VISIT® International Health Insurance
             
Contact Us at epi@visitinsurance.com or 1-800-247-5575 or 1-703-660-9062

Educational Partners International

Teachers Health Insurance Plan from VISIT® Insurance
Plan E Plus 2020-2021
Effective August 1, 20
20
   

What IS Covered by VISIT® Plan E Plus?

  • Medical Expenses - $100,000 per each accident or illness

    Plan E Plus provides coverage for Accidents & Illness and medical emergencies.  Your Plan will cover visits to a Doctor, Specialist, Minute Clinic, Urgent Care, Emergency Room and Hospital, as well as associated X-rays, Lab work and Prescriptions.

    VISIT® Plan E Plus uses the UnitedHealthcare Medical Provider Network.  Be sure to have your doctor notify UnitedHealthcare in the event of any scheduled Hospitalization, Surgery and MRI/CAT Scans.

     

    An Emergency Room should only be used in the event of a life-threatening Medical Emergency.

  • Home Country Coverage - Your plan includes coverage for Incidental Trips to your Home Country:
    Up 14 days.

  • Dental - The plan will pay up to $300 for repair to a tooth due to an accident.  Coverage is for accidents only.

  • Repatriation and Medical Evacuation are included in your Plan E Plus

    Click Here to download the EPI Teacher Health Insurance Plans Overview

VISIT® PLAN E Plus Overview 

Coverages - Plan E Plus  MultiPlan
Benefits
Accident & Sickness Medical

Illnesses (examples of illnesses typically covered: cold, flu, pneumonia, infection, new allergies, bronchitis, urinary tract infection, conjunctivitis, pelvic pain, cyst, rash, eye swelling, nausea/vomiting, animal bites, ear infection, sinus pain, cuts, heart attack, stroke, high fever, sudden/severe stomach pains, etc.)

Accidents (examples of injuries typically covered by the Plan: medical expenses related to a car accident (max $50,000), broken bone, back injury due to a fall, injury from recreational sports, twisted or sprained ankle or wrist, etc.)
$100,000 per accident or illness

Plan E Plus
provides coverage for Accidents & Sickness and medical emergencies.  Your Plan will cover visits to a Doctor, Specialist, Minute Clinic, Urgent Care, Emergency Room and Hospital as well as associated X-rays, Lab work and Prescriptions.

Be sure to notify the UnitedHealthcare in the event of Hospitalization, Surgery and MRI/CAT Scans for a pre-certification.

Physical Therapy treatment requires a referral from a licensed doctor.

An Emergency Room should only be used in the event of a life threatening Medical Emergency.

PRE-CERTIFICATION:
  50% reduction of eligible medical expenses if pre-certification provisions are not met

The following must always be pre-certified for medical necessity before admission or receiving treatments and/or supplies: Any treatment requiring inpatient hospitalization, Surgery or surgical procedure, including outpatient surgery, CAT scans or MRI's, Care in an extended care facility, Home nursing care, Chemotherapy, Radiation Therapy, Interfacility Ambulance Transfer.

Preventive Care
(Annual Wellness Exams, school wellness exam and vaccinations)

NOT COVERED FOR DEPENDENTS
Preventive care and vaccinations are NOT covered by Plan E Plus.  However, EPI Teachers will receive a separate Crescent Health Solutions insurance card that will be used for Preventive care and Vaccines.  This coverage is for EPI Teachers ONLY

When you are visiting the doctor for these services, please present the Crescent Health Solutions insurance card, rather than then the VISIT® Plan E Plus UnitedHealthcare ID Card. (When visiting the doctor for an accident and/or illness, then you will present the VISIT® Plan E Plus UnitedHealthcare ID card.) If you have any questions regarding the Preventive Care coverage, please contact Crescent Health Solutions at 1-828-670-9145 and enter extension 3 directly or by email at epi@crescenths.com.

IMPORTANT:  Routine physical exams and vaccinations are not covered on the J2 Plan.  We recommend that you look for a local Community Clinic or go to a local Pharmacy to have these procedures as they can offer these services for a lower cost than going to a doctor's office.
Prescription Drugs

 

In addition to your VISIT® Plan E Plus Health Insurance ID card, you will receive two Discount Drug Cards (Universal Rx and AllyHealth) for your Prescriptions.  When going to the pharmacy, please present both Discount Drug Cards.  If the prescription is eligible for either discount, it will be applied at the time of your purchase.  If there is a remaining cost due after the discount, please pay the remaining balance to the pharmacy and keep the receipt.   To be reimbursed for the remaining balance of the prescription, please submit a PATIENT Claim Form with your receipt and a copy of your prescription.  The deductible and co-insurance apply.

