Insurance FAQ

Is the YMCA my insurance provider?

No. The International YMCA is not your insurance provider. Your insurance provider is Nationwide Insurance. Your insurance policy with Nationwide Insurance is administered by Consolidated Health Plans (CHP).

What does my insurance cover?

It pays an accidental death benefit, a specific loss benefit (loss of limb, sight, etc.) and covered excess medical expenses resulting from an injury or sickness, less the deductible and not to exceed the overall maximum benefit amount. It also covers travel assistance services including emergency evacuation and repatriation.

Is there anything my insurance doesn’t cover?

Yes. Exclusions that are detailed in the plan brochure include: expenses covered by other insurance, injury or sickness that has been treated within 31 days of the start of your coverage, eyeglasses, eye exams, contact lenses, suicide, hang-gliding or parachuting, dental care except for accidental injuries, physical examinations and other well care services including prescription drugs where no injury or sickness is involved.

When does my insurance start and end?

The International YMCA will provide Nationwide with start and end dates for your coverage. Coverage begins on the first day of your program and ends the last day of your program as printed on your form DS-2019.

Do I need additional insurance if I travel to the U.S. before my program starts or after my program ends?

Yes.

Are there limits to how much the insurance will pay?

Yes. Maternity expenses are limited to $2,500. Psychiatric care is limited to $5,000. Other accident and sickness medical expenses are limited to $100,000.

How do I get information about my insurance and my ID card?

Visit the International YMCA web site and look for the participant section. When prompted for a password, use the password provided to you in information sent with your form DS-2019. You will find internet links to download your ID card and print an insurance brochure.

How do I file a claim?

You must complete a claim form that is contained in the plan brochure and mail it along with any medical bills to Nationwide Insurance at the address shown in the brochure. You can also download additional copies of the claim form via the International YMCA web site.

How do I find a doctor?

You may choose to see any doctor. You can locate a preferred provider near to you at www.phcs.com.

What is a preferred provider?

Preferred providers are required by PHCS to bill Nationwide Insurance for their services. Other providers may require you to pre-pay for medical treatment.

What is a deductible and how much do I pay if I go to the doctor?

A deductible is a one-time payment per injury or sickness that you are required to pay. Your insurance has a deductible that you are required to pay the first time you incur a covered expense such as seeing the doctor for an injury or sickness.

Does my insurance cover medical prescriptions?

Only if they are directly related to an injury or sickness that occurred while you were covered by this plan.

What is a pre-existing condition?

Any injury or sickness that you have been treated for within 31 days of becoming covered under the Nationwide plan.

Am I covered if I am injured at work?

The primary coverage for work injuries is the Workers Compensation insurance program paid for by your employer. Covered expenses in excess of Workers Compensation or that have been denied by Workers Compensation may be covered under this plan.

I lost my insurance papers and ID card. How do I get a replacement?

Follow the same instructions in the previous question.

Do I need to contact International YMCA if I am sick or injured?

If you have a serious injury or illness, contact the International YMCA for assistance with various issues and questions you may have.

What should I do if I get a medical bill after I finish the program and go home?

Mail it with a claim form to Nationwide Insurance at the address in the brochure.

Can I have additional insurance from home that also covers me in the U.S.?

Yes. The Nationwide plan is excess to (pays after) your other insurance.

How do I prove I have insurance coverage when I go to the doctor or a hospital?

Show your insurance ID card and ask them to call Nationwide at the toll-free number if necessary.

What resources are there if my claim is denied?

You may appeal a claim denial by sending a letter to Nationwide at the address in the brochure.

Do I have full coverage if I am traveling to other countries during my J1 program?

Yes. The Nationwide plan covers you while you are engaged in a trip away from where you live in the U.S.

Does this policy include life insurance?

No, life insurance pays a death benefit after most types of deaths. This policy has an accidental death benefit that is paid if you die as a result of injury.

I have a problem with my wisdom tooth and need to see a dentist. Am I covered?

No. This policy covers dental treatment only due to an accident to sound, natural teeth.

I have medication I take every day; how do I fill my prescription in the U.S.?

The Nationwide plan does not cover maintenance medications for blood pressure, cholesterol, birth control, etc. You may be required to pay for the entire cost of the prescription unless you have other insurance.

What are the reasons for a claim to be denied?

A claim can be denied for many reasons including no coverage at the time of the injury or sickness, expenses that are not covered by the plan, failure to file a claim form or provide additional information, injuries that are work-related, pre-existing conditions, not receiving an itemized bill, and deductible not satisfied.

Are skiing and snowboarding injuries covered by the plan?

Yes. There are no sports exclusions other than hang-gliding and parachuting.

How can I make sure all my claims get paid?

First, be sure to file a claim form and provide all the itemized bills to Nationwide. Second, be sure you have paid your deductible amount to the provider. Third, provide Nationwide with information on any other insurance you may have and answer all their questions about the injury or accident. Finally, call Nationwide toll-free at 800-525-8669 to make sure they have everything they need to pay your claims.

How do I extend my insurance?

Nationwide allows you to extend your coverage for up to 30 days following the last of your program as printed on your form DS-2019. Contact the International YMCA to extend your insurance at least 30 days before the end of your program.

Can I extend the insurance to cover me at home after my program ends?

No.