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 Essential 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
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% of Eligible Expenses
Pre-existing Condition
$10,000 Sub-Limit per Coverage Period, $50,000 Maximum Sub-Limit. (After 728 days of continuous coverage**)
Maternity
Normal or Complicated Delivery
OPTIONAL RIDER - $10,000 per Coverage Period ($50,000 Maximum Limit - additional premium: $2,200 per year)
Newborn Care
Included as part of Maternity benefits for maximum of 31 days.
Human Organ / Tissue Transplants
$500,000 Maximum Sub-Limit for Covered Transplants
Hospital Room and Board
Average Semi-Private room rate
Intensive Care Unit
Usual, Reasonable and Customary (URC)
Emergency Dental Due to Accident
$500 Sub-Limit per Coverage Period
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 (Subject to Deductible and Coinsurance)
Prescription Medications
Usual, Reasonable and Customary (URC)
Mental & Nervous Disorders
$10,000 Sub-Limit per Coverage Period for Outpatient Treatment only. $25,000 Maximum Sub-Limit (After 728 days of continuous coverage**)
Physical Therapy
$50 Maximum per visit.
Wellness (Adult)
$250 Sub-Limit per Coverage Period for Participating Members age 25 and over. Not subject to Deductible or Coinsurance (After 180 days continuous coverage**)
Wellness (Child)
$175 Sub-Limit per Coverage Period for Participating Members age 18 and under. Not subject to Deductible or Coinsurance (After 90 days of continuous coverage**)
All Other Eligible Expenses
Usual, Reasonable and Customary (URC)
Emergency Room Illness
Usual, Reasonable, and Customary. Subject to an additional $250 Deductible if Illness or Injury does not result in Hospitalization
Emergency Room Accident
Usual, Reasonable, and Customary (URC)
Emergency Medical Evacuation
$50,000 Maximum Sub-Limit. $25,000 Maximum Sub-Limit for Participating Members age 65 and older
Repatriation of Mortal Remains
$25,000 Maximum Limit per Member
(not subject to deductible)
Emergency Reunion
Reimbursement up to $7,500 for travel expense related to the Emergency Reunion of a relative or friend resulting from a Emergency Medical Evacuation of a Participating Member
Extreme Sports
Optional Rider - $50,000 Sub-Limit per Coverage Period
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 180 days of continuous coverage**)

** 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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