August 2011
The FMCAssist plan offers medical evacuation and vehicle return coverage while traveling in the United States, Canada, and Mexico.
MEMBERSHIP BENEFIT DISCLOSURE: FMCA Member Benefits are subject to change, including the discontinuation of any particular benefit, at any time and without prior notice. FMCA assumes no liability for damages, either direct or consequential, to any person or organization as a result of the use of services offered to members. All benefits may not be available in all states and foreign countries.
FMCAssist Member Benefit “” This PDF includes updated FMCAssist I.D. Cards that you can print, cut out and carry with you.
Who’s Eligible?
Class I: Current FMCA Full (Family) Members
Class II: FMCA Associate Members while attending FMCA-sponsored events.
Class III: Eligible family members who are traveling with the FMCA member.
Class IV: FMCA Full-Time RVers
Emergency Evacuation (Class I, II, III, and IV)
The plan will pay a maximum amount of $300,000 Combined Single Limit for covered emergency evacuation expenses incurred if a member suffers an injury or sickness while he or she is on a trip (while traveling outside a 100-mile radius from his or her primary residence) that warrants an emergency evacuation. Benefits payable are subject to the Maximum Combined Single Limit shown for all emergency evacuations due to all injuries from the same accident. (Initial ambulance service from the scene of the accident to the medical facility is not reimbursed.)
Covered emergency evacuation expenses are the reasonable and customary expenses for necessary transportation, related medical services, and medical supplies incurred in connection with the emergency evacuation of the member. All transportation arrangements made for the evacuation will be by the most direct and economical route possible.
Expenses for transportation must be: (a) ordered by the attending physician, who must certify that the severity of the member’s injury or sickness warrants his or her emergency evacuation and adequate medical treatment is not locally available; (b) required by the standard regulations of the conveyance transporting the member; and (c) authorized in advance by On Call; and (d) if you are traveling alone and after an evacuation you will be hospitalized for more than five (5) days, On Call will coordinate and pay for an economy round-trip airfare for the person of your choice to join you.
If the member is hospitalized and unable to travel due to a covered emergency evacuation, the plan will pay, subject to policy limitations, expenses for:
1. Return of dependent children. If the member is unable to travel due to a covered emergency evacuation, the plan will pay to return home (in the United States, Canada, or Mexico) any of the member’s dependent children who were with the member when the injury or sickness occurred, including the cost of an attendant, if necessary. Should dependent(s) already have airline tickets, On Call will assist in the rebooking of their tickets if it is less expensive. Air travel for dependent children will be based on the cost of a one-way economy airfare ticket.
2. Bedside visit. The plan will pay to bring one family member or close friend to and from the medical facility where the member is confined if the member is alone and is hospitalized for more than five days following a covered emergency evacuation. The payment will not exceed the cost of one round-trip economy airfare ticket.
Full-Time RVers (Class IV)
If you are sick or injured the plan will either return you to your point of origin or alternatively transport you to a family member’s home within the member’s home country if (1) you are unable to operate your vehicle and no one in your traveling party is capable of operating the vehicle or (2) your condition prevents you from traveling as a passenger in the vehicle, or it is deemed medically necessary that you be returned to a family member’s home for inpatient hospitalization or rehabilitation, as determined by your treating physicians and our On Call physician adviser. This benefit will be approved only after your condition has stabilized or your condition has reached maximum medical improvement. If you are transported to a family member’s home, this plan will not be responsible to return you to any other location.
Repatriation of Remains (Class I, II, III, and IV)
The insurer will pay a maximum amount of $300,000 Combined Single Limit for covered repatriation expenses to return the member’s or covered family member’s body to the United States, Mexico, or Canada, if he or she dies during the trip. Repatriation covered expenses are limited to the reasonable and customary expenses incurred to transport the body. On Call must make all arrangements and authorize all expenses in advance for this benefit to be payable.
Return of Traveling Companion
If you are traveling away from home and require an emergency medical evacuation, transportation after stabilization, or a return of deceased remains, the plan will pay for a one-way economy class ticket for one traveling companion to return to either your or their permanent primary residence.
RV/Vehicle Return (Class I only)
If you are unable to complete your trip because of sickness or injury the plan will return your RV and towed vehicles to your permanent primary residence and any rented vehicle to its primary location. The service provider or someone in your traveling party or other family member can return the vehicle(s). If you have someone in your party who can drive the vehicle, the plan will reimburse you for gas, tolls, and $100 per day for incidentals “” food, lodging, etc. (Expenses must be submitted with a receipt.) If someone has to meet the vehicle the plan will pay one-way economy airfare to the vehicle, but not the return. The plan will not pay more than it would have cost to have the vehicle returned by a service provider.
Expenses Not Covered
The plan will not be responsible for any costs or expenses arising from:
1. Hospital or medical expenses of any kind of nature.
2. Travel arrangements that were neither coordinated by nor approved by On Call in advance.
3. Anyone traveling against the advice of a physician, or traveling for the purpose of obtaining medical treatment.
4. Suicide, attempted suicide, or willful self-inflicted injury.
5. Taking part in military or police service operations or traveling in a country in which the U.S. State Department has issued travel restrictions.
6. For incidents that occur due to an intentional unlawful act.
7. Injury or illness caused by or contributed to by use of drugs or alcohol.
8. Pregnancies except in the case of a major, vital complication during the first two trimesters of pregnancy which presents a clear and significant risk of death or imminent serious injury or harm to the mother or fetus.