Click here to download a copy of the Discount card to be used at your local pharmacy

Click Here to register your WellCard

Click here to compare prices for your prescription

 Click here to access Discounts through Lilly (Diabetic Medicine Assistance)

Deductible 
The deductible is the portion of your medical bill that is your responsibility.
$100 Annual Deductible

Your policy has a $100 ANNUAL DEDUCTIBLE.  This means you are responsible for the first $100 of medical expenses each year.  The deductible is paid to the doctor's office or the Medical Facility that has provided you treatment.

Emergency Room: $250
(For Illness only, if not admitted Injuries not subject to ER Deductible)

Copayment Walk In Clinic:  $15
Urgent Care:  $25
Coinsurance
Your share of the costs of a covered health care service, calculated as a percent of the allowed amount for the service.

In-Network - 100%

Out-of-Network - 80/20% Out-of-Network (Maximum out of pocket $1,000)

Local Ambulance
Injury & Illness resulting in Inpatient Hospital admission
100% up to maximum limit

Chiropractor Care
Physical Therapy

Medical Order required from a Doctor
100% In-Network

Emergency Medical Evacuation up to $1,000,000
Repatriation of mortal remains
(Must be approved in advance by the company)
Up to the maximum limit for return of mortal remains or ashes to country of residence, or $5,000 maximum limit for cremation or local burial at the place of death. Not subject to deductible
Pre-existing condition coverage

No coverage for any medical condition, sickness, Injury, Illness, disease that existed at the time of application or any time during the 36 months prior to the effective date of coverage under this policy.

Please consider upgrading to the ELITE, SHA or GEO Blue Plans if you or your dependent(s) have a pre-existing condition.  Click here to review the upgrade options.  Contact VISIT® for more information.
AD&D - Accidental Death & Dismemberment $25,000 per Insured/Spouse $5,000 per Dependent Child
Maternity coverage (including prenatal and miscarriage) No coverage
Please consider upgrading to the ELITE, SHA or GEO Blue Plans if you or your spouse require maternity coverage.  Click here to review the upgrade options.  Contact VISIT® for more information.
Home Country coverage 14 Days
Your plan includes coverage for Incidental Trips to your Home Country:
Up to $50,000. 
Dental (Accident Coverage only) To a maximum of $300 (available only if purchased for 1 month or more)
Dental

Discounts are available on some dental procedures through the WellCard.  For more information, visit the WellCard website at www.wellcardhealth.com/Public/DentalCare.aspx
Use Group# SC001600 to register

Emergency Eye Exam

Loss or Damage to prescription corrective lenses due to an accident


$150 Maximum Limit
$50 Deductible

Discounts are also available on eye exams and corrective lenses through the WellCard.  For more information, visit the WellCard website at www.wellcardhealth.com
Use Group#
SC001600 to register
Personal Liability $100,000
Trip Interruption up to $5,000
Return of minor child up to $100,000
Lost baggage up to $250
Assistance Services Included - 1-800-628-4664 / 1-317-655-4500
Press 0 between 7am-6pm (EST) OR Press 9 between 6pm-7am (EST)
View Policy Details  
 
What is NOT Covered by VISIT® Plan E Plus?


Preventive Care
-  Preventive care and vaccinations are NOT covered by Plan E Plus.  However, EPI teachers will receive a separate Crescent Health Solutions insurance card that will be used for Preventive care and Vaccines.  This coverage is for EPI Teachers ONLY.  When you are visiting the doctor for these services, please present the Crescent Health Solutions insurance card, rather than then the VISIT® Plan E Plus UnitedHealthcare ID Card. (When visiting the doctor for an accident and/or illness, then you will present the VISIT® Plan E Plus UnitedHealthcare ID card.) If you have any questions regarding the Preventive Care coverage, please contact Crescent Health Solutions at 828-670-9145 and enter extension 104 directly.

We also offer optional health plans (the SHA and GEO BLUE Plans) that provide some coverage for pre-existing conditions, mental health and maternity.  These optional plans have higher premiums.

Pre-existing conditions - Any medical condition, sickness, injury, illness, disease that existed at the time of application or any time during the 36 months prior to the effective date of coverage under this policy is NOT covered.  The SHA and GEO BLUE Plans provide some coverage for pre-existing conditions.  Please contact VISIT® at 703-660-9062 for more information.

Mental Health - Any mental and nervous disorders or rest cures are NOT covered.  This includes treatment for anxiety, depression, and stress related conditions.  Treatments by a Psychologist, Psychiatrist, Counselor or Medical Physician that has diagnosed a mental/nervous condition are not covered.  The SHA and GEO BLUE Plans provide some coverage for Mental Health.  Please contact VISIT® at 703-660-9062 for more information.

