Meridian Clear Plan

From Azimuth Risk Solutions

Annually renewable, Meridian Clear is a scheduled benefit international medical insurance plan that provide coverage for people living outside of the US for at least 6 months per year.

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Meridian Clear Benefit Schedule

The Meridian Clear Plan is a scheduled benefit plan with Limits as follows: all Limits are per Coverage Period unless otherwise noted

Benefit

Description

Overall Policy Maximum
$2,000,000 Lifetime
Deductible
$250, $500, $1,000, $2,500, $5,000, $10,000 per Member per Certificate Period.
Coverage Area
  • Area 1 - Including the US and Canada
  • Area 2 - Excluding the US and Canada
Coinsurance
claims incurred in US or Canada
After the Deductible the Plan will pay 80% of the next $5,000 of Eligible Expenses, then 100% to the Overall Maximum Limit. The Coinsurance will be waived if expenses are incurred within the PPO.
Coinsurance
claims incurred outside US or Canada
After the Deductible the Plan will pay 100% of Eligible Expenses to the Overall Maximum Limit
Pre-certification Penalty
50%
Pre-existing Condition
After 24 months of continuous coverage, with a $50,000 Maximum Limit. $5,000 Per Coverage Period.
Sudden Onset of Pre-existing Conditions
Same as any other Injury or Illness (subject to Schedule) $1,000 1st Coverage Period and $2,500 thereafter.
Maternity
Normal or Complicated Delivery / Newborn Care
$10,000 Maximum Limit after 24 months of continuous coverage. Covered Maternity expenses include pre-natal, Delivery, and post-natal care, and Newborn Care for the first 31 days.
Human Organ / Tissue Transplants
$250,000 Maximum Limit for covered Transplant.
Hospital Room and Board
Semi-Private room rate, subject to the set benefits limits.
Prescription Medications
In-Patient prescription drugs covered only if Hospitalized. Out-Patient is URC. NO COVERAGE FOR MAINTENANCE MEDICATIONS
Mental & Nervous Disorders
$25,000 Maximum Limit after 24 months of continuous coverage, subject to the set benefits limits.
Emergency Room Illness / Accident
Usual, Reasonable and Customary (subject to additional $250 Deductible if not admitted)
Local Ambulance
Usual, Reasonable, and Customary (URC)
All Other Eligible Expenses
Usual, Reasonable, and Customary (URC)
Emergency Medical Evacuation
$7,500 Maximum Limit
Repatriation of Mortal Remains
$30,000 Maximum Limit
Emergency Reunion
$30,000 Maximum Limit
Meridian Clear: Scheduled Benefits & Limits

Wellness Benefits

Not subject to deductible and coinsurance

Wellness (Adult)
$250 per Member per Coverage Period including Office Visit (after 24 months continuous coverage)
Wellness (Child)
$50 per visit for a maximum of 3 visits per Coverage Period (after 12 months continuous coverage)

Inpatient Benefits

ALL subject to deductible and coinsurance

Hospital Room and Board
Coverage Area 1
$300 per day, maximum 240 days per Hospitalization (including ICU days)
Hospital Room and Board
Coverage Area 2
$400 per day, maximum 240 days per Hospitalization (including ICU days)
Intensive Care Unit
Coverage Area 1
$800 per day, maximum 240 days per Hospitalization (including ICU days)
Intensive Care Unit
Coverage Area 2
$1,000 per day, maximum 240 days per Hospitalization (including ICU days)

Outpatient Benefits

ALL subject to deductible and coinsurance

Office Visit
including Physician, Specialist Physician, Psychiatrist, Chiropractor, Surgical Consultant, Physical or Occupational Therapist
Limited to 15 visits per Member per Coverage Period.
Physician
$70 per visit
Physician Specialist
$70 per visit
Psychiatrist
$50 per visit (after 12 months continuous coverage)
Chiropractor
$50 per visit (must be prescribed by a non Chiropractor Physician)
Surgical Consultant
$350 per consultation prior to Surgery
Physical or Occupational Therapist
$50 per visit (must be prescribed by a Physician who is not affiliated with the Physical Therapy practice)
Emergency Room
Usual, Reasonable and Customary (subject to additional $250 Deductible if not admitted).
Laboratory
$250 per exam (includes Ultrasounds, Sonograms and diagnostic Mammograms)
Local Ambulance
$1,500 per covered event, per Member, per Coverage Period
X-rays
$250 per exam (includes all procedures carried out on one specimen)

Inpatient or Outpatient Benefits

ALL subject to deductible and coinsurance

Anesthesiologist
20% of Surgeon benefit
Assistant Surgeon
20% of Surgeon benefit
Surgery
Usual, Reasonable, and Customary
Midwife Services
$350 per covered Pregnancy
Prescription Drug Coverage
In-Patient prescription drugs covered only if Hospitalized. Out-Patient is URC. NO COVERAGE FOR MAINTENANCE MEDICATIONS
MRI, CAT Scan, Echocardiography, Endoscopy, Gastroscopy, olonoscopy and Cystoscopy
$500 per exam
Chemotherapy and Radiation
Usual, Reasonable, and Customary

Other Benefits

ALL subject to deductible and coinsurance

Durable Medical Equipment
Usual, Reasonable, and Customary charges for Wheelchair, Hospital Bed, and or Toilet
Emergency Medical Evacuation
$30,000 Maximum Limit
Emergency Reunion
$7,500 Maximum Limit
Return of Mortal Remains
$30,000 Maximum Limit

** With regard to the foregoing Schedule of Benefits/Limits, the references to “continuous coverage” mean continuous unbroken coverage under the Beacon/Axis Series Group Insurance Trust (Anguilla). The applicable benefits described will become first available to the Participating Member only at the end of the continuous Coverage Period so specifified.

Patient Protection and Affordable Care Act

(“PPACA”): This insurance is not subject to, and does not provide certain of the insurance benefits required by, the United States PPACA. PPACA requires certain U.S. residents and citizens to obtain PPACA compliant insurance coverage. In certain circumstances penalties may be imposed on U.S. residents and citizens who do not maintain PPACA compliant insurance coverage. You should consult your attorney or tax professional to determine if PPACA’s requirements are applicable to you. The policy contains the plan benefits, including a lifetime maximum that you have selected. Please review your choices to ensure that you have sufficient coverage to meet your medical needs.

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