Prepaid Air Medical Services Provided to Air Ambulance Card

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					                                                        When We Will Transport You
                                                                                                                       Both the originating and receiving hospitals must
                                                                                                                        be reasonably accessible by ground ambulance to
                                                        If you are hospitalized as an inpatient and wish to             transport the member to and from an airfield
                                                        be transferred to another hospital more than 150                capable of accommodating medical aircraft we
                                                        miles away, we will provide fixed wing air                      provide.
                                                        ambulance services to you, subject to the
                                                        following guidelines:                                          Transportation from remote areas or islands to a
                                                                                                                        location with an airfield accessible to medical
                                                                                                                        aircraft is not provided. Costs of evacuation from
                                                        Air Medical Services Guidelines:                                these remote areas are the responsibility of the
Prepaid Air Medical Services                                                                                            member.
Provided to Air Ambulance Card®                            You must be hospitalized in a domestic or foreign
                                                            hospital as an inpatient transferring to another           Membership does not provide                helicopter
Members                                                     hospital as an inpatient.                                   transports or payment of hospital bills.

Transport Services While Traveling: If you are             You must have a confirmed admission at the                 Due to limited medical and laboratory facilities on
                                                            receiving hospital prior to transport.                      cruise ships, in some cases our Medical Director
hospitalized as an inpatient due to an illness or                                                                       may require a member to be admitted to a hospital
injury while traveling more than 150 miles from
                                                           Prepaid Air Medical Service repatriation flights will       on-shore     before    scheduling   air   medical
home, whether domestically or internationally, Air          only return you home to the United States or                transportation to another hospital.
Ambulance Card will provide you with air medical            Canada.
transportation,     medical     evacuation,     and                                                                    U.S. registered aircraft and personnel cannot be
repatriation services to the hospital of your choice       Interim evacuation flights before repatriation will         sent into countries where the U.S. State
in the United States or Canada.                             be performed if inpatient hospitalization is required       Department has issued travel restrictions, or to
                                                            and due to inadequate medical facilities transfer to        areas where civil aviation has been suspended or
Transport Services to Specialty Hospitals: If               another hospital more than 150 miles away is                restricted, such as the result of a natural disaster
                                                            warranted.                                                  or civil unrest. Membership services are subject to
you are hospitalized as an inpatient in your
                                                                                                                        exclusion in these areas.
hometown hospital and require admission to a
specialty hospital located more than 150 miles             The Air Ambulance Card Medical Director and the
                                                            receiving physician must concur that the patient           One family member, business associate, and/or
away, and you are unable to travel without                  cannot be discharged and travel without                     traveling companion may accompany the patient,
continuous medical care, we will provide air                continuous medical care.                                    at no additional cost, on medical aircraft if space is
medical transportation. The receiving physician                                                                         available and the patient’s care is not
and our Medical Director must agree that the               Air Ambulance Card must make all arrangements               compromised.
transport to the specialty facility is medically            for air medical transportation and repatriation.
necessary.                                                  Since Air Ambulance Card is a membership                   Family members, business associates, and/or
                                                            program and not an insurance plan, members will             traveling companions accompanying patients
Medical Monitoring and Consultation: When Air               not be reimbursed for expenses they incur on their          transported as a patient on a scheduled
                                                            own.                                                        commercial airline are responsible for their own
Ambulance Card is notified that you have been                                                                           airfare.
hospitalized while traveling, our Medical Director
will communicate with the attending physician and          Decisions regarding urgency of the case, the best
                                                            timing, and the most suitable means of                     Prepaid air ambulance service is limited to two
will continue to monitor your condition. If requested       transportation will be made by the Air Ambulance            separate transports per membership per year,
we will communicate with your family during                 Card Medical Director after consultation with the           except for repatriation flights involving enrolled
transport or until the medical condition is resolved.       local attending physician and the member’s                  multiple family members requiring simultaneous
                                                            receiving physician.                                        repatriation. Under these circumstances, each
Transport of Mortal Remains: If a member dies                                                                           family member will receive one fully paid transport.
while traveling internationally we will arrange and        If a member's condition permits, he or she may be
pay for all necessary government authorization,             transported as a patient on a scheduled                    The patient and an accompanying passenger are
                                                            commercial airline in the care of a medical team.           limited to one small carry-on bag each due to
provide a container appropriate for airline
                                                                                                                        limited space available on medical aircraft. We will
transport, and return the remains to the member’s                                                                       assist in arranging for additional luggage to be
place of residence.                                                                                                     forwarded at the member's expense.
