Membership Agreement Terms and Conditions
Contract for Membership
These “Terms and Conditions” (Terms) shall together with the Application form an Agreement between AAC-Air Ambulance Caribbean, Inc. d/b/a AeroMD (AeroMD); and you the member (Member). By signing the Application, the Member agrees, on his or her own behalf and/or on the behalf of any eligible residents (as defined below) of Member’s household who are minors or otherwise legally unable to enter into these Terms listed on the Application, to abide by these Terms. The Agreement formed by these Terms and the Application together form the AeroMD Membership Program (referred to herein as the “Membership Program”). Coverage will begin fourteen (14) days after AeroMD receives a properly signed Application, verifies that all Members and any eligible residents listed on the Application have health insurance, and confirms payment of the Membership Fee as specified in the Application.
This Membership Program will cover the undersigned Member and the residents of his or her household listed in the Application, so long as they meet the conditions below, remain full-time residents of the specified household for the duration of the Membership Program as specified in the Application, and the Membership Fee has been paid. A “household” for the purposes of these Terms may include up to six (6) eligible residents. Eligible residents are defined as family members, including spouses, unmarried natural or adopted children, child/children whose legal guardian is a Member, and grandchildren, under the age of twenty-six (26), who reside at the Member’s residence and are dependent on the Member. Additional eligible residents can be added at the price specified in any additional eligible resident application (“Additional Resident Application”) provided they meet the conditions below, the eligibility requirements described above, and complete an Additional Resident Application to add them to the Membership Program. Coverage of Members and the eligible residents named in their Application or Additional Resident Applications (referred to collectively herein as the “Applications”) will begin fourteen (14) days after AeroMD receives such properly signed Applications, verifies that all Members and any eligible residents listed on the Applications have health insurance, and confirms payment of the Membership Fee. All persons covered by the Membership Program shall be referred to herein as “Membership Program Member(s)” or “Member(s).” References to “I” or “me” and similar references shall be construed as including all Members.
As a condition of obtaining the benefits of Membership and Membership Program coverage, I must: 1) have and evidence active health insurance with medical air transport coverage; 2) submit a complete and accurate Application; and 3) pay AeroMD a non-refundable Membership Fee in the amount specified in the Application. In the event of any change in the health insurance coverage or status of any individual named in the Application, I agree to notify AeroMD within thirty (30) days. Loss of health insurance coverage will result in termination of Membership and loss of Membership Program coverage. Such loss of coverage shall become effective thirty (30) days from termination of Membership. Falsification of any portion of an Application or non-payment will result in immediate termination of Membership from the Membership Program effective immediately upon discovery of such falsification or non-payment.
The undersigned Member understands and agrees that he/she is responsible for payment for any services provided or charges paid by AeroMD, except as provided in these Terms. The benefits provided are subject to certain limitations specified in these Terms. As a condition of receiving these benefits the undersigned Member, on behalf of himself/herself and all other covered Members and/or eligible residents in his/her household, hereby assigns to AeroMD all rights and benefits that they may have under any and all health insurance, worker’s compensation, or auto insurance policies or plans, or from other third party payers or sources which provide coverage or would otherwise pay for air ambulance services covered by the Membership Program. Such payment sources are collectively referred to in these Terms as “Insurance.” The undersigned Member authorizes payment of all Insurance benefits or payments for air ambulance services and/or related goods and services covered by these Terms to AeroMD. The undersigned Member understands and agrees that AeroMD will, whenever it deems it feasible, file claims with and collect the benefits payable from Insurance directly, up to the amount charged by AeroMD. When requested by AeroMD, the undersigned Member agrees to complete any forms and take any other reasonable action that may be necessary to allow AeroMD to collect such amounts. If the undersigned Member or anyone on his/her behalf receives any Insurance or other third party payments for air ambulance services and/or related goods and services provided by AeroMD, the undersigned Member will promptly remit those payments to AeroMD.
