Membership Service Agreement

Member Service Definitions

Application Date

The Application Date is the date the Member’s application for Membership is accepted by SkyMed or a SkyMed certified representative.

Appropriate Airport

A place where fixed-wing aircraft selected by the air ambulance carrier can land, takeoff, and safely use maintenance and ground service facilities.

Emergency Air Transportation

Transport by a medically staffed airplane or by a commercial airline, from an “Appropriate Airport” closest to the Member’s hospitalization to an “Appropriate Airport” closest to the medical facility of choice to serve the need of the Member patient. The airports must be open to receive flights. The receiving hospital must have pre-approved the Member’s admittance.

Expatriate (X-PAT)

Permanent residents or citizens of the USA or Canada who live or travel in Mexico, Bahamas, Bermuda, or Caribbean countries for more than six (6) cumulative months in any twelve (12) consecutive month period.

Expiration Date

The Expiration Date is the date when a Member’s eligibility for services is terminated.

Grace Period

A period of thirty-one (31) days following the Expiration Date of Membership, during which membership fee may be paid to extend membership without termination of services.

Home, Residence, Transport Preference

Home, Residence, or Transport Preference are one and the same unless otherwise designated in the Member record. Members are transported home to a hospital nearest to their legal permanent residence when traveling. The place of Transport Preference may be changed by the Member in writing to SkyMed or emailing membermanagement@skymed.com. Such change is valid thirty (30) days after receipt by SkyMed.

Full-time RVers, living in their RV/Camper may change their Transport Preference by writing SkyMed or emailing
membermanagement@skymed.com. Such change is valid thirty (30) days after receipt by SkyMed.

X-PAT Members who live in Mexico, Bahamas, or the Caribbean may select any hospital in Canada or the USA to be transported to at the time of the emergency.

Medically Necessary

The term Medically Necessary, as used in the “Helicopter Transport” and “Ground Ambulance Transport” services are defined as services provided in the event of a serious illness or injury and when transport in any other vehicle would endanger the Member’s life.

In the event of a Medically Necessary “Helicopter Transport” or Medically Necessary “Ground Ambulance Transport”, transportation is to the nearest facility that can provide the necessary medical care.

“Ground Ambulance Transport” and “Helicopter Transport” are only for emergency medical care.

Member

A Member is an individual and any eligible family Members who have submitted an application and paid Membership fees to SkyMed for Membership. Family Members include:

Legal spouse or domestic partner
Unmarried natural, adopted, or stepchildren of the Member or spouse or domestic partner who are under age 18
Unmarried natural, adopted or, stepchildren of the Member or spouse or domestic partner over age 18 but under age 24 who is a full-time student at an accredited college or university
Newborn children of the Member or spouse or domestic partner are eligible from the moment of birth, and adopted children are eligible from the moment of placement if placed in accordance with state laws
Grandchildren and great-grandchildren of the Member or spouse or domestic partner under the age of 18 are eligible for all Member services when travelling with a grandparent and not accompanied by the grandchildren’s parents or great-grandchildren’s parents or grandparents.
A disabled adult who is incapable of self-sustaining employment by reason of mental or physical handicap and substantially dependent for support and maintenance on the Member.

Serious illness or injury

A sudden and unforeseen condition, a “serious illness or injury” which, in the judgment of the Member’s Attending Physician with the concurrence of SkyMed’s Director of Member Services and/or SkyMed’s Medical Director:

Is of such a serious nature that, in accordance with the customary practice of medicine in the geographic area, where such unforeseen condition, illness, or injury has arisen, will reasonably warrant, will require or has reasonably resulted in, immediate hospitalization of such Member; or
Is of such a serious nature that, in accordance with the customary practice of medicine in the geographic area where such unforeseen condition, illness, or injury has arisen, will reasonably warrant, or will require, transportation of such Member to an appropriate medical facility for treatment, and is of such a serious nature that it could, within reasonable medical certainty, result in permanent, irreparable, or fatal medical consequences to such Member if appropriate treatment is not immediately rendered (e.g., heart attack, stroke, broken hip).

