Royal User Guide

感谢您选择 GoGlobalSafe，我们很高兴成为您留学旅程中的一部分！在海外学习生活充满了新奇与挑战，而我们的使命就是通过专业、高效的保险服务，为您提供安心无忧的保障，让您能够专注于学习和生活。

请随时查看本指南，了解如何充分使用您的保险权益。如果有任何疑问或需要帮助，欢迎通过以下方式联系：

24小时会员服务（inside the U.S.）：+1 855-773-7810

Outside the U.S: +1-786-453-4008

微信客服：公众号安途 GoGlobalSafe 联系我们

紧急情况：请拨打 911

重要：

1. ID card：Understanding your ID Card 购买完成后email内获得的ID card文件，或者certificate 文件底部部分为 “保险卡”。这是您的保险凭证，请确保每次就医时出示此保险卡，可以截图保存到手机或者打印出来保存在钱包。

2. 医疗网络：UnitedHealthcare Options PPO，在预约网络内医生确认保险信息时，请声明自己的医疗网络Network 为Unitedhealthcare Option PPO，医疗人员可通过保险卡上电话 855-773-7810 核实保险保障信息。

3. 药物网络：EHiM，常见CVS药房，校内药房为网络内

4. 实验室检测网络 Lab Test：Quest Diagnostics, 当您需要进行X光、核磁共振等实验室检测时，很多医生会将你指引到他们自己熟悉的实验室，但这些实验室不一定是网络内！建议拨打 855-773-7810 确认所选实验室为网络内以避免高额检查费。

接下来需要了解的事情：

注册保险公司账户：通过购买完成后email内链接进行创建

设立在线问诊Telehealth账户：Telehealth Instruction

可能需要的常规医疗服务

1. 入学要求的疫苗接种：

在学校的Student Health Center（SHC）或网络内药房如CVS进行时，可以100% cover。支付与报销可参考文档理赔报销部分。

2. 入学要求的TB-Test等健康检查：

在学校的Student Health Center（SHC）进行时可以100% cover。部分检测项目校外常见药房或者小诊所，不同州可能不提供或只提供有限相关服务，建议优先选择校内SHC。支付与报销可参考文档理赔报销部分。

3. 常规体检指南：https://www.goglobalsafe.com/preventive-care-guide/

4. 生育怀孕：
1. Royal系列保险按计划报销比例覆盖正常怀孕相关检查和生育费用。可参考plan policy ：Maternity Care and Birth Benefits 部分。
2. 需要在确认怀孕的30天内联系保险公司（855-773-7810）进行登记。
3. 如果是在保险生效前怀孕，则无法获得相应保障。

当你需要看病就医时：

1. 医疗机构选择指南：美国不同医疗机构如何选择

2. 校医院：
1. Student Health Center（SHC）是简单医疗问题的第一选择，大多时候可以walk in就诊，免去预约等待的麻烦（预约能更好的安排时间和获得对应医生科室的治疗）。
2. SHC 就诊可以免去免赔额（Deductible）和共付额（Copayment）大大减少每年的医疗费用支出

3. 网络内医生：
1. Royal 系列计划使用 Unitedhealthcare Options PPO，可通过UHC 查找附近医生（使用指南）。
2. 预约医生：在预约网络内医生确认保险信息时，请声明自己的医疗网络Network 为Unitedhealthcare Option PPO，医疗人员可通过保险卡上电话 855-773-7810 核实保险保障信息。

4. 网络外医生：如果你找不到网络内医疗机构在您附近满足您的医疗需求，你可以选择到任意医疗机构就医。需要注意网络外医疗机构通常医疗价格更高，报销比例更低，且他们不会帮你走直付。

当你需要理赔报销时 Make a claim：

校医院：

1. 当你学校的Student Health Center接受UnitedHealthcare Options PPO医疗网络时，SHC会与保险公司直付direct-billing，这种情况下无需垫付，学校通常会通过email与您沟通相关细节和账单。
2. 当你的学校只接受校内保险时：你仍然被GGS royal系列计划覆盖，只是SHC不会帮您进行direct-billing的相关操作。您可以垫付相关费用，并参照报销指南提交报销。

网络内：

1. 网络内医疗机构会直接通过您保险卡上信息与保险公司确认细节条款和提交direct-billing支付相关费用，无需自己进行操作。当然最好每次与医生确认他向保险公司提交了报销文件或者授权申请。
2. 网络内药物：每次自己只需支付药物等级对应Copayment（参考保险条款），剩下部分由保险公司支付。

网络外：

网络外医疗机构通常情况下也会直接通过您保险卡上信息与保险公司确认细节条款和提交direct-billing支付相关费用。但是也有很多网络外医疗机构和医生不会这样操作，需要您预先垫付费用，这种情况下您可以预先垫付相关费用，并按照报销指南提交报销。

除外条款：

类别	排除内容	原文引用
一般性排除项	未在保险政策中明确列为覆盖的服务或治疗。	“not specifically listed in this Policy as covered.”
	因排除或限制的疾病、受伤或程序直接引起的并发症。	“for any complications directly caused by an Illness, Injury or Procedure for which we exclude or limit coverage.”
	自行治疗、自我用药或未遵循医生建议而导致的健康问题。	“where Treatment or Advice of a medical condition…was a result of self-treatment or auto therapy (self-administered).”
	因酒精、非法药物或未按医生处方服用药物引发的健康问题。	“for Injuries or Illnesses caused by, contributed to or resulting from the Insured Person’s use of alcohol, illegal drugs, or…not taken…as prescribed.”
生育与不孕治疗	促进受孕的治疗（如不孕药物或相关处方）。	“that promote conception including, but not limited to, fertility/infertility drugs, any Prescription Medications, or any complications…”
	避孕措施或绝育手术及其逆转（部分避孕药除外）。	“to prevent pregnancy…or which is aimed at making a person unable to reproduce…and any expenses for male or female reversal of sterilization.”
性功能障碍与性别变更	性功能障碍、阳痿或相关治疗（包括性增强药物）。	“for sexual dysfunction, impotency or inadequacies, including sexual enhancement drugs.”
	性别转换相关的荷尔蒙疗法或手术。	“hormone therapy to change the biological sexual characteristics to those of the opposite sex, implantation or sexual transformation.”
牙科、视力和听力护理	常规牙科或视觉检查，矫正手术（如激光近视手术）。	“routine eye examinations, eyeglasses, contact lenses…or any vision correction surgery.”
	助听设备或相关手术（如人工耳蜗）。	“routine hearing examinations…hearing aids or devices, Surgical implantation of, or removal of bone anchored hearing devices, and cochlear implants.”
基因检测	基因检测或筛查（如BRCA基因测试）。	“any genetic testing or screening including, but not limited to, BRCA1, BRCA2…”
	与遗传疾病相关的治疗或预防性手术。	“preventative prophylactic surgeries recommended by genetic testing or screening.”
排他性医疗服务	学生未利用学校健康中心提供的免费或已支付费用覆盖的服务。	“If Services are provided by your Student Health Center and you do not utilize the Student Health Center for such Services…these Services will be excluded.”
	工作相关的工伤或职业病由工伤赔偿法覆盖的治疗。	“provided by or payment is available from…workers’ compensation law, occupational disease law…”
	不必要的美容或整形手术，包括因心理原因改善外貌的手术。	“any elective and/or cosmetic Service, Surgery, Procedures, Treatments…for the purpose of improving, altering, enhancing…an existing condition.”

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