No, the AmeriCorps Healthcare Benefits Plan is not insurance rather it is a self-funded plan, which means that it is paid for by AmeriCorps, with funds appropriated by the Congress. The approved benefits are paid directly by AmeriCorps. There is no insurance company involved.

The benefit under the Health Benefit Plan is not insurance, and contains limitations and exclusions, such as excluding coverage for pre-existing conditions. You should keep your existing coverage in place and allow the benefit plan to cover additional expenses.

Below is some general information in regard to health insurance that you may hold at the present time.

• Family healthcare coverage: If you are 26 or younger and on a parent's plan, or married and covered by a spouse's plan, you may continue this coverage during your term of service. You can even remain on your parent's plan if you are married, not living with your parents, attending school, or not financially dependent on your parents.
• Healthcare coverage purchased through the Health Insurance Marketplace: Every state has a Health Insurance Marketplace where you can shop for coverage and find out if you qualify for lower costs. You may be eligible to purchase a private insurance plan or enroll in Medicaid on https://www.healthcare.gov.
• Medicaid or Medicare healthcare coverage, or military healthcare benefits: For those already receiving or eligible for Medicaid, Medicare, or military healthcare benefits, you may still receive those benefits during your year of service.

Upon entry into AmeriCorps, all volunteers are encouraged to denote any other healthcare coverage. Please note: claims will not be processed without this information on file. You may submit this information in two ways:

1. Log in or create a new IMG AmeriCorps NCCC account and proceeding to the My Profile page.
2. Proceed to the Volunteer Forms page and complete the Other Coverage or Waiver of Coverage section of the Coverage Information Form. This can be emailed to NCCCcare@imglobal.com.

The AmeriCorps NCCC Health Benefit Plan is secondary to all insurance and only primary to Medicare, Medicaid and military benefits.  The term Secondary is used when there are multiple plans that may cover expenses incurred when seeking care from a provider.  When there are two or more plans it is necessary for the Plan Administrator to coordinate the payments so that no provider is overpaid for any one service.  For questions about coordination of benefits, please contact International Medical Group.

If you have primary insurance you MUST present both ID cards to each provider you visit. Your health benefit plan indicates that coverage is secondary therefore the provider will know how to submit the claims. If your primary coverage is through a Government plan please indicate that the Health Benefit Plan is primary. 

Volunteers are automatically mailed a card upon activation in the AmeriCorps NCCC Health Benefit Program. If you need a replacement card, you can print a card from your IMG AmeriCorps NCCC account. If you require a new hard copy you can contact International Medical Group via email at NCCCcare@imglobal.com or call toll free at 855.851.2974.

No. It is important that the contact information you have on file with AmeriCorps is consistent with the contact information stored on file on your IMG AmeriCorps NCCC account. In order to update your name or address, you must make the edits through the general My AmeriCorps Portal at https://my.americorps.gov/mp/login.do.

Yes. International Medical Group has representatives that speak various languages, including but not limited to Spanish. When calling the toll free number, 1-855-851-2974, you will be prompted to select option 2 to continue your call in Spanish. Forms and guides are also available in Spanish.

A PPO is a network of health care providers that have agreed to participate in the AmeriCorps NCCC Health Benefit plan. These providers bill the plan directly, will not require payment in advance from you (except for the $5 co-pay), and have agreed to a pre-determined fee for all services. Using the PPO can save you money. If you do not go to a provider in the PPO network, you will be responsible for paying the difference between what the provider charges and what is a “usual and customary” fee for that service.

It is important to verify that there are no providers in your area; if there are, you will be responsible for any difference between the charges and the usual and customary rate paid by the health plan. You may visit the Find a Provider page or you can call International Medical Group toll free at 855-851-2974 to verify if there is a PPO in your area. If it is determined that there are in fact no PPO providers within 35 miles of your area, any provider of service may be used without penalty.

If the doctor is in the network, they are required by contract to see you as a volunteer of the network. If you find a network provider refusing to see you because they are denying participation in the medical network, please contact International Medical Group immediately. Please note that appointment availability is based on a physician’s schedule.

No. The health care plan does not cover pre-existing conditions.

A pre-existing condition is any physical or mental condition or illness for which medical treatment was given, or a diagnosis was made, on or before the effective date of coverage. If you have received medical attention for any physical or mental illness or condition before entering AmeriCorps, treatment of that illness or condition is your responsibility; treatment for that illness or condition is not a covered benefit.

