California State University San Marcos



|[pic] |Office of Global Education |

| | |

| |California State University San Marcos |

| |San Marcos, California 92096-0001 USA |

| |Tel: 760 750-4090; Fax: 760 750-3284 |

| |csusm.edu/global |

Travel Abroad

Medical Insurance Requirement

You are required to purchase medical insurance coverage through Wells Fargo of California Insurance Services for the time that you are traveling outside the United States.

The Value Plan covers medical expenses while you are outside the U.S. For an additional premium you can purchase the “Deluxe Plan,” which also includes coverage for certain athletic and hazardous activities, and a home country extension of benefits (see the insurance booklet for a complete description of this coverage).

If you plan to arrive at your destination prior to commencement of your program or stay after the program ends, and wish to be insured during that time you will need to purchase additional coverage.

NOTICE TO PARTICPANTS: The CSU Study Abroad insurance plan is designed to cover eligible medical expenses a student might incur while outside the United States. The plan offers medical insurance, which reimburses you for medical expenses incurred abroad, and a global emergency medical assistance service, offered through AIG Travel Assist, which provides key services including, but not limited to: medical consultation and evaluation; hospital admission guarantee; emergency medical evacuation; critical care monitoring; and repatriation of mortal remains.

Be aware that AIG Travel Assist services do not replace medical insurance during medical emergencies away from home. AIG Travel Assist pays directly for services it provides, but does not reimburse for services that are not arranged through them. Therefore, students and their families should not arrange for any medical or emergency service, such as medical evacuation, except through Assist America.

Even though you have medical insurance that will reimburse you for medical expenses, you should be prepared to pay for medical care at the time it is rendered. While some medical providers may bill the insurance company directly, most providers and facilities will demand payment at the time of treatment. Therefore, you should have a credit card with you with a credit limit sufficient to cover basic medical emergencies.

ACKNOWLEDGEMENT: I understand that if I need medical treatment payment must be made at the time of treatment and I will be reimbursed after filing a claim. I further understand that services provided under this policy by AIG Travel Assist must be initiated through them and that I will not be reimbursed by AIG Travel Assist for any service contracted by me or on my behalf.

Student Signature________________________________________________________________ Date __________

Student Name (print)_____________________________________________________________

Signature of Parent or Guardian if student is under 18: ___________________________________ Date _________

Parent or Guardian Name (print): ____________________________________________________

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