Call:
+1-866-404-2062
Fax:
1-203-399-5596
Email:
Claim Submissions: submityourclaim@mycisi.com
Claim Questions: inquiries@mycisi.com
CareMed Travel Insurance
1 High Ridge Park
Stamford, CT 06905
The plan is provided by CareMed Insurance, in Cooperation with CISI and underwritten by Chubb
Coverage Summary
| Travel Health | Maximum Limits |
|---|---|
| Maximum per Covered Accident or Sickness | $250,000.00 |
| Outpatient Physiotherapy | $500.00 |
| Psychiatric Evaluation | $250.00 |
| Dental Treatment for Injuries ONLY | $750.00 |
| Emergency Dental Treatment for Alleviation of Pain | $250.00 |
| Medical Preparations & Devices | $150.00 |
| Emergency Medical Evacuation | $50,000.00 |
| Repatriation of Remains | $25,000.00 |
| Deductibles: | |
| Non Emergency Treatment in Hospital Emergency Room | $250 per Covered Sickness |
| All other Services/Treatments | $100 per covered accident or sickness |
| Maximum Per Policy Term: | |
| Outpatient X-rays, Diagnostic Testing and Laboratory Services | $500.00 |
| Outpatient Diagnostic CAT Scan and MRI Testing | $1,000.00 |
| Outpatient Medical Aids | $150 |
| Team Assist 24-7 Support | Included |
Please contact our 24/7 assistance team, Robin Assist within the USA by dialing 855-327-1411, or from outside of the USA (call collect) 312-935-1703 or by email at medassist-usa@axa-assistance.us.
For illnesses or injuries that are not life threatening, please utilize our provider search tool to find an Aetna Urgent Care, Walk in Clinic or Physician’s office near you. This Policy utilizes the Aetna Provider hospital and Doctor network for the purpose of delivering quality health care at a preferred fee. You are not required to use the PPO network but you may incur expenses that are not covered under your policy by utilizing an out of network provider. Please contact CareMed for additional information. You are also welcome to use Retail Clinics at CVS, Walgreens, Walmart, Target or Kroger stores.
If you visit a medical provider (doctor, hospital, clinic, etc) that is not part of the Aetna network, you may be required to pay for these services yourself. If so, please specifically request an itemized bill from the medical provider to submit to your insurance. The itemized bill includes diagnosis and procedure codes necessary to process a claim. This type of bill is standard in medical billing in the United States. Once you have this, a claim form can be completed and submitted to CareMed.
If you are being treated for an illness or injury which would otherwise be covered under your CareMed policy, your physician prescribed medication would also be covered. All prescription medications must be paid by you to the pharmacy at the point of purchase. You are encouraged to download the Prescription Rx Card.
A claim for reimbursement can be made by submitting the prescription receipt and a completed claim form. The prescription receipt is normally stapled to the outside of the pharmacy bag and includes your name, your physician’s name, the name of the medication, the dosage and the amount charged. Cash register receipts will not be considered for reimbursement. Once you have this, a claim form can be completed and submitted to CareMed.
A claim form should be completed. Please be sure to include a brief description of the accident or illness that treatment was received for. The claim form will need to be submitted with any itemized bills that you have.
Instructions:
A claim for reimbursement can be made by submitting the prescription receipt and a completed claim form . The prescription receipt is normally stapled to the outside of the pharmacy bag and includes your name, your physician’s name, the name of the medication, the dosage and the amount charged. Cash register receipts will not be considered for reimbursement. If you no longer have the prescription receipt most pharmacies can reprint it for you. Reimbursement claims cannot be processed with register receipts.
For claim submission questions, call (203) 399-5130, or email submityourclaim@mycisi.com.
Claim forms are requested when additional information on an illness or injury is needed. Please complete the form detailing as much information as you can about your condition. Some information we could be looking for: If an illness: When did you first notice symptoms? What were the symptoms? Where you treated for this condition previously? If so, when? If an injury: Where were you when the injury happened? What were you doing? How did the injury occur?
You may have submitted a claim that did not include the diagnosis and procedure coding needed to process your claim. First, check your original submission. Did you submit a receipt or a statement from the medical provider? This is generally what is provided to patients but additional information is needed for insurance processing.
If you are looking for CareMed to pay your claim to the medical provider
Contact the medical provider that has billed you and ensure that they have your insurance information. At the time you received our letter, we would have sent the same letter to the medical provider requesting the same bill. However, if you did not provide that medical provider with your insurance information, they may be unwilling or unable to send CareMed the itemized bill due to privacy laws. You will need to submit your insurance information to the medical provider (there are usually spaces on the back of your statement from the facility with spaces to complete this information) and send it back to the provider. They also may be able to take this information from you over the phone. This way, they can send CareMed what is needed directly.