The AmeriCorps NCCC Healthcare Benefits Plan is not insurance, but rather it is a basic health benefit package; the plan does not cover pre-existing conditions or routine physicals. It was designed by AmeriCorps, and is paid with tax dollars, designed to cover newly diagnosed and acute conditions while in service.

Yes, it would include conditions for which you were diagnosed in the past but not had recently, however acute conditions (such as the flu or a UTI) are looked at as a new occurrence each time and not as a pre-existing condition. For questions about specific conditions or situations, please contact International Medical Group Customer Care directly.

Please refer to the Prescription Coverage questions below.

Most medications are covered as long as it is not on the drug exclusion list. There is a $0 copay on covered generic medications, $5 copay on covered brand name medications, and a $0 copay on covered brand medications with no generic equivalent.

The pre-existing clause does not apply to prescriptions; however there is a non-covered drug list in the AmeriCorps NCCC Health Benefit Guide; please review this list to ensure your prescription will be covered (not all pre-existing medications are covered).

Insulin, lancets, alcohol swabs and test strips are covered. Insulin pumps, supplies for insulin pumps, and insulin pump cartridges are not covered.

It is preferred to use mail order for maintenance medications to save the program money, although it is not required; additionally, mail order will allow a 90 day supply. You can fill any covered medication at a retail pharmacy however you will only be able to get a 30 day supply at a time.

Yes, prescription contraceptives and birth control are covered; for prescription copays please see “Does International Medical Group pay for 100% of our prescriptions?”

No. Any over-the-counter drug that can be bought without a prescription is not covered.

Yes. In order to claim the flu shot costs, you will either need to have the medical provider submit the medical claim for you or (if you paid out of pocket) fill out the claim form available online yourself and attach the receipt; please ensure completed claim forms are mailed to International Medical Group for reimbursement or submitted online using your IMG AmeriCorps NCCC account. Remember - always keep copies for your own records.

Yes, one annual GYN exam with Pap test is covered per service year.

Yes, one bone mineral density test is covered per service year for women 65 years of age and older.

Yes, one mammogram is covered per service year for women 40 years of age and older.

No. AmeriCorps does not cover tests for family history; these are considered routine.

No, not if you visit a network provider; network providers should send International Medical Group a claim on your behalf and should only charge you the initial copay of $5 for office visits.

The blood test would not be covered if anemia is pre-existing; routine labs are not covered. Please refer to the AmeriCorps Healthcare Guide for more information.

As long as it is documented that: the visit is not for a pre-existing condition is a newly diagnosed condition, and a covered benefit under the plan, the visit should be covered. If you wish to discuss your specific situation, please contact International Medical Group.

Coverage is limited and only for emergencies. Routine dental visits are not covered. Please refer to the Member Health Guide for more information.

Routine vision care and exams are not covered.

Yes, you are covered by worker’s compensation if you are injured in the line of duty. If you are injured or experience an emergency illness related to your service assignment, your supervisor (for NCCC, this would be your Team Leader or Unit Leader) must be notified immediately; your MSS will be able to instruct you on how to file for a worker’s compensation claim.

AmeriCorps volunteers are considered employees of the federal government for purposes of coverage under the Federal Employees' Compensation Act (FECA), which is administered by the Office of Workers' Compensation Programs (OWCP) of the U.S. Department of Labor (DOL). FECA provides compensation benefits for an illness or injury if it is judged by OWCP to be service-related (i.e., caused or aggravated by the performance of a member's assignment).

Coverage by FECA begins for AmeriCorps NCCC volunteers the date they arrive on campus for training.

Volunteers are not covered by FECA, however, if the injury or disability results from your own misconduct, intoxication, or willful intent to bring about injury or death to yourself or others.

Benefits approved under FECA begin after termination from AmeriCorps service.

Since worker’s compensation will not begin until your service ends, you should also submit any claims or necessary documents (to include an IMG Injury and Accident Form) to the AmeriCorps Healthcare Administrator, International Medical Group, as soon as possible.

Physical therapy for an injury is covered as long as it happened while in service and is prescribed by a physician. The prescription for physical therapy must be on file at International Medical Group. Your AmeriCorps Healthcare Benefit coverage ends on your last day of service so if you require continued coverage for an injury after service (and the injury happened while carrying out duties as an ACTIVE AmeriCorps Volunteer), you must go through the Department of Labor’s Office of Worker’s Compensation for support. Please see section below on how to file a worker’s compensation claim.

No, they are considered two different types of facilities.  Emergency room should only be used for true medical emergencies.

No, it is considered routine.

No, they are specifically excluded under the plan.

