International Health Insurance > Missionary Medical

CitizenSecure ^SM Messenger

What Are the Exclusions and Limitations?

Pre-existing Conditions:

If you are insured under the Messenger plan, and your pre-existing conditions have been fully disclosed on your application and not excluded or restricted by a rider or any other provision of your Certificate, your pre-existing conditions are covered the same as any other illness or injury as of your effective date.

Pre-existing conditions include any Injury, Illness or Mental Health disorder that existed at or prior to your initial effective date, including chronic or recurring conditions.

The following charges, treatments, care, services, supplies and/or conditions are excluded from coverage:

1. Charges not incurred during the Certificate period
2. Services or treatment payable by another insurance or government
3. Substance abuse
4. Charges which exceed Usual, Reasonable and Customary
5. Investigational or experimental surgeries or treatment
6. Custodial, educational or rehabilitative care
7. Weight modification
8. Cosmetic surgery, unless reconstructive surgery is directly related to a covered Injury or Illness
9. Charges for use of Emergency Room for treatment of Illness unless the patient is directly admitted to the Hospital as Inpatient for further treatment of that Illness
10. Individuals HIV+ at effective date
11. Drugs or treatment for sexual dysfunction
12. Drugs or treatment to promote or prevent conception
13. Devices or procedures to correct sight or hearing
14. Self-inflicted Injury or Illness
15. Foot care, unless related to a covered accidental Injury
16. Treatment or supplies not ordered by a physician or not medically necessary
17. Organ transplants, except for covered transplants
18. Speech, acupuncture, occupational or sleep therapy
19. Acts of terrorism, war, insurrection, riot or any variation thereof
20. Dental treatment, except emergency treatment following a covered accident, or unless Dental Rider is purchased
21. Orthodontia (Dental Rider Exclusion)
22. Sealants, Bleaching and oral hygiene expenses (Dental Rider Exclusion)

This is a summary of the exclusions contained in the Master Policy. See the Master Policy for a complete list of exclusions.

Special Illness Exclusion:

The following conditions which manifest themselves within the first 180 days of coverage are excluded: Any condition of the breast, prostate, the reproductive system, tonsils, adenoids, hemorrhoids, hernia, gallstones, kidney stones, glaucoma, cataracts, disk disease, all types of cysts, and any disorder or disease of the skin.

Wellness:

If you are insured under the Messenger Plan, after 12 months of continuous coverage, you may be eligible for Wellness benefits that are not subject to the deductible. If you are at least 35 years old, you will be entitled to the following Wellness benefit: $250 per Certificate Period for a routine physical exam, including mammogram and OB/GYN visits for females. If you are under the age of 19, you will be entitled to the following Wellness benefit: $50 per visit (including immunizations) with a maximum of three visits per Certificate Period.

Emergency Medical Evacuation:

If you are insured under the Messenger plan, you are covered for emergency medical evacuation to the nearest medical facility qualified to treat your life threatening condition. All emergency medical evacuations must be approved in advance and coordinated by MultiNational Underwriters, Inc. MultiNational Underwriters, Inc. is available 24 hours a day, 7 days a week, to approve and coordinate emergency medical evacuations. Emergency medical evacuations provide you with access to care when you need it most.

Emergency Reunion:

In the event of a covered Emergency Evacuation, the platinum plan will provide the following benefits: the cost of an economy round trip air or ground transportation ticket for one of your relatives (parent, spouse, sibling or child age 18 years or older) for transportation to the area where you are hospitalized following Emergency Evacuation, and reasonable expenses for lodging and meals for your relative for a period not to exceed 15 days.

Other services provided by MultiNational Underwriters, Inc:

• Medical referrals
• Up-to-the-minute travel medical advisories
• Assistance with prescription drug replacement
• Dispatch of a doctor or specialist
• Emergency travel arrangements for family members
• Lost passport or travel documents assistance
• Embassy and consulate referrals
• Legal and accounting referrals
• Bail bond assistance
• Translation and interpretation assistance

Patient Advocacy Services:

If you are faced with a complex or severe medical condition, you will be assigned to one of MultiNational's Patient Advocates. Your Patient Advocate is your personal assistant at MultiNational Underwriters on all matters relating to your treatment and claim, with the goal of securing the best possible care for you in a convenient and cost effective setting.

General Customer Service:

You've lost your ID card or your Certificate. Or, you have a question about your insurance. Or, you have filed a claim and you want to know the status of payment. These and many more questions may arise from time to time. MultiNational Underwriters, Inc. Customer Service Team is ready to respond. If you do not speak English, your Customer Service Representative will arrange for a telephone translator to monitor your call and assist in providing the answers you need.

Pre-notification

The CitizenSecure Messenger plan contains pre-notification provisions. Pre-notification simply means that you must contact MultiNational Underwriters, Inc. as soon as possible before a planned hospitalization or surgical procedure, or within 48 hours of an emergency hospital admission, or within the first 90 days of pregnancy. Pre-notification allows us to establish contact and make payment arrangements with your providers, negotiate discounts which will benefit both you and us, pre-arrange future care, and plan for your claim. Pre-notification helps us help you.