AeroMD will not seek any deductibles, co-pays, or claim forms for its services. AeroMD does not screen for any pre-existing medical conditions and no health questions will be asked unless necessary to provide effective treatment or otherwise perform services according to the Membership Program. AeroMD is staffed with advanced critical care medical professionals directed by AeroMD’s Medical Director. As a Member, AeroMD and its contracted billing specialists will work on your behalf with your Insurance to secure payment for your air ambulance flight and/or related goods and services.
Payment of the Membership Fee and compliance with these Terms entitle Members to the following benefits as specified below:
AeroMD will arrange for the ordinary and necessary expense of air and or surface transportation associated with an air transport, medical care during transportation, communications, and all usual and customary ancillary charges incurred in transporting a Member to a hospital where appropriate medical care is available, which may be a location other than the Member’s home residence. This service will be provided to a Member requiring air and or surface transportation while located in the Caribbean. Service from other locations may be provided at the sole discretion of AeroMD. Prior authorization from Member’s health insurance provider and AeroMD will be required for service outside of the Member’s coverage area. AeroMD reserves the right to determine in its sole discretion whether the Member’s medical condition warrants medical evacuation, the location to which the Member will be evacuated, and the means or method by which such evacuation or repatriation will be carried out. In making such arrangements, AeroMD may consider all relevant circumstances, including, but not limited to, the Member’s medical condition, the degree of urgency, the Member’s fitness to travel, airport availability, weather conditions, and travel distance in determining whether transportation will be provided by private aircraft, medically-equipped aircraft, a regularly scheduled flight, or any other viable mode of transportation. Transportation shall be carried out under appropriate medical supervision, unless otherwise approved by AeroMD’s Medical Director working in conjunction with the sending and receiving physicians.
To facilitate AeroMD’s provision of services under the Membership Program, each Member agrees to sign an authorization permitting AeroMD and any medical staff to disclose or discuss such Member’s medical information, including but not limited to medical records, diagnostic images, and test results with any physician, nurse, medical assistant, or other persons as may be necessary for AeroMD to provide services under the Membership Program.
AeroMD will provide air transport, in appropriate cases as determined by AeroMD in its sole discretion, when the Member is confined in a medical facility located one hundred (100) air miles or more from his/her residence and his/her treating physician and AeroMD’s Medical Director agree that it is medically necessary and advisable to transfer the Member to a medical facility closer to his/her permanent residence.
In the event of death of any Member at a location more than one hundred (100) air miles from his/her place of residence, AeroMD will reimburse the cost of repatriation of the Member’s remains by commercial airline to the commercial airport nearest his/her place of residence with a limitation of a maximum of $2,500. Place of residence is established by the address on the Application.
AeroMD will monitor the Member’s condition if he/she is hospitalized away from his/her usual place of residence and keep the Member’s family informed with the agreement of the Member. Additionally, AeroMD will receive and transmit emergency messages between the family and the Member when needed for such assistance as determined by AeroMD in its sole discretion.
At the request of a Member and subject to AeroMD’s approval and written consent, following a Member’s medical evacuation, AeroMD will reimburse the reasonable and customary costs as determined by AeroMD in its sole discretion for one economy-class, round-trip airfare for a relative, or friend, to join a Member who has or will be hospitalized more than one hundred (100) air miles from his/her usual place of residence for more than seven (7) days. This service benefit will be provided with a limitation of a maximum of two thousand five hundred dollars ($2,500) per Member per evacuation.
In conjunction with the benefit above, in situations in which AeroMD has agreed to reimburse the cost for one economy-class, round trip airfare for a relative or friend to join a hospitalized Member, AeroMD will also reimburse the reasonable and customary costs of hotel accommodations as determined by AeroMD in its sole discretion for the Member’s companion who is visiting the Member while he/she is hospitalized more than one hundred (100) air miles from his/her usual place of residence for more than seven (7) days (not including personal expenses such as meals, telephone charges and personal services). This service benefit will be provided with a limitation of a maximum of one thousand dollars ($1,000) per Member per evacuation.
