Frequently Asked Questions

What do I do if I have an accident or become sick while insured under your plan?
How do I file a claim?
What is an ITEMIZED bill?
How soon should I file my claim after my medical treatment?
Do you pay the Provider or me?
Will you need information from me in addition to what I put on the claim form?
What other information would you need?
What if I have Insurance with another Company in addition to yours?
What is a “Deductible?”
What is “Co-Insurance”?
What is a “Co-Pay”?
What is “Usual & Reasonable”?
My Plan has a PPO associated with it. What does that mean and how does the PPO discount work?
Where do I find a list of medical Providers in my PPO?
Is a Pre-Certification required before I get treatment?
What address do I mail my bills and /or claim forms to?
Does my plan cover routine exams, vision exams, or dental treatment?
Does my plan cover immunizations?
I am travelling out of the country and will need travel immunizations, are they covered?
How do I file a claim for Prescription drug reimbursement?

MOST COMMON FAQ’s

The following questions are common inquiries that we will need to respond to you with specific information from our claim files. Since our phone lines can often be busy during peak hours, feel free to send an email to us detailing your question exactly, and we will attempt to reply very shortly. For all written claim inquiries, always provide us with your name, school attending, return email address, and a complete detailed question. Our email address for all claim questions is customerservice@amaofsa.com.

Is my particular injury/illness covered?

Give complete details of the injury or illness including when the accident happened or when you first noticed the symptoms of the illness

What has been paid on my claim?

Have you received bills from my Provider?

What are the benefits/details of my plan? (provide us the school you attend, policy # from the brochure, your ID#)

Why did you not pay all of my claim? (list the Providers not paid in full)

Have you received my claim form?

How do I appeal a denied claim?

I do not understand your correspondence, please explain (Provide date of correspondence)

I do not understand your Explanation of Benefits.

Have you received my premium payment?

When does my coverage start/end?

OTHER COMMON FAQ’s

My ID Card has the wrong address, how do I get a replacement?

The address on the ID Card is used mainly so the Post Office can deliver it to you. It is not necessary for your Card to have your current address to get medical attention, therefore we do not replace ID Cards for an address change. However, if our office errors in the spelling of your address, a replacement card will be issued.

My name/address has changed.

Drop us an email at customerservice@amaofsa.com with your corrected name or address.

How do I add my newborn child to my policy?

A newborn child needs to be added to the coverage within 30 days of his/her birth. Send us an email with the newborn’s name, date of birth, address and the primary insured’s name.

What doctors and Hospitals can I use?

Unless your plan requires you to use a PPO provider, you can use any licensed physician or hospital. (See reference to PPO plans above)

Do you have a copy of my brochure/policy online or on the Website?

Yes, we do have the brochures for our plans available on this Website. Click on the claims tab, Download Forms, find your school, select a policy year, and download your brochure.

Can I enroll in my insurance plan online at your website?

Not currently.

Can my wife/parents/friends/roommate/relative call you and get information on my claim?

Because of Federal Privacy laws, we are not allowed to give private medical information to anyone other than the insured student. To be in compliance with this law, we will need the insured student to give us prior written and signed authorization specifically stating who we may provide medical information to other than himself. The form, Authorization for Disclosure of Protected Health Information, is on this website and may be e-mailed to customerservice@amaofsa.com or faxed to 210-822-4113.

Will I get a refund or reimbursement when I cancel my coverage?

A pro-rated premium refund will be made for the following situations only: if the Plan Administrator receives a written notice, including the date of occurrence that the insured student has entered into full-time active duty military service; or if the insured student withdraws from his/her academic activities at the school and returns permanently to his/her home country. A refund will not be issued if any claims have been filed. Otherwise, the coverage you purchase stays in force for the full time period chosen, no refunds.

When will I receive my ID Card?

During fall and spring enrollment periods we have hundreds of colleges enrolling, and data input may take a little longer than usual. You should receive a card in about two weeks. However, should you need medical attention before then, simply present your Student Insurance brochure to the Provider, who may call us for coverage verification.

When does my coverage go into effect?

If you mail or fax your application to us, your coverage will be effective on the day after postmark if mailed, or the day after you fax it to us.