Service Area

includes USA, Canada, Mexico, the Caribbean, Bermuda, and the Bahamas

The 32 country SkyMed service area includes the following countries:

Anguilla, Antigua & Barbuda, Aruba, Bahamas, Barbados, Bermuda, Bonaire, British Virgin Islands, Canada, Cayman Islands, Curacao, Cuba, Dominica, Dominican Republic, Grenada, Guadeloupe, Haiti, Jamaica, Martinique, Mexico, Puerto Rico, St. Barthelemy, St. Kitts & Nevis, Sint Eustatius, St. Lucia, St. Maarten, St. Martin, St. Vincent & Grenadines, Trinidad & Tobago, Turks & Caicos Islands, USA, US Virgin Islands

General Provisions

30 Day “Free Look”

This Agreement has a 30-day “Free Look” period. The Member has 30 days from Membership Application Date to review the Agreement and, if not satisfied, return all materials along with a written request to cancel the Membership to SkyMed. Should the Member decide to cancel during the “Free Look” period, the Member is entitled to a full refund of the membership fees. Refunds will be transacted within 30 days of SkyMed’s receipt of written notice to cancel. Credit Card payments will be refunded to the originating credit card. If payment is made other than with a credit card, a check will be sent to an address provided by the Member.

After the 30-day “Free Look” period, membership subscription fees are not refundable.

Extension of Services

Termination of this agreement by SkyMed shall be without prejudice to any continuous loss which commenced while the agreement was in force, providing that such Member’s right to such services accrued in connection with a serious illness or injury which occurred prior to such termination by SkyMed. The benefit extension shall be for services that commenced prior to termination have been completed or a period of ninety (90) days from the termination date, whichever is the lesser period of time.

Medical Flight Services

Medical flights can communicate air-to-ground and use pilots rated for air ambulances. To provide emergency care onboard, flights will include the required pharmaceutical products, medical equipment, trained paramedics or RNs, and Physicians. In addition, the medical flight crew will have communication with a medical advisory team.

Membership Fees are LOCKED for LIFE

SkyMed GUARANTEES,

your Membership fees are LOCKED FOR LIFE when you continue to renew your membership subscription on time. At the time of Membership expiration and after the Grace Period, any new and applicable fees will apply if Member wishes to reapply for membership.

Membership Transferability

In the event of death of the Member, SkyMed will extend the Membership to the surviving spouse/companion Member to a value of the remaining and unused term of the deceased’s Membership. At expiration, renewal rights will be available. In the event of death of all adult Members in the Membership, the remaining and unused term of the deceased’s Membership may be transferred to medically qualifying immediate family members as designated by the deceased’s notarized instructions.

Renewal

Within the period of two (2) years prior to the Membership Expiration Date, Members may renew the Membership with SkyMed by calling 1-800-475-9633. Prior to the Membership Expiration Date, a renewal notice will be sent by postal mail, email, or both.

Request for Medical Information

SkyMed reserves the right to obtain any past or current medical records and insurance information of the Member. You may obtain a copy of SkyMed’s Notice of Privacy Practices by:

Visiting our website at www.skymed.com and click on the PRIVACY POLICY link
Email SkyMed at HIPAA@skymed.com to request a copy be emailed to you
Request a copy by mail to SkyMed, 9089 E. Bahia Drive, Scottsdale, AZ 85260 – 1561

Service Area

“SkyMed Services 1 through 17” are services provided to SkyMed Members travelling in the SkyMed 32 country Service Area, including the USA, Canada, Mexico, the Caribbean, Bermuda, and the Bahamas.

Subrogation

In order to mitigate any losses, the Member agrees that SkyMed shall have the right to recover any benefits paid hereunder against others liable for the loss. Furthermore, Member agrees to cooperate, protect SkyMed’s rights, and assist SkyMed in mitigating these rights.

Termination of Eligibility

Except for non-payment of the membership fee or loss of eligibility, SkyMed will give at least forty-five (45) days written notice of any cancellation, termination, or non-renewal of this Agreement, including the reason for such action. SkyMed may cancel or terminate the coverage of a Member for the following reasons:

Fraud or material misrepresentation in applying for or presenting any claim for benefits
Misuse of the documents provided as evidence of services
Non-payment of membership fee; and
A dependent reaching the limiting age for eligibility

Exclusions & Limitations

Act of God

SkyMed shall not be liable for any failure or inability to provide the services described in this Agreement where such failure or inability arises from factors beyond SkyMed’s control, including but not limited to: labor disputes affecting providers, civil disturbance, riot, war, fire, flood or an Act of God.

Acts of Terror

SkyMed is not responsible for any costs or expenses arising from acts of terror as defined by 18 U.S.C § 2331 Chapter 113B of the U.S. Code (www.fbi.gov). SkyMed shall not be liable for any failure or inability to provide the services described in this Agreement where such failure or inability arises from factors beyond SkyMed’s control due to any act of terror.