In circumstances, as described above, in which AeroMD has agreed to reimburse airfare for a relative or friend, and the return portion of the airline ticket has expired or otherwise become unusable, AeroMD will reimburse the net costs of the return of the relative or friend to his/her original departure point as determined by AeroMD in its sole discretion. This service benefit will be provided with a limitation of a maximum of one thousand two hundred fifty dollars ($1,250) per Member per evacuation.
In circumstances in which, following a Member’s medical evacuation by AeroMD, the Member’s return air ticket has expired or otherwise become unusable, with AeroMD’s prior written approval, AeroMD will reimburse the reasonable and customary costs as determined by AeroMD in its sole discretion of a one-way economy class air transport for the Member to resume his/her trip and/or return to his/her home. This service benefit will be provided with a limitation of a maximum of one thousand two hundred fifty dollars ($1,250) per Member per evacuation.
AeroMD will arrange air transportation for a Member when a transplant of a heart, lung, liver, kidney, or pancreas is required. The type of air transport will be decided by AeroMD Medical Director in his/her sole discretion based on, among other things, the time factors involved, commercial airline availability, and the urgency of the medical need.
Termination and Renewal of Coverage
AeroMD may terminate the participation of any Member in the Membership Program for failure to comply with these Terms. Written notice will be provided to the Member at least thirty (30) days before the date of termination via electronic or physical mail using the address provided by the Member in his/her Application. AeroMD reserves the right to discontinue its Membership Program at any time with notice to Members. AeroMD also reserves the right to unilaterally modify these Terms in its sole discretion, including but not limited to the Membership Fee to be charged to Members who join and/or renew their Memberships after the effective date of such change. Subject to the foregoing, each term of coverage shall automatically renew for subsequent periods of the same length as the initial term described in the Application unless either party gives the other written notice of termination via electronic, physical mail, or hand delivery at least thirty (30) days prior to expiration of the then-current term. Renewal contracts may include changes in coverage.
Existing Health Care Coverage
The benefits provided under this Membership Program may overlap with the benefits provided by Insurance. If you have a question regarding whether your Insurance offers benefits for ambulance services, you should contact that company directly.
Limitations / Restrictions / Exclusions
The AeroMD Membership Program is not an insurance program. AeroMD must be contacted and arrange medical transport for membership benefits to take effect. AeroMD will not compensate or reimburse air ambulance or other emergency services furnished by providers other than AeroMD. A patient’s medical condition as determined by the Member’s attending physician in conjunction with AeroMD’s Medical Director, not Membership status, will dictate whether or not air transportation is appropriate and required.
Membership benefits include only medically necessary fixed wing (airplane) air ambulance services provided by AeroMD as described in these Terms and the Application. At its sole discretion, AeroMD may require a “certificate of medical necessity” or equivalent, from a qualified physician in determining whether or not ground or air transportation is appropriate and required. Any ground or air ambulance service that is deemed to not be a medical necessity by the Member’s health insurance carrier, shall not be covered by these Terms. AeroMD retains the sole right and responsibility for determining whether or not air transportation is appropriate and required. The primary determinant of whether to accept a flight is always the safety of the patient and medical crews as determined by AeroMD in its sole discretion.
Medicare requires that you travel to the closest appropriate medical facility.
In situ UnitedHealthcare Members will be transported to the closest and most appropriate facility for their care unless pre-authorized by UnitedHealthcare.
In time of need, AeroMD may utilize a mutual aid air ambulance provider to provide air ambulance services to Members and/or eligible residents. There may also be occurrences when AeroMD is unable to perform within a medically appropriate timeframe due to factors beyond AeroMD’s control, such as use of the appropriate aircraft by another patient or other circumstances governed by operational requirements or restrictions including, but not limited to, equipment manufacturer limitations, governmental regulations, maintenance requirements, patient size or weather conditions.
AeroMD will arrange for ground ambulance services and will bill the cost to Member’s Insurance.
The Membership Program is not responsible for any commercial airline delays, flight arrivals, cancellations, or other issues related to commercial airline travel.