9. Mountaineering or rock climbing necessitating the use of guides or ropes; spelunking; skydiving; parachuting; ballooning; hang gliding; deep sea diving utilizing hard helmet with air hose attachment; flying in an experimental aircraft; racing of any kind other than on foot; bungee jumping; operating a vehicle when not properly licensed; or participating in professional sports unless otherwise agreed in writing by On Call prior to your coverage period.
10. Psychiatric, psychological, or emotional disorders.
11. Unless specifically listed herein, incidental expenses, including but not limited to accommodations, local transportation, meals, telephone, and facsimile charges.
12. Subsequent evacuations for the same or related medical condition, regardless of location.
13. Services covered by other valid and collectible insurance, including Medicare.
14. Services not otherwise shown as covered.
15. Members who enroll in this plan while hospitalized.
Assistance Services
24-Hour Medical Assistance “” 24-hour medical monitoring: Physicians monitor your condition by maintaining close contact with the attending physicians, your family physician, and immediate family members.
Medical Records “” On Call will assist in hospital admissions, relaying insurance information, and with member’s consent transfer records to treating physician. Any fees charged are the responsibility of the member.
Emergency Cash Advance “” On Call will assist if the hospital demands a cash deposit or settlement prior to your departure. They will arrange the forwarding of funds from the member’s account, credit card, or family member. All fees will be billed to the member’s credit card on file with On Call at time of service.
Replacement of Lost or Stolen Travel Documents Assistance “” On Call will provide assistance to you by arranging for the replacement of passports, visas, airline documents, birth certificates, and other travel-related documents. All fees associated with the acquisition or forwarding of these documents will be billed to the member’s credit card at the time of service.
Legal Referrals “” On Call will assist in locating an attorney for needed services in the event of arrest, auto accident, bail bonds, etc. Phone conversation with attorney will be without charge. Any legal remark after the initial conversation will be the responsibility of the member.
Translation Services “” On Call will not charge for foreign language assistance over the telephone or up to one-page translation submitted by facsimile. Referrals to translators and subsequent fees are the responsibility of the member.
Emergency Pet Housing and/or Pet Return “” On Call will coordinate arrangements for boarding and pet return because of injury or sickness of a member. Any fees will be paid by member’s credit card at the time of service.
Emergency Message Center “” On Call will forward your emergency message via telephone or e-mail to your employer or family member.
Emergency Roadside Service “” The On Call plan will assist with arrangements, but all related expenses must be paid by the member. The following services are available: towing assistance; flat-tire assistance; oil, fluid, and water delivery service; fuel delivery service; lock-out assistance; and battery jump-start assistance.
Conditions and Limitations
The plan will only direct-pay and not reimburse you for any transportation costs to the transportation providers, unless approved by On Call in advance for the following benefits: emergency medical evacuation, return of deceased remains, transportation after stabilization, return of minor children, return of traveling companion, and transportation to join hospitalized member.
The plan will not be responsible for the availability, quality, results of, or failure to provide any medical, legal, or other care or service caused by conditions beyond our control. Your legal representative shall have the right to act for you and on your behalf if you are incapacitated or deceased.
Definitions
“Coverage” means the period of time for which you are enrolled in an FMCA membership or FMCA Associate membership and for which On Call has received the appropriate enrollment fee. A member’s coverage is restricted to TRAVEL AWAY FROM HOME, within the United States, Canada, or Mexico unless otherwise specified.
“Dependent” means the member’s unmarried children from birth and under age 19; or under age 23 if enrolled as a full-time student in an accredited college, university, vocational or technical school; and children whose support is required by a court decree. Children include natural children, stepchildren, legally adopted children, or adult children with mental or physical disabilities. The children must be primarily dependent on the member for support and maintenance. This plan shall also cover the member’s grandchildren when traveling with the member in their motor coach.
“FMCA Associate Member” means a family unit that does not include an individual within that family unit owning or partially owning an FMCA-qualified motor coach.
“FMCA Full-Time RVers” means a member who lives full-time in their motor coach and considers the motor coach their primary residence.
“FMCA Member” means a family unit (i.e., a family membership) and includes an individual owning a qualifying motor coach (as defined in the FMCA organizational documents) and a group of two individuals jointly owning a qualifying motor coach who share a membership number. Any individual adult covered under an FMCA membership constitutes an FMCA member.
“Physician” means physicians retained by On Call to provide us with consultative and advisory services, including the review and analysis of the quality of medical care you are receiving.
“Illness” means a sudden and unexpected sickness that manifests itself during your coverage period.
“Injury” means an identifiable accidental injury caused by a sudden, unexpected, unusual, specific event that occurs during your coverage period.
“Member” means the person either enrolled in an FMCA Membership or an FMCA Associate Membership for whom On Call has received the appropriate enrollment fee.
“Permanent Primary Residence” means the locale of the address as shown on YOUR state driver’s license or state-issued identification card.
“Spouse” means the member’s spouse (to include legally recognized domestic partner), unless they are legally separated.
“Traveling Away From Home” means on a vacation or business trip away from your permanent primary residence for a purpose other than your normal daily activities or routine. Coverage will begin once you are away from your permanent primary residence defined as follows:
- FMCA Membership: Must be traveling in your motor coach/RV 100 miles or more from your permanent primary residence.
- FMCA Associate Membership: Must be traveling to an FMCA-sponsored event away from your permanent primary residence.
- FMCA Full-Time RVers: Are covered 24 hours a day, 7 days a week.
“Traveling Companion” shall mean any individual traveling on the same itinerary, and accompanying member or member’s trip for more than 50% of the time sharing the same accommodations.
“You,” “your” shall mean member with regard to single membership and shall mean member, spouse, and dependent with regard to family membership.