Elective Surgery

This Agreement excludes from service any elective, non-emergency surgical procedures, including but not limited to elective cosmetic surgery. However, emergency medical air transport in connection with cosmetic surgery due to a serious illness or injury shall be serviced under this Agreement.

Enrolling while Hospitalized

SkyMed is not responsible for any Member Service costs or expenses arising from Members who have enrolled in Membership while hospitalized or being treated in an emergency trauma clinic.

Extended stays outside of the USA & Canada

At the time of a serious illness or injury, SkyMed Takes You Home guarantee and services are available 24/SEVEN/365 to permanent residents or citizens of the USA & Canada for travel throughout the USA, Canada, Mexico, the Bahamas, Bermuda, and the Caribbean countries identified in this Agreement. When living outside of the USA & Canada for more than six (6) months in a cumulative twelve (12) month period, membership in SkyMed’s X-PAT Plan provides year-round eligibility for SkyMed services.

For information to upgrade to the SkyMed X-PAT Membership Plans, please contact your SkyMed Representative or SkyMed home office.

Extreme Sports

Services are excluded in connection with any serious illness or injury resulting from EXTREME recreational activities performed by the Member.

The exclusions include a serious illness or injury sustained by a Member in connection with the following extreme recreational activities:

3 wheeled All-Terrain Vehicles;
4 wheeled (quad) All-Terrain Vehicles when utilized in racing, dune riding, beach running, or any other EXTREME activity. Normal street use of quads or use as a standard transport vehicle is not excluded;
Bungee Jumping • Hang Gliding • Cliff Diving • Motor Car Racing of any nature
- Motocross and/or motorcycle racing of any nature • Helicopter Skiing • Rodeo Events involving animals
- Rock climbing necessitating the use of guides or ropes • Spelunking • Skydiving • Parachuting • Ziplining
- Ballooning • Ultralight Aircraft • Experimental Aircraft • Operating vehicles when not properly licensed
- Professional sports or any other activity which, at SkyMed’s discretion, is considered extreme in nature or otherwise, expose the Member to a substantial risk of sustaining a serious illness or injury unless otherwise agreed in writing by SkyMed prior to the Membership Application Date.

Flight Compliance

SkyMed shall assume no liability from flight delays or late arrivals or departures that arise from:

Compliance with airport, USA Federal Aviation Administration or other rules, regulations and/or instructions from any government authorities; and/or
Decisions made by the pilot in response to weather, mechanical, air traffic, or any other safety considerations.

In addition, SkyMed shall assume no liability for delays resulting from decisions made by airlines in connection with scheduling and rescheduling of flights.

General Liability

SkyMed is not responsible for the availability, quality, results of, or failure to provide any medical, legal, or other care or service caused by conditions beyond SkyMed control. This includes the Member’s failure to obtain care or service or where the rendering of such care or service is prohibited by United States of America law, local laws, or regulatory agencies. The Member’s legal representative shall have the right to act for the Member and on the Member’s behalf if the Member is incapacitated or deceased. All legal actions arising under this Agreement shall be barred unless SkyMed receives written notice thereof within one (1) year from the date of the event giving rise to such legal action and the legal action is initiated within18 months of the event. Members will be required to release SkyMed or any health care provider from liability during emergency evacuation and/or repatriation.

Jurisdiction

The services provided pursuant to this Agreement are not available in any jurisdiction where prohibited by law.

Medical Bills

SkyMed does not pay for any hospital or medical expenses of any kind or nature.

Medical Condition Exclusions

Services will not be provided to Members with tuberculosis or any other chronic airborne pathogens. Medical transport services will not be provided to any Member who has a diagnosis of or is suspected of having a Biosafety Class Level 3 (or above) pathogen as classified by either the USA Centers for Disease Control and Prevention (CDC) or the USA National Institutes of Health (NIH).

Medical Liability

Without limiting the foregoing, SkyMed’s actions and obligations under this Agreement are ministerial in nature, and all medical care is provided by medical professionals ultimately selected by the Member, and in no event is this the responsibility of SkyMed. SkyMed is not liable for any malpractice performed by a local doctor, healthcare provider, or attorney.

Military Duty

Any injuries, illnesses, or conditions resulting from a Member’s active duty in the military are excluded from service eligibility in this Agreement.

Other Services

SkyMed is not responsible for any costs or expenses arising from services not otherwise shown as provided for in this Agreement.