Reimbursements will be processed within thirty (30) to forty-five (45) days from the request for reimbursement. Reimbursement submissions must include original receipts and must be submitted by: mail to our USVI corporate office; in-person delivery at our USVI corporate office; or email at contactMD@aeromd.com, attention to accounts payable.
The Membership Program does not cover transportation related to cosmetic or elective surgeries.
AeroMD is not liable for any failure or inability to provide service due to related issues beyond its control, including, but not limited to: riot, civil unrest, war, natural disaster, labor dispute, fire, flood, or act of God.
Members and any eligible residents are responsible for having a valid Visa or Passport, or other required documentation for travel. AeroMD cannot operate in foreign countries where conducting business is prohibited by US Federal law.
The Membership Program limits travel to two (2) medical air transports for any one (1) Member or eligible resident during any one (1) calendar year.
These Terms and the Applications together constitute the entire agreement between AeroMD and each Member. If any provision of the Terms or Applications is determined to be unlawful, void, or unenforceable for any reason, then such provision shall be deemed severable and shall not affect the validity or enforceability of any remaining provisions. AeroMD reserves the right to update these Terms with notice in writing. The most current version of the Terms is available for review by visiting www.AeroMD.com. AeroMD is solely responsible for the interpretation and application of the rules and regulations communicated in these Terms. All determinations by AeroMD shall be final and conclusive in each case. Enrollment and renewal is subject to approval at the sole discretion of AeroMD. AeroMD does not discriminate Membership based on race, color, creed or nationality. Memberships are nontransferable and non-refundable.
These Terms shall be governed and interpreted in accordance with USVI law and all Members agree to indemnify, save, and hold AeroMD, its affiliated companies, contractors, employees, agents, partners and their affiliated companies harmless from any claims, losses, damages, liabilities, including legal fees and costs, arising out of a Member’s or eligible resident’s use or misuse of the Membership Program, any violation of these Terms, or any breach of the representations, warranties, and covenants made by Members herein or in their Applications.
All Members agree that with regard to any dispute arising between a Member or eligible resident and AeroMD out of or in connection with these Terms, an Application, or the Membership Program generally (including any dispute as to the construction and validity thereof) the courts of the USVI shall have exclusive jurisdiction, and all Members and eligible residents hereby consent and submit to the personal and exclusive jurisdiction of such courts for the purposes of litigating any such action. Members and any eligible residents agree that any cause of action arising out of or related to the Membership Program must be noticed on AeroMD within one (1) year after the cause of action arises.
Effective Date: May 10, 2017
We may collect the following personal information from you: any information that you voluntarily submit to AeroMD; your payment information; medical information necessary to provide treatment; insurance information related to medical treatment; and data relating to purchases made with vendors at a discount upon presentation of an AeroMD membership card.
We use this personal and personally identifiable information to: provide you with services under the Membership Program; communicate with you; accomplish payment under the Membership Program; and facilitate marketing and improvement of goods and services by vendors and AeroMD.
We use commercially standard technology to help protect against the unauthorized disclosure of your personal and personally identifiable information, including encryption. Though we do our best to protect your personal and personally identifiable information, you provide all such information at your own risk. If any medical information is shared with companies that provide emergency medical services or related services, AeroMD will take reasonable steps to share only data that is reliable and relevant for its intended use. AeroMD will take reasonable steps to ensure that any parties with which it shares personal information to facilitate medical treatment or related services protect your privacy and personal information and use it solely for the intended purpose.
We will only share your personal or personally identifiable information with third parties in the following situations: when you have consented to sharing information; when it is necessary to provide services under the Membership Program; if AeroMD is purchased by a third-party; when it is necessary to respond to valid information requests made by governmental authorities; when it is demanded by a valid court order or subpoena; when it is necessary or desirable to assist in arranging emergency medical care for you; and as required by applicable law.
AeroMD is available at your convenience 24/7/365. One of our Communications Specialists will be available to help you answer questions or to arrange your transport. We can be reached by any of the following:
Toll Free Phone – 1-844-AeroMD1 (1-844-237-6631)
Local Phone – 340-715-7942
Email – contactMD@aeromd.com
Web – www.aeromd.com