'GLOBAL MEDICAL INSURANCEsm
PPO and Pre-Certification

ACCESSING THE PPO

IMGsm network providers are available throughout the U.S. When you receive treatment for eligible medical expenses from a network provider, your deductible will be reduced by 50% and any coinsurance applicable to that charge will be waived. If a U.S. hospital outside the provider network is used, a co-payment of US$250 is required in addition to the regular deductible and coinsurance. This co-payment is waived if there is not a provider within 50 miles of the location of treatment.

You may access the PPO in two ways:

1. When requested, we will either forward a copy of the facilities available in the area you are seeking treatment or refer a provider to you.

2. The PPO directory may also be accessed on the IMGLOBALsm Web site, www.imglobal.com Providers are listed by location and specialty.

PRE-CERTIFICATION

Pre-certification (notification of illness or accident) simply means calling the company prior to treatment. The following treatments must be pre-certified:

  • Any surgery or treatment requiring hospitalization
  • Outpatient surgery
  • CAT scans, MRI's
  • Notification within the first 90 days of pregnancy
  • Within 48 hours after an emergency admission to the hospital
  • Care in an extended care facility
  • Home nursing care
  • Durable medical equipment including artificial limbs
  • Transplants

By notifying IMG we will be able to verify benefits, review length of stay and coordinate payment with the hospital or outpatient facility. Pre-certification may be done by you, the doctor, a hospital administrator or relative.

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