You should call them directly; you do not need a prescription.

For all questions related to allergies, please refer to your Volunteer Guide. Any services for the treatment, including tests, surveys, injection medication and treatment are not covered. This exclusion does not include emergency treatment due to an allergic reaction, which is covered.

Yes, your benefits cover you during your extension.  Please note – you are not covered during times you are not considered an active AmeriCorps volunteer.

To access your EOB, please log in to your IMG AmeriCorps NCCC account. You can then navigate to the Manage Claims page under the My Account dropdown which is designed to allow you secure access to your health benefit plan and claim information.

A medical bill is a statement sent to a member from a provider or hospital. A medical claim is a standard form submitted by a provider or hospital directly to an insurance company or benefits manager for processing. This standard format is commonly known as a CMS 1500 form- the approved form by CMS (Centers for Medicare and Medicaid) which all providers in the United States must use.  International Medical Group cannot pay a provider by using a member statement or bill; providers must submit all claims in the standard CMS 1500 format either on paper or electronically to International Medical Group for consideration.

If you receive service for an approved benefit, your claim will go to International Medical Group, Inc., the contractor administering the health benefits plan. International Medical Group pays those claims that are for approved benefits. When a claim is submitted by your doctor, International Medical Group pays the claim according to the guidelines established by CNCS in your Volunteer Guide.  International Medical Group is responsible for:

• Determination if the claim is for an approved benefit;
• Payment of the claim or denial of the claim;
• Appeals and;
• Customer service. 

Call International Medical Group, the health benefits administrator toll free at 855.851.2974.

You are responsible for your health care and for making sure that the treatment you are seeking is a covered benefit; you are also responsible for ensuring that all the information required to pay your bills has been forwarded to the proper place. You should not assume that information will automatically be sent to International Medical Group by your provider and you should not assume that your bill will be paid automatically. If you are having problems getting a bill paid, it is your responsibility to work with the provider and International Medical Group to make sure that all required information has been sent to International Medical Group. 

You should call the provider for further information. The most common reasons for this are:

• No claim was ever sent in - verify that the provider sent a claim to International Medical Group;
• The doctor or hospital is billing you instead of sending the bill to International Medical Group - verify that a claim has been submitted to International Medical Group;
• The claims administrator, International Medical Group, has asked the provider for more information concerning your claim before it can be paid - verify that the provider has sent the information requested.  To find out more, you may also ask the provider to read you the Explanation of Benefits they received from International Medical Group;
• International Medical Group may be waiting on information from you like an injury form, Coordination of Benefits form, or a prior treating physician list;
• You were treated for a pre-existing condition - the health benefits plan specifically excludes pre-existing conditions, you are responsible for paying the entire claim;
• You received care that is not a covered benefit - check your Volunteer Guide. 

• Examine the reason given for the denial carefully by reading the Explanation of Benefits (EOB) available in your IMG AmeriCorps NCCC account. 
• Check if a form is required from you; you can find this information by reading the remark code on the bottom of the EOB. 
• Ask the doctor or office manager why the claim was denied.
• Review the Volunteer Guide; if you believe the claim should be paid according to the documentation, you can appeal the decision.
• Call International Medical Group for Assistance.

You are responsible for paying the claim. 

Yes.  Please let International Medical Group know immediately. 

When you are admitted to the hospital, a registered nurse monitors your hospital stay. This is to document that your condition meets medical necessity for hospitalization and certifies the length of stay is appropriate for the condition. This is done both to protect you the patient as well as the health benefit. The AmeriCorps NCCC Health Benefit does not want a patient discharged early if there is still a medical need for hospitalization, nor does it want a patient hospitalized for longer than necessary.

Outpatient refers to anything done while not admitted to the hospital; inpatient refers to an admitted overnight stay in the hospital.  All inpatient stays and services must be pre-certified by IMG prior to admission.

21 days maximum per service term (60 days per lifetime of service).

The AmeriCorps Healthcare Benefits Plan requires that you call 1 day in advance to a scheduled hospitalization and within 3 days following an emergency hospitalization.  If your AmeriCorps NCCC Health Benefit ID Card is presented to a hospital, they will typically do this for you; however, it is your responsibility to verify this is done to avoid a $300 pre-certification penalty.

No, you are not eligible for COBRA. COBRA applies to group health care plans in the private sector. The AmeriCorps NCCC Health Benefit Plan is not a group health care plan as defined in the COBRA law and AmeriCorps is not a private sector organization.  For more information on possible healthcare options to you upon completion of service, please see www.healthcare.gov .