Payment of Services

SkyMed will only direct-pay any transportation costs under this Agreement to any transportation providers unless
otherwise approved by SkyMed in advance.

SkyMed is not responsible for reimbursement or direct payment of services aged ONE year or more. Timely submission of
expense receipts is appreciated.

Pre-Existing Conditions

All pre-existing medical conditions will be eligible for Member services commencing on the ninety-first (91) day after the Application Date of Membership.

Pregnancy

SkyMed does not provide services for complications due to pregnancy.

Psychiatric, Psychological or Emotional Disorders

SkyMed is not responsible for any costs or expenses arising from psychiatric, psychological, or emotional disorders.

Suicide or Self Injury

SkyMed is not responsible for any costs or expenses for any Member who has committed suicide, attempted suicide, or sustained any injuries from a willful self-inflicted injury.

Travel Arrangements

SkyMed does not pay for any travel arrangements that were not coordinated by or pre-approved by SkyMed in advance.

Travelling Against Advice of Physician

SkyMed is not responsible for any costs or expenses for any Member travelling against the advice of a Physician.

Transplant Candidate

Transplant candidates on a transplant recipient list at the time of application are ineligible for membership. Failure to disclose the fact that an applicant is on a transplant recipient list will result in the termination of Membership.

Truth of Information

Any person who knowingly and with intent to injure, defraud or deceive SkyMed files a statement of claim for service or an application containing any false, incomplete, or misleading information will have all requests for services denied, and Membership fees will be refunded to the Member and Membership will be cancelled. The Member will be liable for any financial obligations to SkyMed as a result of intentional deception and false information provided.

Unlawful Acts

SkyMed is not responsible for any costs or expenses for any Member who has committed or attempted to commit any unlawful act, including but not limited to the unlawful use of substances such as illicit drugs or drugs not prescribed specifically for the Member by a Physician.

USA State Department Limitations

The SkyMed Membership is not applicable in any country where the government of the USA forbids the USA domiciled businesses to conduct business or any other locations of which the USA State Department has issued any travel restrictions.

SkyMed provides services in all regions and territories of Canada & Mexico and does NOT limit travel or emergency evacuation restrictions to match Travel Advisory Levels issued by the USA State Department.

Member Grievance Procedures

The following procedures apply in the event that any Member has a grievance of any nature in connection with SkyMed International Inc. Grievances must be submitted within one year of the occurrence of the event(s) that gave rise to the grievance.

Submission in Writing

If the Member wishes to submit a grievance to SkyMed, it must be in writing and addressed to:
Grievance Coordinator
SkyMed International, Inc.
9089 E Bahia Drive, Suite 100
Scottsdale, AZ 85260-1561

In order to facilitate a prompt resolution, all such grievances may be sent via fax to 866-255-5824 or sent by email to membergrievance@skymed.com. All grievances submitted in writing should include the Member number and a detailed description of the facts underlying the Member’s grievance.

Evaluation by SkyMed

The Grievance Coordinator shall evaluate all written grievances and perform such investigation as he/she shall deem necessary to such evaluation. A written summary will be submitted within ten (10) business days to the President of SkyMed that shall include the following information:

The name, address, and Member number of the aggrieved Member
Name and address of all providers who have performed services for the aggrieved Member on behalf of SkyMed pursuant to this Agreement; summary of all information gathered from SkyMed’s internal records and investigation initiated by the submission of the Member’s grievance; and
A detailed description of the Member’s grievance.

In the event that the Member’s grievance is medically related, a copy of such summary shall simultaneously be submitted to a Physician, other than the Member’s Attending Physician, who is qualified to evaluate a medical grievance of the type submitted. In the event that a meeting between the aggrieved Member and a representative of SkyMed is necessitated to fully resolve the Member’s grievance, the meeting will take place in the Scottsdale, Arizona offices of SkyMed International, Inc.

Processing Time

Though Members are encouraged to contact SkyMed by telephone to ensure prompt resolution of a Member’s grievance, SkyMed shall process oral and written grievances within a time which shall not exceed sixty (60) days of submission. In the event that a complete and proper investigation of a Member’s grievance requires that SkyMed obtain information outside of its service area, SkyMed shall be entitled to an additional thirty (30) days within which to process the Member’s grievance. In the event that such grievance is submitted to arbitration, SkyMed shall have additional time, not to exceed 270 days, from the date of initial submission within which to process the grievance.

