Medical Coverage
All AFS participants are covered under the AFS Participant Medical Plan. This medical plan provides an extensive secondary medical insurance, meaning it is ultimately responsible for medical expenses only if the expenses are not payable through a primary policy first, such as a national health plan or private insurance held by the sending family. The AFS Medical Plan responds to injury and/or illness.
Volunteers should be aware of certain “uncovered” situations/events. Pre-existing conditions are not covered under the AFS Medical Plan and natural families are informed in advance of financial responsibility for all medical costs related to these conditions.
In addition, The Participant Medical Plan does not pay for routine physicals, inoculations, vaccinations, or examinations, even if required by schools.
Summary of expenses excluded because they are to be expected or are elective:
- Routine vision care
- Routine dental care
- Routine physical exams
- School physical exams
- Inoculations
- Vaccinations
- Pre-existing conditions
- Birth control treatment
- Medicine and checkups for regular control of chronic conditions
All dental and eye problems must be reported to AFS-USA before any medical procedures are performed to ensure that arrangements for payment are made in advance with the natural family.
Additional Benefits Coverage
AFS provides a package of additional travel-related benefits for AFS participants. This package offers seven kinds of benefits that can be helpful with illness or injury that happens during travel, but that is not covered under the Participant Medical Plan.
The additional benefits include:
- Accidental Death and Dismemberment (AD&D)
- Emergency Dental
- Reunion Benefit
- Trip Interruption Benefit
- “Tail” Medical Insurance
- Permanent and Total Disability Insurance
- Bereavement and Trauma Counseling Benefit
For more information on medical insurance coverage including additional benefits, please see AFS Medical Plan.
Going to the Doctor
If a participant needs to see a doctor, please ensure that they bring their Medical ID card to the appointment. The Medical ID card contains a participant's ID number and the insurance billing information for Global Medical Management, Inc., the Insurance Administrator. Please be sure the doctor knows to submit the bill to Global Medical Management, Inc. A bill submitted to AFS will only delay payment. If for any reason the host family paid for the medical service, the AFS Medical Claim Form must be completed and sent along with the original receipt to GMMI. Medical records/notes should also be included, if any. Copies of receipts should be kept on hand. Host families should not send these claims to AFS as this reduces processing efficiency.
To download the AFS Medical Claim Form click here.
Contact information for billing:
Global Medical Management, Inc.
880 SW 145th Avenue, Suite 400
Pembroke Pines, FL 33027
USA
Phone: 888-444-7773
Fax: 954-370-8130
email: customerservice@gmmi.com
This one-pager provides tips for communicating with medical providers and the insurance administrator. We recommend proactively sharing it with host families when they are in need of guidance on medical processes for AFS students.
Please note some participants may be reluctant to seek care from a medical doctor or to take medications that are common in the U.S., including pain relievers and cough medicine. They may have a distrust of physicians or feel that it is better to heal oneself in time through non-medicinal measures such as rest or maintaining a healthy diet. If you feel it is necessary to take the participant to the doctor, keep in mind that this may be a less routine occurrence for them compared to a typical U.S. teenager. As such, they may need additional support and encouragement in the process.
Reporting
High level or emergency medical situations MUST be reported to AFS USA staff/ Duty Officer immediately
- Hospital admittance
- Surgery
- Suicidal ideation/ self-harm
- Alcohol/ drug abuse
- Car accident
Colds, sore throats, flu, upper respiratory infections, sprains, and uncomplicated childhood diseases do not need to be reported to AFS-USA. Please only report these events if they appear to linger for an unusually long period of time after visiting a medical professional.
Serious Illness and Hospital Admittance
Serious illness and hospital admittance must be reported immediately to AFS-USA staff or the AFS Duty Officer (if after business hours). This information will be shared with the participant’s natural family via the AFS Partner Office in the participant’s home country.
If an AFS participant is admitted to a hospital, it is important to have the following information when making the report:
- Name and country of participant
- Date of accident or commencement of illness/injury that led to hospitalization
- Date and approximate time of hospitalization
- Name, address, and phone number of hospital
- Name and telephone number of attending physician
- Diagnosis of illness/injury and prognosis for recovery
- Treatment (what medication is being given, what other tests are planned)
Automobile Accidents
Automobile accidents must be reported to AFS-USA as quickly as possible. Even if there is no apparent injury, the AFS participant must be seen by a physician. A Medical Claim Form should also be completed and submitted to AFS-USA.
To download the AFS Medical Claim Form click here.
In case of a medical emergency involving an AFS participant, call 1-800-AFS-INFO (800-237-4636) and press 9. AFS-USA has the power of attorney to act on the behalf of the participant in the case of medical emergencies.
Parental Authorization
In the event of serious illness or accident, AFS has written authorization from natural parents to act on behalf of AFS participants where authorization for treatment or surgery is required. Both the participant and natural parents have signed an AFS Participation Agreement. The AFS Participation Agreement contains the following clause:
Should any medical emergency arise, if time permits, AFS will communicate with us through the National Office and request permission for surgery or other necessary treatment; however, if in the sole judgment of AFS, time and circumstances do not permit communication with us, we authorize AFS to consent to medical treatment, the administration of x-ray examination, anesthetics, blood transfusion, medical or surgical diagnosis or treatment and hospital care which is deemed advisable by, and is to be rendered under the general or special supervision of any physician and surgeon.
In addition, natural parents have signed a separate authorization form containing the same clause. If participants or host families do not have a copy of this form, and it is requested by a doctor or a hospital, please contact AFS-USA.
Immunizations
Vaccines are considered "routine" and do not require AFS approval prior to receiving a vaccine while on program. However, it is critical that the participant's parent(s)/legal guardian(s) have given their consent.
