STUDENT AND DEPENDENT MEDICAL PLANS

Special Circumstances

Repatriation

In the event of the death of a covered student while outside his/her home country, the Plan will pay expenses incurred in connection with the preparation and transportation of the body to the student's place of residence in his/her home country, up to a maximum amount of $7,500. This coverage does not include transportation expenses of any person accompanying the body, or visitation, memorial or funeral expenses. Repatriation benefits must be pre-approved by the Plan.

Medical Evacuation

The Plan will pay expenses incurred for air evacuation of a covered student to his/her home country or to a hospital operated pursuant to applicable law, where required special treatment can be rendered, if the attending Physician certifies that:

1. adequate treatment is not available locally and
2. the special treatment is medically necessary for the proper care of the student's covered Sickness or Injury.

Covered expenses include those incurred for an accompanying physician or nurse, if medically necessary. Coverage is limited to a maximum of $10,000 per Plan Year. Medical evacuation benefits must be preapproved by the Plan.

Coverage Termination

Coverage terminates at 11:59 p.m. local time at the address of the university on the earliest of the dates indicated below:

– The end of the Period of Coverage;

– The date on which the Medical Plan terminates;

– The date a student withdraws from school to enter military service; in this case a prorated refund will be available upon request;

– The first day of any term for which a student waives coverage;

– The end of the period for which the required payments have been received, if future payments cease.

If Case Western Reserve University terminates and does not replace this Medical Plan, students then receiving or entitled to receive benefits for a covered Sickness or Injury will continue to be covered for that Disability for up to 52 weeks following the date of termination or in accordance with the time period stated under the Medical Plan, whichever is less.

Benefits payable during this period will not be more than the amounts provided under the Plan at the time the Disability began.

PLEASE NOTE: Any subsequent change in the limits provided under this Plan will not affect the benefits payable for a Disability for which benefits have been extended under this provision.

Personal Medical Leave

Coverage may be continued without interruption for one additional semester for a student who leaves the University due to a personal medical condition provided the student was registered and enrolled in the Student Medical Plan during the semester in which the student left.

In order to continue medical coverage under the Student Medical Plan, the Student Medical Plan Coordinator (located at the University Health Service) must be notified of the leave prior to the semester in which the leave is to take effect.

Students must provide the following to the University Health Service:

1. A letter from the Dean or Advisor of the School in which the student is enrolled approving the requested medical leave.
2. A letter from the student’s medical provider or counselor/therapist confirming the medical necessity for the requested medical leave.
3. Payment (in cash or check) of the Student Medical Plan fee prior to the beginning of the semester in which the leave is to take effect.

This extension does not apply to students who are leaving the University for reasons other than a personal medical condition.

PLEASE NOTE: When a student is on a leave of absence, the student is not eligible to use the services offered by the Case Western Reserve University Health Service or the Case Western Reserve University Counseling Services. When a student is on a personal medical leave of absence, payment of the Student Medical Plan fee allows coverage under the Student Medical Plan only, subject to the exclusions and limitations of the Plan, as outlined.