APOLLO MEDFLIGHT, LLC MEMBERSHIP TERMS & CONDITIONS
In consideration of the payment by the Member of the membership fee, Apollo MedFlight LLC (“Apollo”) agrees to provide the following benefits, subject to the terms and conditions specified herein:
“Members” shall include the individual who signed the Application (“Primary Member”) and all household members listed in the Application, so long as such individuals reside at the same address as the Primary Member. However, under state law, Medicaid beneficiaries are not eligible for membership. The applicant(s) represent that they are not Medicaid beneficiaries.
The membership fee constitutes prepayment by the Member of all deductible, copayment and other charges which are not paid by the Member’s health insurance or other third party sources such as a homeowners or automobile policy (collectively, “Insurance”) for Covered Transports, as defined herein. Apollo shall accept the amounts paid by the Member’s Insurance as payment in full for such transports. Subject to the foregoing, the Member is financially responsible for all costs of air ambulance services, up to the amount that would be paid by insurance for a medically necessary transport.
“Covered Transports” include only medically necessary air ambulance services provided by Apollo to the closest appropriate hospital. Air ambulance transports which are determined by the Member’s primary Insurance not to be medically necessary are not Covered Transports. The Member is responsible for all Apollo charges for air medical services that are not Covered Transports.
Membership only covers transports provided by Apollo. Transports provided by other air medical providers or by ground providers are not covered. Apollo may not be available when requested due to factors beyond Apollo’s control. For example, Apollo’s aircraft may be occupied providing transports to other patients, or Apollo may be unable to respond due to weather conditions, maintenance requirements, governmental market restrictions or other factors. Further, Apollo does not operate in all areas.
As a condition of receiving membership benefits, the Member assigns and transfers to Apollo all rights and benefits that the Member has under any and all Insurance, including but not limited to auto or homeowner’s insurance policies. The Member authorizes payment of all such benefits for air ambulance services to Apollo. In the event payment is made to the Member or any other party on the Member’s behalf, the Member agrees to remit all such amounts promptly to Apollo. As requested by Apollo, Member will assist Apollo in the collection of claims made on Insurance. Apollo is not an insurance company and the Membership is not an insurance policy.
Membership shall become effective three days after Apollo receives a complete application with full payment. Memberships are nonrefundable and nontransferable. The Member agrees to inform Apollo within ten (10) days of any change in the Member’s health insurance status (e.g., loss of coverage) or any change in the household Members covered by this membership.
I HAVE READ AND UNDERSTAND THE TERMS AND CONDITIONS OF THE APOLLO MEDFLIGHT MEMBERSHIP PROGRAM AND AGREE TO ABIDE BY ITS TERMS AND UNDERSTAND THAT THESE TERMS AND CONDITIONS SUPERSEDE ALL OTHER WRITINGS DOCUMENTS AND DISCUSSIONS RELATING TO MEMBERSHIP.