1. Fulbright Grants for U.S. Citizens / 2015-2016 Presentation prepared by the Commission for Cultural, Educational and Scientific Exchange between the United States of America and Spain Health Care ASPE Insurance Orientation sessions at the Instituto Internacional en España Madrid, September 7-10, 2015

2. 2 Even though you may not be thinking about it now, you will most likely get sick at some point! New Germs Working with Kids Air Quality

3. ASPE INSURANCE ASPE = Accident and Sickness Program for Exchanges U.S. DoS health care benefit plan administered by SevenCorners Inc. Coverage: during the grant period and direct travel to and from the States. Only covered in Spain unless on a Fulbright related trip. Coverage: Maximum of $100,000 per sickness or accident. Reimbursement of medical expenses (except for a $25 - $75 co-pay per visit). 3

4. ASPE INSURANCE ASPE Brochure at http://www.usdos.sevencorners.comhttp://www.usdos.sevencorners.com Call collect Customer Service 24/7/365 00-1-317-818-2867 Make sure you always check the “OUTSIDE THE U.S.” information Be aware that some forms are specific for “OUTSIDE THE U.S.” 4

5. ASPE INSURANCE WHAT IT DOES COVER Regular doctor visits: Cold, flu, stomach bug, etc. Injuries A limited gynecological check-up after the first six months of the grant. Some prescription drugs either through mail order from the US or through reimbursement. More info: ASPE booklet. 5

6. ASPE INSURANCE WHAT IT DOES NOT COVER Pre-existing conditions Routine check-ups Shots / Vaccinations Dental care, except for pain treatment Any kind of treatment inside the U.S. Accompanying dependents Loss or damage to luggage during travel 6

7. SECONDARY POLICY ASPE is SECONDARY to any other policy you may hold (except for Medicare / Medicaid), which means: If you are covered by another insurance company while in Spain, ASPE is your secondary insurance. In this case, you always have to request reimbursement from your U.S. insurance company first. If your U.S. insurance rejects your claim, ASPE will then cover the treatment (if it is not a pre-existing or excluded condition). 7

8.  Two types of grantees: 1. Covered only by ASPE: They have no U.S. insurance coverage 2. Covered by U.S. insurance: (with the exception of Medicare/Medicaid) They will only be covered by ASPE in case of claim denial 8 ASPE INSURANCE

9. HOW YOU SHOULD PROCEED: Varies depending on where you live. 9

10. ASPE INSURANCE If you live in Madrid, Barcelona, Sevilla, Granada, or La Coruña- listen up! 10

11. Madrid, Barcelona, Sevilla, Coruña, Granada Tourist Health Spain Service (not a clinic/hospital) that acts as a liaison between insurance companies and doctor’s offices. Available in Madrid, Barcelona, Sevilla, Granada and La Coruña Tourist Care Assistance (TCA)- Barcelona Medical Care South- Sevilla & Granada Can be used for both ASPE and most U.S. insurance companies. Have agreements with more than 200 companies 11

12. ADVANTAGES Coordinate all bills and policy information with your insurance company Provide an interpreter to accompany you to your appointment Offer a wide variety of services: General consults Psychological counseling & Psychiatry Gynecology Dermatology Radiology, Tests Etc. 12

13. How to make an appointment Call the International Department representative to set up an appointment or clarify coverage: Madrid: 629 823 493 (9:00-21:00) 629 824 020 (21:00-9:00) Barcelona: 628 604 412 (9:00-19:00) 681 195 204 (19.00-9.00) Sevilla: 619 773 383 or 954 694 204 Granada: 618 671 168 La Coruña: 639 139 298 or 981 144 011 13

14. How to make an appointment Or go directly to urgencias and ask for THS/TCA/Medical Care South at check-in desk: Madrid: Hospital de Madrid Plaza del Conde del Valle de Suchil, 16 Barcelona: Clínica Sagrada Familia Carrer de Torras i Pujalt, 1 Sevilla: Hospital Viamed- Santa Angela de la Cruz Avenida de Jerez, 59 AND Clínica Santa Isabel Avda de Luis Montoto, 100 La Coruña: Hospital Modelo C/ Virrey Osorio 30 Granada: Hospital Inmaculada C/ Dr. Alejandro Otero 8 14

15. Every Madrid, Barcelona, Sevilla, Granada and La Coruña grantee can use Tourist Health Spain! 15

16. REMEMBER! You can also use it if you live elsewhere but are visiting Barcelona, Madrid, Sevilla, Granada or La Coruña, PLUS: Bilbao- Clínica IMQ Virgen Blanca C/Maestro Mendiri, 2 (608 667 888 or 944 666 967) San Sebastián- Policlínica Gipuzkoa Paseo Miramón, 174 (620 432 481 or 943 502 039) 16

17. We recommend you use THS, but you are free to choose any provider 17 REMEMBER!

18. OTHER REGIONS But what if I don’t live in Madrid, Barcelona, Sevilla, Granada, or La Coruña? 18

19. OTHER REGIONS Find a private clinic in your area More information about where to go on city guide website Pay out of pocket for the visit Save all receipts If more than you can afford, the Commission can pay for you and be reimbursed Make claim to SevenCorners Links to claim forms found on city guide website Most reimbursement takes about three weeks Remember, Victoria and Clara can always help you! 19

20. Your ASPE Card 20

21. Emergency In case of an emergency go to the nearest hospital or call 112. If you need assistance, call Victoria’s cell: 699 059 202. The Commission can advance payment for hospital bills. 21

22. Be Prepared Think ahead and be prepared before you get sick! As soon as you move in, make sure to find closest primary care provider, hospital and clinic. 22