Meridian Essential & Enhanced Plans

From Azimuth Risk Solutions

Annually renewable, Meridian Essential & Meridian Enhanced are comprehensive international medical insurance plans that provide coverage for people living outside of the US for at least 6 months per year.

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Meridian Enhanced Benefit Schedule

Benefit

Description

Coverage Area
  • Area 1 - Including the US & Canada
  • Area 2 - Excluding the US & Canada
Overall Policy Maximum
$5,000,000 Lifetime
Deductibles
$0, $100, $250, $500, $1,000 or $2,500 per Member per Certificate Period
Family Deductible
Maximum of 3 Deductibles per family per Certificate Period
Coinsurance - Claims incurred in US or Canada:
After the Deductible the Plan will pay 90% 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% of Eligible Expenses
Pre-existing Condition
Same As Any Other Injury or Illness if fully disclosed on Application and not excluded or limited by a Rider (after 12 months of continuous coverage)
Maternity
Normal or Complicated Delivery
Same As Any Other Illness; $5,000 additional Deductible, $100,000 Maximum Limit (after 12 months of continuous coverage)
Newborn Care
Included as part of Maternity benefits for maximum of 60 days.
Human Organ / Tissue Transplants
$2,000,000 Maximum Limit
Hospital Room and Board
Usual, Reasonable and Customary (URC)
Intensive Care Unit
Usual, Reasonable and Customary (URC)
Local Ambulance
$1,500 Sub-Limit per Coverage Period when covered Illness or Injury results in Hospitalization. Not subject to Deductible and Coinsurance.
Surgery
Usual, Reasonable and Customary (URC)
Subject to deductible and coinsurance;
Prescription Medications
Usual, Reasonable and Customary (URC)
Subject to deductible and coinsurance
Vision Care
$100 Maximum Limit per Coverage Period for exams and materials (after 12 months of continuous coverage).
Dental Coverage
Optional Rider - $750 Maximum Limit per Participating Member per Calender Year. $50 Deductible per Participating Member. Schedule of Benefit payout:
  • Class A=90%;
  • Class B=70%;
  • Class C=50%;
  • Ortho=No coverage
(after 6 month waiting period)
Mental & Nervous Disorders
$50 per visit, per day for outpatient care. $15,000 per Coverage Period (after 12 months continuous coverage). $30,000 Maximum Limit.
Physical Therapy
$50 Maximum per visit.
Wellness (Adult)
$350 Sub-Limit per Coverage Period, Participating Members age 25 and over. Not subject to Deductible or Coinsurance. (After 90 days of continuous coverage**)
Wellness (Child)
$200 Sub-Limit per Coverage Period. Participating Members age 18 and under. Not subject to Deductible or Coinsurance (After 60 days of continuous coverage**)
High School Sports Injury
$10,000 Maximum Sub-Limit. Subject to additional $250 Deductible
All Other Eligible Expenses
Usual, Reasonable and Customary (URC)
Emergency Room
Illness or Accident
Usual, Reasonable, and Customary. Subject to an additional $250.00 Deductible if Illness or Injury does not result in Hospitalization
Emergency Medical Evacuation
$110,000 Maximum Sub-Limit, $55,000 Maximum Sub-Limit for ages 60 and older
Repatriation of Mortal Remains
Reimbursement up to $30,000 for the return of a Participating Members mortal remains to his/her home country. Not subject to Deductible or Coinsurance
Emergency Reunion
Reimbursement up to $10,000 for travel expense related to the Emergency Reunion of a relative or friend resulting from a Emergency Medical Evacuation of a Participating Member

** 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.

* This is only a consolidated and summary description of some of the current Azimuth Risk Solutions benefits, conditions, limitations and exclusions. An Evidence of Insurance containing the terms, conditions and exclusions will be included in the fulfillment kit. Azimuth reserves the right to issue the most current Evidence of Insurance for this plan in the event this application and / or brochure has expired, is modified, or is replaced with a newer version. A complete copy of the Master Policy is available at all times upon request.

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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