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Aetna

Aetna Global Benefits
Global Personal Health Plan
(for groups only)

Global Medical Benefits
Our Global Personal Health Plan offers a unique range of medical benefits for global Members, including:

Continuous Worldwide Coverage
Global Personal Health provides you and your dependents with continuous worldwide coverage that remains with you virtually anywhere you may travel or be located while residing overseas.

Coverage for you and your dependents
All international travelers and/or residents and their dependent spouse/children are eligible for coverage under Global Personal Health, except for those residing in the United States, Puerto Rico, the U.S. Virgin Island, Bermuda, or U.S. embargo countries. Coverage for individuals over age 70 is also available for non U.S. citizens after they have been an AGB member over 10 years.

No lifetime Maximum
With our Global Personal Health Plan, there is no lifetime maximum in terms of coverage. Without a lifetime maximum, you are free to obtain the care you need, without fear of exceeding an imposed coverage limit.

Access to U.S. Care
With an Open Choice Personal Health Plan
Should you or your dependents chose to sees care within the U.S. our Open Choice Plans provide access to a nationwide network of doctors and hospitals through an agreement with Aetna U.S. Healthcare, Aetna's U.S. benefits company. Aetna's network of credentialed providers is the largest in the U.S., today, with over 380,000 providers, including 2,400 participating hospitals. Aetna's pre-negotiated discounts with these providers are extremely competitive because of Aetna's continually growing U.S. membership. Today, Aetna is the largest provider of health care in the world with over 20 million health members globally. We encourage you and your dependents to seek care through these providers while in the U.S., though we do not require you to do so. Some key advantages of utilizing of utilizing Aetna's Preferred Providers include:

· Reduction in health care costs and lower out-of-pocket expenses.
· Higher level of benefits.
· Elimination of claims filing.
· Access to quality medical programs and providers that offer the latest, most efficient and effective treatments.

Emergency Evacuation and Medical Assistance
AGB works with Baltimore, MD bases MEDEX Assistance Corporation to offer you and your dependents access to emergency medical evacuation and other assistance services 24 hours a day, 365 days a year. Emergency assistance services include:

· Medically Necessary Emergency Evacuations.
· Medical Referrals.
· Access to worldwide network of providers.
· Transportation after initial evacuation.
· Confinement Visitation.
· Return of dependent children.
· Emergency medication, vaccine and Blood Transfers.
· Hospital deposit and emergency cash advance.
· Repatriation of mortal remains.
· Legal referral assistance.
· Translation services.
· Emergency message transmittal.
· Assistance with lost or stolen passports
· Assistance in obtaining necessary specialists.

Wellness Program
The Global Personal Health Plan includes the Aetna Wellness Program. This Program provides coverage for several types of annual exams, which help monitor and maintain the overall health and well-being of both you and your dependents. Annual exams covered under our Wellness Program include:
· Annual physical check for all Members.
· Annual mammography screening at age 40 and over ("Well Women Program").
· Annual physical check-up and vaccinations for babies ("Well Baby Program")
· Annual prostate check-up for men as needed.

Reimbursement for Prescription Drugs Purchased Overseas
Outside the U.S., we realize that the term "prescription drug" may apply to drugs that might not be FDA approved, or might be considered over-the-counter in the U.S. (e.g. aspirin can be considered a prescription drug in some countries.) Because there are many variables overseas in terms of what is and is not considered a prescription drug, we consider each drug purchase carefully and provide reimbursement s as appropriate. Because prescription drug guidelines vary from country to country, our reimbursement guidelines are also variable and flexible.

Global Member Services
Our Global Personal Health Plans offer a wide range of Global Member Services including:

24-Hour Emergency Medical Evacuation and Assistance
Through MEDEX Assistance Corporation, AGB's emergency services providers, you and your dependents can obtain emergency assistance for evacuations and other medical needs, including consultation with medical personnel, 24 hours a day, 2365 days a year via MEDEX'S global multilingual hotline. For more information on services provided through MEDEX, please refer to the section called "Emergency Evacuation and Medical Assistance."

