24/7 Emergency Assistance – Team Assist
*trips 22 days or longer, the Monthly Rate applies
You must enroll for the full duration of your program or sponsored activity with Texas A&M University System. The earliest your coverage can begin is two days from now. Rates are based on full months and are not prorated. You may purchase coverage for additional days directly before and/or after the actual dates of your program, but the total number of additional days may not exceed 30. Coverage must be in place for the full duration of time on the program, including any time spent on campus prior to the commencement of classes/sponsored activities and must be purchased in a single transaction (month-by-month enrollments are not permitted). If coverage is desired for a subsequent term at a later time due to a change of plans, it should be purchased with an effective date which directly follows the end date of the current policy so as to ensure there are no gaps in coverage.
Certain policy conditions (such as the waiting period for pre-existing conditions) will automatically reset in the event that coverage periods are not consecutive. Please note that this is considered a short-term limited duration policy. The policy does not constitute comprehensive health insurance coverage (often referred to as “major medical coverage”). Benefits and exclusions can be found within the brochure on the left-side menu and should be carefully reviewed prior to waiving out of any other plans that may be offered to you.
To enroll your dependents, please complete the “Dependent Enrollment Form” posted on the left-side menu bar and submit to firstname.lastname@example.org. You must be enrolled in this coverage in order for your dependent(s) to be enrolled. Dependent coverage dates cannot exceed your coverage dates.
|Coverages and Services||Maximum Limits|
|TRAVEL ACCIDENT INDEMNITY INSURANCE|
|Accidental Death and Dismemberment Per Insured Person||$10,000|
|ACCIDENT AND SICKNESS INSURANCE|
|Medical expenses (per Covered Accident or Sickness):|
|Annual Deductible||$250 In-Network / $500 Out-of-Network|
|Coinsurance||80% In-Network / 60% Out-of-Network|
|Out-of-Pocket Expense Maximum||$2,500 In-Network / $5,000 Out-of-Network|
|Student Health Center Copay||$0|
|Office Visit Copay||$25 In-Network / $50 Out-of-Network|
|Hospital Copay||$100 In-Network / $200 Out-of-Network|
|Emergency Room Copay (waived if admitted)**||$200 In-Network / $400 Out-of-Network|
|MRI/Cat Scan Copay||$100 In-Network / $200 Out-of-Network|
|Prescription Drugs (Inpatient/Outpatient)||80% of Covered Expenses|
|**The Emergency Room Copay will be waived if the Insured Person is admitted to the Hospital as an inpatient or if the illness is life threatening. Life threatening means the illness will likely cause the death of the Insured Person.|
|TRAVEL ASSISTANCE INSURANCE|
|Emergency Medical Reunion||(incl. hotel/meals, max $100/day) $2,500|
|EVACUATION AND REPATRIATION INSURANCE|
|Emergency Medical Evacuation||$100,000|
|Repatriation/Return of Mortal Remains||$100,000|
|Security Evacuation (Comprehensive)||$50,000|
Team Assist Plan (TAP): 24/7 medical, travel, technical assistance
**The Emergency Room Copay will be waived if the Insured Person is admitted to the Hospital as an inpatient or if the illness is life threatening. Life threatening means the illness will likely cause the death of the Insured Person.
Please see the brochure posted on the left-side bar under ‘Brochure/Plan Info’ to view all plan benefits and exclusions.
This policy is a short-term limited duration insurance policy and provides coverage for individuals traveling outside of their home country. This policy does not constitute comprehensive health insurance coverage (often referred to as “major medical coverage”), and does not satisfy a person’s obligation to secure the requirement of minimum essential coverage under the Affordable Care Act (ACA).
Please contact the Team Assist line by phone at 1-877-714-8179 (in the US) or +001 603-952-2660 (outside of the US - collect calls accepted) or email email@example.com. The Team Assist Emergency Assistance Provider is On Call International. Non-Emergency questions may be directed to CISI at 203-399-5130 (toll free 800-303-8120).