If you are looking for reimbursement from CareMed for medical services you have paid
You likely only submitted a receipt of payment to CareMed. You can contact the medical provider whom you paid and ask for an itemized bill to submit to your insurance company. This type of billing is standard in the United States. The provider can send this bill to you and then you can resubmit a claim to CareMed or the provider is welcome to send this directly to CareMed.
Phone 1-866-404-2062
Email inquiries@mycisi.com
Fax 1-203-399-5596
Mailing Address CareMed Travel Insurance, 1 High Ridge Park Stamford, CT 06905
Provider Look Up www.aetna.com
Routine care, wellness, preventative care, dental cleaning, vision are the most common expenses that are not covered by insurance.
If you come to the USA with a condition that is currently being monitored/treated or taking medication, then unfortunately your insurance will not cover these types of expenses.
| Schedule of Benefits | |
| Benefits | Limits |
| Medical Expenses Limits: | |
| Lifetime/Annual Maximum | Unlimited |
| Per Accident or Sickness | $250,000 |
| Per Occurrence Deductibles: | |
| Emergency Room Deductible (waived if admitted) | $250 |
| Call-A-Doc | $0 |
| Physician/Outpatient/Dr. Visit | $100 |
| Urgent Care | $50 |
| Walk in Clinic | $25 |
| MRI/CAT Scan | $0 |
| Rx Copay | $0 |
| Pre-Existing Conditions-12 Month Look Back; thereafter up to policy max | Up to $500 |
| Coinsurance Percentage (%) | 100% Coinsurance |
| Prescription Drugs (inpatient/outpatient) | Inpatient: 100% of Covered Expenses Outpatient: 100% of Covered Expenses |
| Mental Health | Inpatient up to 30 days/Outpatient 30 visits |
| Pregnancy (conception must occur while covered under this plan) | Treated as any other illness |
| Physiotherapy | Covered |
| Chiropractic Care & Therapeutic Services | Up to $500 max, $50 per visit |
| Emergency Reunion | $15,000 (hospitalized 3 days) |
| Home Country (Incidental Trips) | $1,000 |
| Trip Delay (applies mid trip as well) 24-hour time | Up $1,500/daily limit $100 |
| Political Evacuation | $10,000 |
| Dental Injury Only | Up to policy max |
| Palliative Dental | $1,000max/$200 per tooth |
| 24/7 Assistant Services & In-house Crisis Team | Included |
| Medical Evacuation | $50,000 |
| Repatriation of Remains | $25,000 |
| Accidental Death & Dismemberment | $15,000 ($1M aggregate limit) |
| Schedule of Benefits | |
| Benefits | Limits |
| Medical Expenses Limits: | |
| Lifetime/Annual Maximum | Unlimited |
| Per Accident or Sickness | $2,000,000 |
| Per Occurrence Deductibles: | |
| Emergency Room (waived if admitted) | $250 |
| Call-A-Doc | $0 |
| Physician/Outpatient/Dr. Visit | $50 |
| Urgent Care | $50 |
| Walk in Clinic | $25 |
| MRI/CAT Scan | $0 |
| Rx Copay | $0 |
| Pre-Existing Conditions-12 Month Look Back; thereafter up to policy max | Up to $500 |
| Coinsurance Percentage (%) | 100% Coinsurance |
| Prescription Drugs (inpatient/outpatient) | Inpatient: 100% of Covered Expenses Outpatient: 100% of Covered Expenses |
| Mental Health | Inpatient up to 30 days/Outpatient 30 visits |
| Pregnancy (conception must occur while covered under this plan) | Treated as any other illness |
| Emergency Reunion | $15,000 (hospitalized 3 days) |
| Physiotherapy | Covered |
| Chiropractic Care & Therapeutic Services | Up to $500 max, $50 per visit |
| Home Country (Incidental Trips) | $1,000 |
| Trip Delay (applies mid trip as well) 24-hour time | Up $1,500/daily limit $100 |
| Political Evacuation | $10,000 |
| Dental Injury Only | Up to policy max |
| Palliative Dental | $1,000max/$200 per tooth |
| 24/7 Assistant Services & In-house Crisis Team | Included |
| Medical Evacuation | $50,000 |
| Repatriation of Remains | $25,000 |
| Accidental Death & Dismemberment | $15,000 ($1M aggregate limit) |
| Trip Interruption | $1,000 |
| Personal Liability | |
| Personal Liability Limit | $2,000,000 |
| Liability deductible | $100 |
| Medical Payments to Others | $25,000 | Additional Living Expenses | $10,000 |
| Payment of Homeowners Deductible | $1,000 |
| Personal Property | $1,500 |
You are now being directed to Travel Insured International. On this page, you will be able to review a quote for Trip Cancellation for Any Reason and Trip Interruption for Any Reason. Please keep in mind this plan is completely separate from the CISI AIFS Abroad Insurance Coverage. This plan can be purchased with a major credit card.
