January2006
Effective January 1, 2001, FMCA contracted with MEDEX Assistance Corporation to provide active family and life members with coverage under the MEDEX PLUS Program. This program helps traveling members to effectively manage the complexities and expenses of out-of-area medical and travel emergencies. Members receive this coverage with no sign-up required. Travel can be for business or pleasure at a distance of 100 or more miles from your primary residence. Coverage is provided while traveling within the United States, Canada, or Mexico, 24 hours a day, seven days a week, 365 days a year. MEDEX must approve and coordinate all services.
MEDEX provides members with toll-free access to travel assistance services and also coordinates and pays the approved costs associated with the following:
1. Emergency medical air and ground evacuation: Medically supervised evacuation to the nearest appropriate facility if an FMCA member is involved in an accident or suffers a sudden, unforeseen illness and adequate medical facilities are not available.
2. Repatriation of remains: The return of an FMCA member’s mortal remains in the event of death.
3. Return home of unattended grandchildren and dependent children: Transportation home for an FMCA member’s children and/or grandchildren left unattended as the result of a member’s accident, illness, or death.
4. RV and automobile return home: Return of an FMCA member’s drivable vehicle to his or her residence (or return of a rental vehicle) if the member is unable to operate the vehicle due to accident, illness, or death.
5. Transportation to join a hospitalized member (for member traveling alone “” if member is hospitalized for seven days or more): The transportation of a family member or friend to visit an FMCA member who is hospitalized for seven days or more.
6. Transportation home after initial evacuation: The transportation of an FMCA member to the point of origin, or permanent residence, following an emergency evacuation.
Each of these services has no limit to the cost that will be paid by MEDEX with the exception of the fifth one “” family member visit transportation for the member traveling alone “” which has a limit of $1,000.
Please remember that MEDEX must approve and coordinate all of these services.
The above description of benefits summarizes the principal features of the MEDEX PLUS program and is not intended to be a contract. The contractual provisions for the MEDEX PLUS program are stated in the MEDEX PLUS service agreement, Group 7030, issued by MEDEX Assistance Corporation to the Family Motor Coach Association, Inc., with an effective date of January 1, 2001. The final answer to any questions will be subject to the MEDEX PLUS service agreement.
The primary focus of this MEDEX plan is to provide basic benefits to FMCA members during medical emergencies and to assist with travel arrangements after the situation is resolved. A summary of benefits is provided below. Please note that while this program includes payment for emergency medical transportation, it does not provide payment for the initial transportation to a medical facility, and only specific conditions will warrant emergency medical transportation to a member’s home. As a general rule, MEDEX pays for an emergency evacuation when it is medically necessary to obtain a higher level of care.
If you have another plan purchased individually for which you pay a premium, consider all benefits you may have purchased before canceling, as it may include different coverage than what FMCA provides through this blanket plan. You can still use MEDEX coverage even if you have another plan; however, benefits will be payable after benefits have been paid from your other coverage.
MEDEX has been in business for more than 25 years, supplying different plans to organizations interested in providing their families with peace of mind when they travel away from home. MEDEX’s specially trained coordinators answer calls 24 hours a day from its centralized command center, and they are prepared to provide immediate help with any MEDEX service. Each ongoing case receives expert attention from case coordinators, operations management, medical personnel, provider specialists, and MEDEX Physician Advisers strategically located throughout North America “” assuring quality attention and responsiveness.
In addition to the paid services listed above, the MEDEX PLUS Program also provides assisted services both of a personal and medical nature. When talking with MEDEX coordinators, you should provide them with information regarding the specifics of your concerns and needs so they can best assist you.
There is one underlying question to which we all would like the answer: “In the case of a medical emergency, will they fly me home to familiar surroundings and let me be treated by my personal physician?” Under the program currently being provided to you by FMCA, the decision regarding the location to where you will be evacuated is based on getting you to the nearest and most appropriate location that can provide care for you. That location, in certain circumstances, could be somewhere near your home. In most cases, the initial location will be based on getting you to the best place for care as soon as possible so you are not exposed to unnecessary risks. Under these circumstances, feel comfortable in knowing that there is a coordinated effort to make sure care is given in your best interest. The attending physician most knowledgeable of your current condition; your personal physician most aware of your ongoing health history; and MEDEX’s physician most familiar with the issues regarding medical evacuations will consult with each other and make decisions based on what is most appropriate for you.
We also need to point out a few of the specifics of the contract language.
1. There is an exclusion in the contract for travel that is made for the purpose of securing medical care or medical advice. Travel when performed against the advice of a physician is excluded. Traveling with a chronic or life-threatening illness also is excluded if that condition is the reason for the evacuation.
2. If it’s necessary to verify eligibility as to whether you’re 100 miles from your permanent residence, contract language indicates that MEDEX will use the address on your driver’s license.
3. The MEDEX PLUS Program is a travel assistance program, and payment is over and above or on top of any existing insurance program or private pay plan that is in force. Your primary payer would pay these expenses, and MEDEX will be the secondary payer.
4. The MEDEX PLUS Program does not cover per diem costs or pet return.
FMCA members can call toll-free (800-527-0218) or collect (410-453-6330) for emergency medical, travel, and personal assistance services. When calling, please refer to MEDEX group number 7030. For more information about this program, phone FMCA (800-543-3622) or send an e-mail to membership@fmca.com and ask for a brochure.
In order to secure this benefit, it is imperative that MEDEX be notified immediately when medical travel assistance is required. Below we have printed two cards that you can cut out for you and your spouse, laminate, and place in your wallet and purse so that you will have the information with you at all times.
Member benefit disclosure: FMCA member benefits are subject to change, including the discontinuation of any particular benefit, at any time and without prior notice.