-the-counter in the U.S. (e.g. aspirin can be considered a prescription
drug in some countries.) Because there are many variables overseas in
terms of what is and is not considered a prescription drug, we consider
each drug purchase carefully and provide reimbursement s as appropriate.
Because prescription drug guidelines vary from country to country, our
reimbursement guidelines are also variable and flexible.
Global Member Services
Our Global Personal Health Plans offer a wide range of Global Member Services
including:
24-Hour Emergency Medical Evacuation and Assistance
Through MEDEX Assistance Corporation, AGB's emergency services providers,
you and your dependents can obtain emergency assistance for evacuations
and other medical needs, including consultation with medical personnel,
24 hours a day, 2365 days a year via MEDEX'S global multilingual hotline.
For more information on services provided through MEDEX, please refer
to the section called "Emergency Evacuation and Medical Assistance."
International Claims Management
The AGB international Claim Processing Unit, housed in Tampa, Fl, is dedicates
to the management and processing of international claims for you, our
global Members, Our Member Service Representatives and Claim Processors
utilize a custom-built call tracking system which is integrated with our
claim payment, benefits and eligibility systems to allow seamless access
to all account information. Using this system, Members Service Representatives
can access all Member information simultaneously, and provide current
status on claim payments. Claims are typically processed within 10-12
business days.
Claim Reimbursement in Foreign Currency
AGB offers claim reimbursements in 100 + foreign currencies, including
US dollars and Euros. Payments are made via check or wire transfer, as
available, direct to your US or overseas bank accounts. Currency rates
applied to calculate the correct reimbursement amount based upon date
service was rendered.
Multilingual Services
AGB offers translation services and foreign language capabilities through
a variety of sources:
Real-time Translations Assistance via Phone
AGB offers real-time translation assistance through the AT&T language
Line. Should you need immediate translation/interpreter assistance, you
may contact our Member Service Representatives via toll-free phone, 24
hours a day, 7 days a week. Our service representatives will then conference
in an AT&T language line representative who will act as a translator
for you and or your medical provider as needed.
Translation of Foreign Language Claims
AGB offers translation of foreign language claims through our international
claim unit. We employ a multilingual staff, experiences in the translation,
administration and investigation of foreign claims. We will accept and
process claim forms submitted in nearly any language. Should there be
a language for which we do not have in-house expertise, we utilize an
outside vendor to assist with translation.
In-country Language Assistance from Medical Personnel
Through our Emergency Service provider - MEDEX Assistance Corporation
- we can direct you and your dependents to providers and hospitals where
you will be the most comfortable and receive quality care (primarily Western-style,
English speaking providers). <EDEX also employs Regional Medical Advisors
(RMAs) throughout the world. These RMAs are full-time employees of MEDEX,
on call 24 hours a day, 7 days a week to assist you and your family members.
They are Western-trained physicians who speak the local language and are
familiar with local customs and medical treatments. In time of crisis,
their intervention and assistance with the treatment process can greatly
help members - not only by providing interpreter capabilities, but also
by consulting with local with physicians to help determine appropriate
treatment options.
Global Personal Health
Plan Options
OPEN CHOICE |
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Plan Features: In The UnitedStates |
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In-Network |
Out-Network |
Outside Of The U.S. |
|
Physician Office Visits |
100% - $10 |
70% |
100% |
Other Physician Charges |
90% |
70% |
100% |
Hospital Inpatient |
90% |
70% |
100% |
Hospital Outpatient |
90% |
70% |
100% |
Inpatient Treatment of Mental and Nervous Disorders, Alcoholism, and Drug Abuse |
90% |
70% |
100% |
Outpatient Treatment of Mental and Nervous Disorders, Alcoholism, and Drug Abuse |
90% |
70% |
100% |
Maximum Lifetime Benefit for Treatment of Mental and Nervous Disorders, Alcoholism And Drug Abuse |
$25,000 |
$25,000 |
$25,000 |
Home Health Care, Convalescent Home and Hospital Care |
80% |
80% |
100% |
Other Medical Expenses |
80% |
80% |
100% |
Medical Evacuation |
MEDEX |
MEDEX |
MEDEX |
Emergency Room |
90% |
90% |
100% |
Wellness Benefits |
100%-$10 $250 Max. |
70%* $250 Max. |
100% $250 Max. |
Prescription Drugs |
80% |
80% |
80% |
Maternity |
Not Covered For 12 Months |
Not Covered For 12 Months |
Not Covered For 12 Months |
Pre-Existing Conditions |
Not Covered For 12 Months |
Not Covered For 12 Months |
Not Covered For 12 Months |
Over Age 70 Feature |
Yes |
Yes |
Yes |
Maximum Lifetime Benefit |
Unlimited |
Unlimited |
Unlimited |
*Services Covered At 80% If Rendered outside Network Location.