Maternity - Maternity including Pregnancy or Illness resulting from Pregnancy, childbirth, or miscarriage is NOT covered by Plan E Plus.  The SHA Plan provides coverage for maternity, however, you MUST be on the plan prior to conception.  The GEO BLUE Plan is available for coverage if you are already pregnant.  Enrollment can occur after conception; however, enrollment must occur within 3 months of conception, and enrollment must continue at least through delivery. Click here to review the upgrade options.  Please contact VISIT® at 703-660-9062 for more information.

Dental -
Regular dental care, treatment for cavities, root canals, and any other dental condition is not covered.  Damage to a tooth due to an accident is covered to a maximum of $500.  Discounts are also available on eye exams and corrective lenses through the WellCard.  For more information, visit the WellCard website at www.wellcardhealth.com
Use Group# SC001600 to register


Vision -
Glasses and Eye Exams are not covered.  Infections and medical conditions like Pink Eye may be covered.  Please contact the Claims Office with any specific medical condition questions.  Discounts are also available on eye exams and corrective lenses through the WellCard.  For more information, visit the WellCard website at www.wellcardhealth.com
Use Group# SC001600

Where Can I Find a Doctor or Hospital?   
(If you have an emergency medical condition, please
call 911 or your local emergency services number)
 
PRE-CERTIFICATION


Precertification is a requirement under your certificate for certain medical services.  Pre-certification is a general determination of medical necessity only, not an assurance of coverage, verification of benefits or a guarantee of payment.


The following must always be pre-certified for medical necessity before admission or receiving the treatments and/or supplies:

  • Any treatment requiring inpatient hospitalization
  • Surgery or surgical procedure, including outpatient surgery
  • CAT scans or MRI's
  • Care in an extended care facility
  • Home nursing care
  • Chemotherapy
  • Radiation Therapy
  • Interfacility Ambulance Transfer
During the pre-certification process, medical professionals review the planned medical services against standard medical criteria to ensure that the services are within accepted medical standards and are medically necessary. 
Precertification may be initiated by you, your representative or your medical provider.  This can be done through 
MyIMG, through the Client Resources page of www.IMGLOBAL.com or by calling IMG at 1-800-628-4664 (within the U.S.) or 1-317-655-4500. 

Most U.S. hospitals and physicians are familiar with the precertification process and will make the phone call for you, though they are not required to do this.  You are responsible for ensuring the precertification process is done five days before you are hospitalized or within 48 hours after an emergency admission to the hospital.

Click here to submit a Precertification online

How To Set-up Your MyIMG Account
Watch Now - How to Set-up Your MyIMG Account Video

 

Service at your fingertips anytime, anywhere - that’s what
MyIMG provides. MyIMG is our proprietary online service that allows you to access information and manage your IMG accounts, 24 hours a day, seven days a week, from anywhere in the world. Our service centers in the U.S. and Europe are always available to help or handle emergencies 24 hours a day, but through MyIMG you have immediate access to a wealth of information about your account and can manage routine areas to help you save time when you may need it most. Some features include:

  • Get explanation of benefits

  • Initiate precertification

  • Obtain certificate documents

  • Locate a provider

  • Recommend a provider/facility

  • Request or print ID cards

  • Submit a Claim online

  • Check the status of a Claim

Don't have an account?  Create an account

You will need to put in your Health Insurance ID Number and Date of Birth to set-up an account.  If you do not have your Health Insurance ID Number, please contact our office at 703-660-9062.

IMG Privacy Policy - www.imglobal.com/legal/privacy-policy 

 

How To File A Claim
Watch Now - How to Submit & Track Your Claim Video
 

DOCTORS Claim Form


Be sure your Doctor files your claim through UnitedHealthcare using the information found on your VISIT® Plan E Plus ID Card.  This will allow your doctor to file your claim electronically which will help expedite the claims process.  Your ID card includes a Member ID Number and a Group Number your Doctor must use to file the claim properly.  Improperly filed claims may be delayed or denied.

UnitedHealthcare Member ID: xxxxx
(
This number is found on your ID Card and is unique for each person)

Your Doctor may contact UnitedHealthcare at 1-800-628-4664 with any questions on how to submit a claim.