Click here to proceed: Trip Cancellation & Interruption Protection for Academic Travel (culturalinsurance.com)
Salvator Mundi International
Viale Mura Gianicolensi 67
00152 Roma
Tel: +39 06 588961
(Private Hospital)
Aventino Medical Group
Via Sant’Alberto Magno, 5, apt. 3,
00153 Rome, Italy
Tel: +39 06 5728-8349 or 06 578-0738
(Private Clinic)
*You do not need to contact TeamAssist before visiting this provider. Your ID Card is sufficient.
Mater Dei
Via Bertoloni, 34
Tel: +39-068-22-01
(Private Hospital)
EuroSanita (Villa Stuart)
Via Trionfala, 5952
00136 Roma
(Private Clinic)
*You do not need to contact TeamAssist before visiting this provider. Your ID Card is sufficient.
Casi di Cura Santo Volta Hospital
Piazza del Tempio di Diana, 13 Roma
(Private Hospital)
*Student should contact Team Assist before admission.
Paideia
Via Vincenzo Tiberio, 46
Tel: +39-063-309-41
(Private Clinic)
Valle Giulia
Via de Notaris, 2/8
Tel: +39-063-247-91
(Private Clinic)
Dr. Julia Chabrera
Av. Reina Mercedes 29, Bajo, Ext. D.
41012 Sevilla
Tel: +34-954-61-26-40
clinicachabrera@gmail.com
Clinica Fatima
C/Fglorieta de Mexico No. 1
41012 Sevilla
Tel: +34-954-613-300
(General Practice Clinic)
Usp Clinica Sagrado Corazon
C/Rafael Salgado No. 3
41013 Sevilla
Tel: +34-954-937-676
(Multi specialty clinic)
Policlinica los Remedios
c/ Fernando IV 24, 41011
Seville, Spain
Tel: 34 954 279 786
esther.policlinica@hotmail.es
(General Practice Clinic)
*You do not need to contact TeamAssist before visiting this provider. Your ID Card is sufficient.
Centro Medico Nervion
Av. San Francisco Javier No. 18
41000 Sevilla
Tel: +34-954-659-955
(General Practice Clinic)
American Hospital of Paris
63 Boulevard Victor Hugo 92200 Neuilly-sur-Seine, France
Tel: 01 46 41 25 25
(Private Hostpital)
Clinique Ambroise Pare
7 Boulevard Victor Hugo 92200 Neuilly-sur-Seine
Tel: 08 26 20 03 00
(Private Clinic)
Centre Medical Europe
44 rue d’Amsterdam 75009
Tel: 01.42.81.93.33
(Private Clinic)
International Medical Center of Paris
29 av. General Leclerc 75014 Paris
Tel: +33(0)143950055
Email: j.duplessisnelson@gmail.com
(Private Clinic)
Dr. Anne Valerie Meyers
10, Rue Royale – Dorrway C, 4th Floor – 75008 Paris
Phone: +33 (0)1 42 66 47 82
Email: avm@prontomail.com
*You do not need to contact TeamAssist before visiting this provider. Your ID Card is sufficient.
(General Practicioner)
Dr. Nancy Salzman
1 avenue de Lowendal – 75007 Paris – France
Phone: +33 (0)1 45 63 18 43
Email: drsalzman@noos.fr
(General Practitioner & Gynecology)
Justine Du Plessis Nelson
11, Rue Bosio – 75016 Paris – France
Tel: +33 (0)1.6.17.92.62. 50
Email: j.duplessisnelson@gmail.com
*You do not need to contact TeamAssist before visiting this provider. Your ID Card is sufficient.
(Mental Health / Psychologist)
Dr. Suzanne Black
+33 (0)6 3206 5806,
Email: drsuzablack@gmail.com (Appointment location will depdend upon treatment needs)
*You do not need to contact TeamAssist before visiting this provider. Your ID Card is sufficient.
(Mental Health / Psychologist)
Sharon Korman, Psychotherapy
91 Rue du Theatre – 75015 Paris
Tel: +33 (0)6 50 02 30 66, korman.lmft@free.fr
*You do not need to contact TeamAssist before visiting this provider. Your ID Card is sufficient.
(Mental Health / Psychotherapy)
Marie Rose Richardson
66 Rue de Lisbonne 75008 Paris
*You do not need to contact TeamAssist before visiting this provider. Your ID Card is sufficient.
(Mental Health)
You are now being directed to Travel Insured International. On this page you will be able to review a quote for Trip Cancellation for Any Reason and Trip Interruption for Any Reason. Please keep in mind this plan is completely separate from the CISI Boston College Travel Abroad Insurance Coverage. This plan can be purchased with a major credit card.
Click here to proceed: Trip Cancellation & Interruption Protection for Academic Travel (culturalinsurance.com)