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Lost your insurance card?
Contact Christine Wasil at (800) 928-7247 ext. 5130 or email cwasil@aifs.com. Include your full name, ID number and your Host Family’s address.
All au pairs are covered under a medical insurance policy arranged
by Au Pair in America. The cost of this policy is covered by the
program fees that the host family pays. Details of the medical insurance,
including the policy number, dollar limits of coverage, and excluded
illnesses, can be found here
(this document is a pdf file; to read this document, you will need
to download Adobe
Acrobat Reader if you do not already have it).
List of Preferred Physicians, Hospitals and Medical Centers
To access a listing of preferred physicians, hospitals
and medical centers in the U.S., please visit http://partnertools.hygeia.net/culturalinsurance.
If there is no participating provider in your area, then you may
use any physician or hospital.
Insurance and Claim Filing Process Outline
This is a brief outline of the insurance and claim filing
process. Please consult the brochure provided for detailed policy
information.
The insurance policy has a yearly deductible. This means that the
first $200 of medical expenses ($100 for aupairs with the comprehensive
coverage) each year is your responsibility to pay. You need to submit
the itemized bills for these expenses to the insurance company, so your
expenses can be credited to your deductible. Once this deductible
is paid, if the doctor will accept payment from the insurance, the
bills can be paid directly to the doctor.
Here are the benefits offered under each plan:
| Basic Plan |
Comprehensive Plan |
|
$200 deductible
$100,000 of coverage per illness/injury
$500 of Emergency Dental coverage
Team Assist Plan
Personal Liability coverage
Coverage for 12 months |
$100 deductible
$500,000 of coverage per illness/injury
$500 of Emergency Dental coverage
Team Assist Plan
Personal Liability coverage
Coverage for 13 months
$1000 of personal effects coverage |
Insurance for Extension Au Pairs/Companions:
Au pairs/companions will continue to have full medical coverage
provided by the Basic Plan.
Au pairs/companions who upgraded to the Comprehensive Plan prior
to arrival in the U.S. must continue the coverage under the comprehensive
plan for the extension period and will be required to pay an additional
fee for this coverage. The fee is $290 for a 12-month extension,
$230 for a 9-month extension, and $175 for a 6-month extension term.
Au pairs/companions are subject to the annual deductible during
the extension term.
How to file a claim:
Au pairs can use any medical provider that they wish and are not
limited to specific places; however, in some cases the doctor will
require the au pair to pay the bill at the time of service and obtain
reimbursement from the insurance. As of 3/1/05, we now belong to
the Hygeia/First Health Network. This means that there is a list
of doctors who will accept the insurance, and if you can locate
a doctor in your area on this list, they will accept payment from
the insurance directly, after your deductible is paid, and as long
as the condition is covered under the insurance. You will not have
to make additional payments when you visit the doctor. For a link
to search for the doctors in your area, click
here. If you can’t find a doctor on the list, you can
go to any physician.
When you use your insurance for the first time, you are responsible
to pay your deductible, whether the physician is on the list or
not. If the doctor or hospital is not on the list of doctors who
accept the insurance, you may be required to pay for the services.
If this happens, please ask for a completely itemized bill from
the doctor’s office and submit the bill, along with your completed
claim form, to Cultural Insurance Services International for reimbursement.
Please note that when purchasing prescription medication, you must
always pay the pharmacy and then submit the receipt for reimbursement
or credit to your deductible.
Exclusions:
Some of the most frequently occurring exclusions are the following:
- Pre-existing conditions
This is any condition that existed prior to coverage. This also
applies even if the condition started before you arrived but you
did not have any medical attention. If you had no symptoms or
treatment of a condition within the 12 months prior to arrival,
then this exclusion does not apply.
- Routine services
There is no coverage for any routine medical, dental or vision
examinations. This includes physical exams that may be required
by school and immunizations.
- Alcohol/drug related
Any illness or injury caused by your use of alcohol or illegal
drugs is not covered
- Pregnancy and pregnancy testing are not covered
- Birth control is not covered
- Mental nervous conditions including eating disorders are not
covered.
- Dental services are not covered except in the case of an accidental
fall or blow to the face causing damage to a sound natural tooth.
These are the most common exclusions. There is a detailed list
in the insurance brochure that has been provided to you. If you
require a replacement brochure or claim form, click
here.
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