Life in the US: Insurance

Life in the US

Life in the United States: Insurance

Regular Insurance Details | Travel Month Insurance

Regular Insurance Details

Lost your insurance card?
Contact Melisha Williams at (800) 928-7247 ext. 5563 or email mwilliams@culturalinsurance.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 in the following brochures:

Click here if you arrived in 2008.

Click here if you arrived in 2009.

Click here if you arrived in 2010.

(To read these documents, you will need to download Adobe Acrobat Reader if you do not already have it.)

Need to file a claim?
Click here to get the form. Submit form and attachments to:
Cultural Insurance Services International
River Plaza
9 West Broad Street
Stamford, CT 06902-3788.
For claim submission questions, call (203) 399-5130 or e-mail mwilliams@culturalinsurance.com.

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://www.hygeia.net/customer_tools/customers/aupairsinamerica/main.asp. 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 or contact the Insurance Specialist, Melisha Williams, at (203) 399-5130 or e-mail mwilliams@culturalinsurance.com.

The insurance policy has a deductible (see the Benefits below for details). You need to submit the itemized bills for all insurance 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:

Benefits for au pairs arriving in 2008

Benefits for au pairs arriving in 2009

Benefits for au pairs arriving in 2010

			Additional Insurance Options
		Basic Plan	Travel Package (A)	Medical Upgrade (B)	Travel (A) + Medical (B)
	Duration	12 months	13 months	12 months	13 months
Medical coverage	Maximum cover Per-incident deductible*	$100,000 $100	$100,000 $100	$500,000 $0	$500,000 $0
Baggage cover	Maximum cover Deductible/claim	$2,500 $250	$2,500 $100	$2,500 $250	$2,500 $100
Emergency treatment	Dental ER deductible	$500 $250/claim	$500 $250/claim	$500 $250/claim	$500 $250/claim
* Per-incident means that you must pay the first $100 of your medical bills for each accident or illness. For example, if you have a chest infection and the treatment costs $500, you will pay $100 and the insurance company will pay $400. If you need further treatment for the same chest infection, you do not have to pay another deductible. If you later need treatment for a broken arm, you will pay the first $100 again, and the insurance will pay for all other covered treatment for this condition. If you purchase Medical Upgrade insurance option (B), you will not have to pay this $100 per-incident deductible.

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 their insurance prior to arrival in the U.S. must continue the coverage with the same upgrade(s) for the extension period and will be required to pay an additional fee for this coverage. The Comprehensive Plan fee for 2009 extension terms are $310 for a 12-month extension, $245 for a 9-month extension, and $185 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.