International Claims Management
The AGB international Claim Processing Unit, housed in Tampa, Fl, is dedicates to the management and processing of international claims for you, our global Members, Our Member Service Representatives and Claim Processors utilize a custom-built call tracking system which is integrated with our claim payment, benefits and eligibility systems to allow seamless access to all account information. Using this system, Members Service Representatives can access all Member information simultaneously, and provide current status on claim payments. Claims are typically processed within 10-12 business days.

Claim Reimbursement in Foreign Currency
AGB offers claim reimbursements in 100 + foreign currencies, including US dollars and Euros. Payments are made via check or wire transfer, as available, direct to your US or overseas bank accounts. Currency rates applied to calculate the correct reimbursement amount based upon date service was rendered.

Multilingual Services
AGB offers translation services and foreign language capabilities through a variety of sources:

Real-time Translations Assistance via Phone
AGB offers real-time translation assistance through the AT&T language Line. Should you need immediate translation/interpreter assistance, you may contact our Member Service Representatives via toll-free phone, 24 hours a day, 7 days a week. Our service representatives will then conference in an AT&T language line representative who will act as a translator for you and or your medical provider as needed.

Translation of Foreign Language Claims
AGB offers translation of foreign language claims through our international claim unit. We employ a multilingual staff, experiences in the translation, administration and investigation of foreign claims. We will accept and process claim forms submitted in nearly any language. Should there be a language for which we do not have in-house expertise, we utilize an outside vendor to assist with translation.

In-country Language Assistance from Medical Personnel
Through our Emergency Service provider - MEDEX Assistance Corporation - we can direct you and your dependents to providers and hospitals where you will be the most comfortable and receive quality care (primarily Western-style, English speaking providers). <EDEX also employs Regional Medical Advisors (RMAs) throughout the world. These RMAs are full-time employees of MEDEX, on call 24 hours a day, 7 days a week to assist you and your family members. They are Western-trained physicians who speak the local language and are familiar with local customs and medical treatments. In time of crisis, their intervention and assistance with the treatment process can greatly help members - not only by providing interpreter capabilities, but also by consulting with local with physicians to help determine appropriate treatment options.

Global Personal Health

Plan Options

OPEN CHOICE

Plan Features: In The UnitedStates

     
 

  In-Network

  Out-Network

Outside Of The U.S.

Physician Office Visits

 100% - $10

70%

100%

Other Physician Charges

90%

70%

100%

Hospital Inpatient

90%

70%

100%

Hospital Outpatient

90%

70%

100%

Inpatient Treatment of Mental and Nervous

Disorders, Alcoholism, and Drug Abuse

90%

70%

100%

Outpatient Treatment of Mental and Nervous

Disorders, Alcoholism, and Drug Abuse

90%

70%

100%

Maximum Lifetime Benefit for Treatment of

Mental and Nervous Disorders, Alcoholism

And Drug Abuse

$25,000

$25,000

$25,000

Home Health Care, Convalescent Home and

Hospital Care

80%

80%

100%

Other Medical Expenses

80%

80%

100%

Medical Evacuation

MEDEX

MEDEX

MEDEX

Emergency Room

90%

90%

100%

Wellness Benefits

 100%-$10

$250 Max.

70%*

$250 Max.

100%

$250 Max.

Prescription Drugs

80%

80%

80%

Maternity

Not Covered

For 12 Months

Not Covered

For 12 Months

Not Covered

For 12 Months

Pre-Existing Conditions

Not Covered

For 12 Months

Not Covered

For 12 Months

Not Covered

For 12 Months

Over Age 70 Feature

      Yes

      Yes

      Yes

Maximum Lifetime Benefit

 Unlimited

 Unlimited

 Unlimited

*Services Covered At 80% If Rendered outside Network Location.