    When We Will Not                                             Transport of Mortal Remains
    Transport You
                                                                 The following restrictions or limitations apply to the
   A member with mild lesions, simple injuries                  transport of the mortal remains of a member.
    such as sprains, simple fractures or mild                    Depending on foreign laws and customs, embalming
                                                                  may not be available outside of North America;
    illness that can be treated by local doctors
    and do not prevent the member from                           Documents required by some countries can delay
                                                                  transport by several days;
    continuing his trip or returning home does
                                                                 Caskets, other than those certified for airline transport,
    not qualify for air medical services.                         are not included; and
                                                                 Air Ambulance Card representatives must make all
   A member who is hospitalized or anticipating                  arrangements for the transport of mortal remains. No
    hospitalization at the time of enrollment will                reimbursement will be made for expenses incurred by
    not be eligible for transport benefits for that               members.
    hospitalization.                                                                                                                   Membership Information
                                                                 Eligibility                                                                 Booklet
   A member traveling outside of the United                    Membership eligibility is limited to residents of the U.S. or
    States or Canada to receive medical care                     Canada under the age of 75.                                     This booklet contains the rules and guidelines
    will not be transported.                                    Family dependents must meet requirements published on
                                                                                                                                 for your prepaid air medical service
                                                                 Air Ambulance Card enrollment forms.
   A member with tuberculosis or other chronic                 Standard annual memberships are available for
                                                                                                                                 membership. If you have any questions
    airborne pathogens may not be transported.                   uninterrupted travel outside the U.S. or Canada of 90           please contact Air Ambulance Card®.
                                                                 days or less per trip. Extended Stay memberships are
   A member with an infectious disease under                    available for members traveling or living outside the U.S.
                                                                 or Canada for an uninterrupted period in excess of 90           Air Ambulance Card, LLC
    treatment at the time of enrollment will not be              days.                                                           2 North 20th Street, Suite 1300
    transported for any condition related to that
                                                                Membership        enrollments      and     renewals      are    Birmingham, AL 35203-4077
    infection.                                                   non-transferable, non-refundable, and subject to approval
                                                                 by Air Ambulance Card.
                                                                                                                                Telephone:     (205) 297-0060
    A member on or seeking placement on an                      Membership is valid only if the applicable membership
    organ transplant list at the time of enrollment              fee is collected.
                                                                                                                                 Toll Free:     (877) 424-7633
    is not entitled to a transport for that                     Intentional or unintentional errors or omissions in             Fax:           (205) 297-0065
    transplant.                                                  information provided to Air Ambulance Card may result in        Web:
                                                                 refusal of services and/or cancellation of your
   A member beyond the second trimester of                      membership.
    pregnancy may not be transported.
                                                                                                                                 Air Ambulance Card is an indirect air carrier
                                                                 General Terms and Conditions                                    authorized under U.S. Department of Transportation
   Members will not be entitled to air medical                 Air Ambulance Card, LLC reserves the right to change or         Order 83-1-36, 99 C.A.B. 801 (1983), and uses the
    services if their illness or injury is a result of           amend these rules and regulations without notice to             services of licensed FAA Part 135 direct air carriers to
    or is contributed to by the following:                       members.                                                        meet the air ambulance or medical evacuation
                                                                The interpretation and application of the rules and             transportation needs of its members/clients. Air
        >War, invasion or civil war;                             regulations communicated in this publication, as well as        Ambulance Card does not own, lease or operate any
        >Suicide, attempted suicide or                           any subsequent changes or amendments, are within the            aircraft. As an indirect air carrier, Air Ambulance Card
        intentional self-injury;                                 sole discretion of Air Ambulance Card.                          contracts for the provision of air transportation services in
        >A member's own criminal or felonious                   All determinations by Air Ambulance Card shall be final         its own name and coordinates the provision of medical
        act, or                                                  and conclusive in each case.                                    services. All flights are operated by licensed direct air
        >Sustained while the member is in a                     By applying for membership you accept and agree to Air          carriers.
        state of mental incapacity.                              Ambulance Card’s terms and conditions of membership.
                                                                Air Ambulance Card is not insurance. We must make                  01/2010 revision 2010 Air Ambulance Card, LLC
                                                                 all the arrangements for air medical transport                           Supersedes all previous publications
                                                                 services; we cannot reimburse expenses incurred by                 Air Ambulance Card is the registered trademark of
                                                                 members on their own.                                                          Air Ambulance Card, LLC