Please note that vaccines are not covered under the Travel Medical Plan and any costs associated with obtaining a vaccine(s) will also be the responsibility of the participant and the sending parent(s)/legal guardian(s).
What should we do if a participant requests to receive a COVID-19 vaccine or booster?
Each year AFS participants receive immunizations while on an AFS program. These immunizations can be school-related or not (such as the influenza vaccine). AFS does not require an AFS specific consent form for any immunizations, including the COVID-19 vaccine and booster.
Should a participant both be eligible and request to receive a COVID-19 vaccine(s) or booster while on program, the participant should speak with their sending parent(s)/guardian(s) in their home country to obtain permission for the initial vaccine or booster. If the US healthcare facility requires parental/guardian permission the participant should arrange to obtain their sending parents’/guardians’ signatures for these form(s). AFS does not require special permission or a consent through the AFS organization.**
Like all other vaccines, these are considered "routine" and do not require AFS approval prior to receiving the vaccine while on program. However, it is critical that the participant's parent(s)/guardian(s) have given their consent.
The COVID-19 vaccine and booster, as with any other vaccine, is not covered under the Travel Medical Plan and any costs associated with obtaining the vaccine will also be the responsibility of the participant and the sending parent(s)/guardian(s). For ECA Sponsored Programs participants (CBYX, FLEX, and YES), if there is a cost involved in a participant receiving the COVID-19 vaccine while in the US, the cost will be covered by program funds.
You can find a COVID-19 Vaccination One-Pager with information for host families here.
** Please Note: ECA Sponsored Programs (CBYX, FLEX and YES) participants and their sending parents were required to sign a Department of State COVID-19 Vaccine Permission Consent document prior to program. The AFS liaison, Area Team Support Coordinator and host family will be notified, in advance, if a participant and their parents do not consent to a COVID-19 vaccine. If you have not been notified it means that AFS has consent on file and the participant can proceed with obtaining their parent(s) signatures for the healthcare facility specific form.
What if the local volunteer team and/or host families are not comfortable speaking with (or do not yet have access to speak with) the sending parent(s)/guardian(s) and participant about their COVID-19 vaccine openness/status?
For NH22 participants, AFS Sending Partners have been requested to provide participants’ COVID-19 vaccination status during the application process. For participants who have received the COVID-19 vaccination, COVID-19 vaccination details will be indicated in the Health Certificate in the vaccination section, including vaccination dates and vaccination type (e.g., Moderna). AFS-USA has also requested that AFS Sending Partners/applicants upload the vaccination card/document for participants’ COVID-19 vaccinations to the application.
However, if a participants’ vaccination status is not clear in the application or Placement Detail Comment screen and/or clarification/update is needed for placement, a partner request can be submitted to your Regional Field Specialist who will contact the Hosting Operations team to reach out to the sending partner.
After the participant’s placement is confirmed (FPC), prior to program, if additional information is needed about COVID-19 vaccination and/or booster and the host family/local team are not comfortable discussing the COVID-19 vaccine with the participant, a partner request can be submitted to your Regional Field Specialist and AFS-USA will reach out to the AFS Sending Partner for clarifying information.
Once the participant is on program, if a host family is interested to know the student’s vaccine status and/or the sending parents’/guardians’ position on their child receiving the COVID-19 vaccine and are not comfortable discussing this topic with the participant directly, the host family should reach out to their AFS volunteer liaison for guidance. The AFS liaison can follow up with AFS Participant Support Department staff for further guidance.
AFS-USA has included COVID-19 vaccine related content in the Host Family Handbook. Please refer to this document for information provided to the host family on this topic.
Should any questions or concerns arise during the participant’s program which requires additional assistance, please contact our Participant Support Department 1-800-AFS-INFO, press 3.
What if the AFS participant has questions about the COVID-19 vaccine, a COVID-19 booster vaccine, or the host family has questions about the AFS participant being eligible/receiving the COVID-19 vaccine?
If the AFS participant has questions about the COVID-19 vaccine (including boosters), encourage them to discuss this topic with their host family and sending parent(s)/legal guardian(s). If the AFS participant would like additional resources share the CDC Key Things to Know About COVID-19 Vaccines with them.
If the host family has questions about the AFS participant eligibility/parental permission to receive the COVID-19 vaccine or any other immunization(s) (including COVID boosters), encourage the host family to speak with their primary care physician regarding eligibility.
If the host family requests for the AFS participant to receive the COVID-19 vaccine (including a COVID booster), or any other vaccine, and is not comfortable approaching this topic with them or their parent(s)/guardian(s), please reach out to your Regional Field Specialist if it is prior to the student’s arrival. If the student is already on program in the US, please reach out to your Participant Support Specialist for guidance.
Prescription Drug Reimbursements
Participants or host families are expected to pay for prescription drugs up-front and then to request reimbursement. The Medical Claim Form must be completed and sent along with the original receipt to GMMI. Medical records/notes should also be included, if any. Copies of receipts should be kept on hand. Host families should not send these claims to AFS as this reduces processing efficiency.
To download the AFS Medical Claim Form click here.
Finding a Provider in Network
Using a service provider that is in-network can eliminate requests for up-front payments for services and reduce the frequency of balance billing. Consult the GMMI website to search for a network provider in your area and log in using the following username and password.
GMMI Website:
https://www.gmmi.com/login.asp
Username: AFS
Password: AFS
Balance Billing
AFS's Insurance Administrator, GMMI, frequently negotiates discounts with service providers. Sometimes, those providers attempt to collect the remaining balance from host families. This is called "balance billing" and is illegal in some states. Host families should never pay these balances. Instead, the families should contact the service provider directly to request an end to the balance billing. If this does not prove effective, host families should then contact GMMI for assistance.