PATIENT Claim Form


You must also complete a PATIENT Claim Form.  This is a separate form than the Claim information provided by your Doctor.  Click here for a PATIENT Claim Form for you or your dependents.  You must submit the completed PATIENT Claim Forms to VISIT® within 90 days of your visit to the doctor or hospital.  SUBMIT YOUR PATIENT Claim Form Online: MyIMG  By email: epi@visitinsurance.com  Fax: 703-991-9164

How can I be reimbursed for medical payments I paid?
Any medical expense you have paid may be submitted to the claims office for reimbursement.  Please complete and submit a PATIENT Claim Form and include all receipts for expenses you have paid.

How do I Pay for My Prescriptions?
In addition to your VISIT® Plan E Plus Health Insurance ID card, you will receive two Discount Drug Cards (Universal Rx and AllyHealth) for your Prescriptions. Be sure to Register your WellCard online at www.wellcardhealth.com.  When going to the pharmacy, please present both Discount Drug Cards.  If the prescription is eligible for either discount, it will be applied at the time of your purchase.  If there is a remaining cost due after the discount, please pay the remaining balance to the pharmacy and keep the receipt.   To be reimbursed for the remaining balance of the prescription, please submit a PATIENT Claim Form with your receipt and a copy of your prescription.  The deductible and co-insurance apply.

If you have lost your ID CARD, please email us at epi@visitinsurance.com to request a replacement or you can download a copy from your MyIMG Account.

If you are filing for a reimbursement, you will need to file a Claim Form, please submit the original, itemized bills and payment receipts to us along with a Claim Form below. Claims must be filed within 90 days of your medical pro
cedure.

CLAIM FORMS
VISIT® E Plus Plans - Medical Claim Form - English
VISIT
® E Plus Plans - Medical Claim Form - Spanish
 
How do I check my Claim Status? 


How do I check on the status of my Claim?

For claims and benefits questions contact VISIT® at 1-800-628-4664 or you can check your MyIMG Account

If your Claim is showing as PENDING, please be sure to check the status of the claim on your MyIMG Account to see what information is needed to finalize your claim. 

There is no record of my claim
Contact your doctor's office and ask them to submit the claim to IMG.  If they say they have already submitted the claim, be sure to verify the address they sent the claim to and the date it was sent.  Email this information to insurance@imglobal.com and ask the Claims Office to research their records to see if the claim is in their system.  If the Claims Office is unable to locate the claim, please contact your doctor's office and ask them to resubmit the claim.  Claims can be mailed to:

International Medical Group, Inc.
Claims Department
PO BOX 88500
Indianapolis, IN  46208-0500 USA

Patient to submit a completed IMG Claim Form
You must complete a PATIENT IMG Claim Form to process your claim.  This form can be completed online through your MyIMG Account or you can download the IMG Claim Form and mail it or fax it to the claims office.

Charges pending receipt of medical records requested from provider
To process your claim, your doctor must provide the medical records to IMG for your treatment.  Please contact your doctor's office and ask them to submit your medical records to the IMG.  Medical records can be mailed to:

International Medical Group, Inc.
Claims Department
PO BOX 88500
Indianapolis, IN  46208-0500 USA

Your file has been closed due to a lack of response
This means that additional information has been requested but the Claims Office has not received the information.  The file can be reopened once the information is received.

In order to process these charges, please submit on a HCFA/UB Form Indicating Standardized procedure (CPT) and Diagnosis (ICD) codes.
These forms are standard forms that doctors use to file a claim with an insurance company.  Your doctor should have these forms available.  If they are not sure what to file or have questions, please have the them call IMG at 1-800-628-4664.

How long do I have to file a claim?
Your
IMG PATIENT Claim Form must be submitted to the IMG Claims Office within 90 days of your visit to the doctor, urgent care, emergency room and/or hospital.  You and your doctor, hospital and other healthcare and medical service providers and suppliers shall have one hundred eighty (180) days from the date a claim is incurred to submit a complete Proof of Claim, medical records and any additional information needed to process your claim.

Click Here - Answers to Frequently Asked CLAIMS Questions
For Members For Providers

VISIT® at 1-800-247-5575 or 1-703-660-9062
Monday - Friday 9am to 6pm, available by email after hours.

Email: epi@visitinsurance.com

For emergency and other assistance services Assist 24/7:
1-800-628-4664 (toll free) or
0-317-655-4505 (collect)

Click Here for 2018-2019 Plan Information

To a Report a Claim, Verify Eligibility or Check on the Status of a Claim Contact:
International Medical Group, Inc.
Claims Department
PO BOX 88500
Indianapolis, IN  46208-0500 USA

Phone: 1-800-628-4664
Fax:
1.317.655.4505
Email: insurance@imglobal.com

24-Hour Worldwide Assistance Services:
1-800-628-4664 / 1-317-655-4500
Press 0 between 7am-6pm ( EST )Press 9 between 6pm-7am (EST)


Health Insurance Optional UPGRADES 2020-2021
Upgrade Comparison

We also offer optional health plans (VISIT® ELITE, SHA, and GEO BLUE Plans) that provide some coverage for pre-existing conditions, mental health, and maternity. These optional plans have higher premiums, please contact VISIT® at 703-660-9062 for more information. The EPI Teacher MUST be the Primary Insured on these plans for the dependent to be eligible. Please Complete the Application Form by the 20th of the prior month of enrollment. The enrollment start date is on the 1st of the Month only.

