INSURANCE COVERAGE SUMMARY FOR US STUDENT FULBRIGHT FELLOWS
The U.S. Department of State has established health and accident insurance for all Fulbright Fellows. The Accident and Sickness Program for Exchanges (ASPE) is a basic policy and as stated in the U.S. Fellows Orientation Handbook, it is not a substitute for your private insurance coverage. It is not intended to cover long-term health care and has limitations in coverage. For this reason, you are encouraged to maintain your current policy or to obtain comprehensive health insurance coverage to offset the cost of major medical contingencies that may occur when you are abroad, to cover you if you travel outside of the host country, and/or to provide you with immediate coverage when you return to the US.
As of April 1, 2007, the third-party administrator for the U.S. Department of State Accident and Sickness Program for Exchanges (ASPE) is Seven Corners, Inc.
The ASPE policy provides coverage up to $100,000 per illness or accident with a $25 deductible for each claim. For grantees in countries where there is a Fulbright Commission, the Commission will provide you the Accident and Sickness Program for Exchanges Booklet and a Medical Insurance ID card. For grantees in non-Commission countries, IIE will send you these materials with your first stipend check. You can also access the complete brochure at:
http://www.usdos.sevencorners.com
FREQUENTLY ASKED QUESTIONS
When does my coverage start and end?
Generally, coverage begins when you leave the U.S. for your grant county and continues until you return to the US at the end of the grant period. In most circumstances, you are only covered while you are in your grant country during the grant period. Stopovers during travel, diversionary travel outside of the country of assignment, or stays in the country prior to the start of the grant or after completion of the grant will not be covered by the Department's insurance. You will not be covered if you take a trip or vacation outside of your host country. See the Booklet for further details on when and where you are covered.
How does the plan work?
Normally, if you need medical attention or if you are hospitalized, you will need to pay for these services and submit claims for reimbursement. If you need extensive treatment (i.e. surgery, extensive tests, etc.), you should contact the Seven Corners Administrator to determine coverage and payments.
Seven Corners can provide assistance to US students trying to locate a physician overseas and in some cases has established a process where overseas physicians can direct bill Seven Corners (lessening the out-of-pocket expenses for US grantees). US grantees will also have the option to order maintenance drugs prior to their overseas departure.
Click here for a Quick Reference Guide to the ASPE program for U.S. Students. Where can I find information about supplemental medical insurance for me or general coverage for my family?
Neither IIE nor the State Department provides supplemental medical insurance for grantees or coverage for their dependents. If you require insurance coverage for periods when you are not in the host country, following your Fulbright grant, and/or for your dependents, click here for a list of companies that offer Short-term Insurance for Educational Exchange Participants.
How do I file a claim?
U.S. grantees generally will pay for medical services abroad and then file a claim with Seven Corners. The Seven Corners website and the APSE Insurance booket provide detailed information and claim forms; however, keep in mind that to receive reimbursement for medical services, you will need to provide the following: - Fully itemized, original bills including Patient’s Name, Nature of Illness / Injury
- Description and Charge for each service provided
Who should I contact when I have questions about eligibility, filing a claim or claims status?
All queries regarding the ASPE plan should be directed to the program administrator, Seven Corner, Inc. Seven Corners, Inc.
P.O. Box 3724
Carmel, Indiana 46082-3724 USA
Telephone: 1-800-461-0430 (toll free for grantees in the United States)
or 317-818-2867 (a collect call for grantees outside of the United States)
E-Mail: aspeinfo@sevencorners.com
Website: www.usdos.sevencorners.com |