Binding Arbitration

Any controversy arising out of or related to this Agreement or the breach thereof shall be settled by arbitration in Maricopa County,
Arizona, in accordance with the rules of The American Arbitration Association, and judgment entered upon the award rendered may
be enforced by appropriate judicial action. The arbitration panel shall consist of one person, which shall be the mediator if mediation
has occurred or shall be a person agreed to by each party to the dispute within 30 days following notice by one party that he desires
that a matter be arbitrated. If there was no mediation and the parties are unable within such 30 day period to agree upon an arbitrator,
then the panel shall be one arbitrator selected by the Maricopa County office of The American Arbitration Association, which arbitrator
shall be experienced in the area of air travel concerning medical transport and who shall be knowledgeable with respect to the subject
matter area of the dispute. The losing party shall bear any fees and expenses of the arbitrator, other tribunal fees and expenses,
reasonable attorney’s fees of both parties, any costs of producing witnesses and any other reasonable costs or expenses incurred by
him or the prevailing party or such costs shall be allocated by the arbitrator.

The arbitration panel shall render a decision within 30 days following the close of presentation by the parties of their cases and
any rebuttal. The parties shall agree within 30 days following selection of the arbitrator to any prehearing procedures or further
procedures necessary for the arbitration to proceed, including interrogatories or other discovery; provided, in any event each Limited
Partner shall be entitled to discovery.

GLOBAL Emergency Travel Services

For complete information about our FAMILY and INDIVIDUAL SkyMed memberships, download and read the SkyMed Member Services Agreement. Once your enroll with SkyMed, you will receive a printed copy of this agreement with your permanent membership cards for your wallet. If at any time within 30 days after receiving your Membership Packet in the mail you decide that SkyMed TAKES YOU HOME is not for you, just give us a call and we’ll completely refund your membership fees and cancel your membership.

SkyMed Individual Membership:

SkyMed International Florida, Inc is a wholly owned subsidiary of SkyMed International, Inc. With our administrative office located in Lakeland, Florida, SkyMed Florida is regulated by the Florida Office of Insurance Regulation. If you are a resident of Florida and enroll within the state of Florida, you will receive the SkyMed Florida Member Services Agreement. Feel free to read the fine print now and after you have received your Membership Packet, if you decide that SkyMed is not for you within 30 days, give us a call and we will refund your membership fees immediately.

Choose Your SkyMed Plan:

Includes 18 Emergency Services for your peace of mind at Home & Away!

Please Select

Family Plan

$995 / year

Includes one companion & dependent children as per our Member Services Agreement

Individual Plan

$795 / year

Protects one individual as per our
Member Service Agreement

Daily Travel Protection
Available Here

Family Plan

$2,595 3 years

Includes one companion & dependent children as per our Member Services Agreement

Individual Plan

$2,195 3 years

Protects one individual as per our
Member Service Agreement.

Daily Travel Protection
Available Here

Family Plan

$3,995 5 years

Includes one companion & dependent children as per our Member Services Agreement

Individual Plan

$2,995 5 years

Protects one individual as per our
Member Service Agreement.

Daily Travel Protection
Available Here

Your Skymed Membership Includes 18 Services:

Your SkyMed Membership Includes 18 Services

Hospital-to-Hospital Emergency Air Transport

Ground Ambulance Service

Commercial Carrier Medical Escort Flights

Vehicle RV, Auto, Motorcycle and Vessel Return

Helicopter Transport

Visitor Transportation

Transportation for Recuperation Nearer Home

Minor Children & (Great) Grandchildren Return

Physical Remains Return

Companion Transportation

Return Transportation After Recovery

Incidental Expense Allowence

Organ Transport

Organ Recipient Transportation

Primary Driver Disability

SkyMed Plus

Home or Away Services 100 miles from home

Global Emergency Travel Services

Hospital-to-Hospital Emergency Air Transport

By Choice of the Member means EVEN if you can be treated in the emergency facility you are in, SkyMed will Take You Home if you choose. SkyMed will arrange and pay for medically equipped air ambulance transportation by fixed-wing aircraft, to the hospital nearest your US or Canadian home when a serious illness or injury occurs. Ground ambulance to and from each hospital is included

For more detailed explanations of the above services please refer to our Member Service Agreement

Please Select:

Hospital-to-Hospital Emergency Air Transport

Vehicle RV, Auto, Motorcycle and Vessel Return

Visitor Transportation

Incidental Expense Allowence

Organ Transport

Organ Recipient Transportation

Physical Remains Return

Companion Transportation

Return Transportation After Recovery

Transportation for Recuperation Nearer Home