GEO BLUE - www.visitinsurance.com/epi-geoblue.html

VISIT® Elite www.visitinsurance.com/epi-elite.html

SHA - www.visitinsurance.com/episha.html

Important Insurance Terms


What is a Deductible?

For a covered medical expense, the deductible is the portion of your medical bill that is your responsibility.  The deductible will first be subtracted from the total medical bill and you will need to pay this portion directly to the doctor or hospital. 

Your deductible is $100 per year.

What is Co-insurance?
After You pay the Deductible, the plan pays 80% of the next $5,000 of eligible expenses, then 100% to the selected Medical maximum.

How do I Pay for My Prescriptions?
Prescriptions are a reimbursable expense. You will need to pay for your prescription and then complete a claim form to be reimbursed.

If you need to apply for a reimbursement, download a Claim Form.
VISIT® E Plus Plans - Medical Claim Form - English
VISIT® E Plus Plans - Medical Claim Form - Spanish



What is a pre-existing condition?

A Pre-existing condition means any medical condition, sickness, Injury, Illness, disease, Mental Illness or Mental Nervous Disorder, regardless of the cause including any congenital, chronic, subsequent, or recurring complications or consequences related thereto or resulting therefrom that with reasonable medical certainty existed at the time of application or any time during the 36 months prior to the effective date of coverage under this policy , whether or not previously manifested , symptomatic, known, diagnosed , treated or disclosed. This specifically includes but is not limited to any medical condition, sickness, Injury , Illness, disease, Mental Illness or Mental Nervous Disorder , for which medical advice , diagnosis , care or treatment was recommended or received or for which a reasonably prudent person would have sought treatment during the 36 month period immediately preceding the effective date of coverage under this policy.

What is Precertification?
Emergency Pre-certification: In the event of an Emergency Hospital admission, Pre-certification must be made within 48 hours after the admission, or as soon as is reasonably possible.

Pre-certification Does Not Guarantee Benefits – The fact that expenses are Pre-certified does not guarantee either payment of benefits or the amount of benefits. Eligibility for and payment of benefits are subject to all the terms, conditions, provisions and exclusions herein.

Concurrent Review – For Inpatient stays of any kind, the Plan Administrator will Pre-certify a limited number of days of confinement. Additional days of Inpatient confinement may later be Pre-certified if a Member receives prior approval.

What is a Reasonable & Customary charge?
Reasonable and Customary charge is the amount normally charged by medical service providers for similar services and supplies in your area of living.  Doctor's not in the Multiplan Network are not required to charge the Reasonable and Customary charge.  Please note: Going to a doctor or hospital outside the UnitedHealthcare Network may result in higher payments for your medical procedure and a higher out-of-pocket expense for you and your family.

What is Medical Evacuation?
Medical Evacuation means transferring the insured person to the nearest hospital or medical facility in case of an emergency injury or sickness or back to his/her home country. It can be done by any necessary means of transportation. 

What is Repatriation?
In case of death, the Repatriation benefit covers the transportation of your remains back to your family and your home country. 

Are Injuries from Sports Covered?
Recreational sports are covered through the regular medical coverage.  Injuries from intercollegiate, interscholastic, intramural or club sports are not covered.

Is there Dental Coverage?
There is limited coverage injury to natural teeth on your policy.

Do I need a referral to go to a Specialist?
A doctor’s referral typically is not required.   
 

Important Contact Information
   
Contact VISIT®
   

VISIT® International Health Insurance Programs
P.O. Box 210
Mount Vernon, VA  22121
Phone: 1-703-660-9062 / 1-800-247-5575
Fax: 1-703-991-9164
Email: epi@visitinsurance.com

Hours:
Monday - Friday 9:00 am to 6:00 pm.
Available by email after hours!

 

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VISIT® International Health Insurance Program
www.visitinsurance.com/epi.html
Correspondence: P.O. Box 210, Mount Vernon, VA  22121 (703) 660-9062/ (800) 247-5575/ (703) 991-9164 fax
email:
 epi@visitinsurance.com

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