ADmed: Major Medical
Providing coverage when you need it most!
Our ADmed product was designed to finance unexpected major medical bills at an affordable price by providing a comprehensive package of benefits. The ADmed Card guarantees instant admittance to accredited private hospitals. ADmed Accredited Hospitals are able to check the system and verify the ADmed Cardholder’s available benefits.
The ADmed package includes the following benefits:
This benefit will be paid whenever the insured undergoes a surgical operation that is medically necessary and appropriate, invasive and requires a surgical incision. A specific amount will be paid, depending on the type of surgery required.
Hospital Diagnostics Benefit
This benefit will be payable if the insured incurs expenses for room and board, diagnostic lab tests/X-rays, machine testing or hospital ancillary services at a hospital in respect of diagnostic services as a result of accident, emergency or sickness on a Doctor’s recommendation.
Accident & Emergency Services Benefit
This benefit is payable if you incur expenses at a hospital in respect of medical services required as a result of an accident or emergency. This benefit covers the first 48 hours of expenses, up to the benefit maximum.
Dread Disease Acceleration Benefit
This critical illness benefit is payable on diagnosis of a Heart Attack, Stroke, Cancer, Renal Failure, Paralysis, Multiple Sclerosis, Terminal Illness, Major Burns, Coma and Total and Permanent Disability. The benefit is only payable once.
This benefit is payable on the death of the Life Insured.
How ADMED Works
1. Visit one of the ADmed Accredited Hospital and show your ADmed Card along with a valid picture ID at the hospital’s Accident and Emergency Department.
2. The hospital clerk will verify the Client’s available coverage via the online system.
3. Once the doctor indicates the Client’s visit meets the contract definition of accident and/or emergency, the ADmed Attending Physician’s Statement will be completed by the doctor and the ADmed Claimant’s Statement to be completed by the Client.
4. Note if after the doctor’s examination the symptoms do not meet the contract definition of accident and/or emergency, the Client will be responsible for their bill as this would not be a valid ADmed claim.
5. The hospital will submit to Maritime Life (ADmed Department) the completed claim forms along with their invoices.
6. Invoices will be settled by the ADmed department and settlement cheque made out to the relevant hospital(s).
7. If the Client pays their bill in full, the Client will be responsible for getting the ADmed claim forms completed and submitting the original bills where necessary to Maritime Life (ADmed Department) for reimbursement. Once the claim is valid the settlement cheque will be made out to the Client.
8. If the Client has to have a scheduled, surgical procedure, the Client will have to submit a letter completed and signed by the doctor giving the details of the ailment, surgical procedure to be done, the name of the hospital at which the procedure is to be done and a breakdown of the expenses. This letter can be emailed or faxed to the ADmed Department at 675-7485. This information will be reviewed and a letter emailed or faxed to the hospital stating the amount ADmed will cover.
9. For the hospital diagnostic benefit, the Client will have to submit a letter completed and signed by the doctor giving the details of the ailment, the test to be done, the name of the hospital at which the test is to be done and a breakdown of the expenses. This letter can be emailed or faxed to the ADmed Department at 675-7485. This information will be reviewed and a letter emailed or faxed to the hospital stating the amount ADmed will cover.
10. All claims must be submitted within 90 days from the date of service.
|Kerri-Ann Hyndman-Borris||Extension 2041|
|Daesha Allen||Extension 2058|
|Cheryl-Ann Sylvester||Extension 2048|