Medical & Dental Information

General Information

APIA’s health (medical) insurance plan is administered by Cultural Insurance Service International (CISI) and is part of the Aetna Health Network. It is valid anywhere in the world except your home country. It covers injuries and illnesses.

  • Your Insurance Website & App – Use the myCISI app and the myCISI desktop log-in to obtain information about your insurance coverage, account and reprint your insurance card.
    • Search for doctors and facilities who accept your insurance here. Choose “Passport to Healthcare Primary PPO Network”.
  • Your Insurance Card – You should carry your personal health insurance card with you at all times. The card is attached to an email from ‘My CISI’ which you received at orientation. Search your email for “enrollments@mycisi.com”.  If you cannot find the email or you lose your insurance card, you can:
      • Go on the myCISI desktop log-in and print a new card.
      • Contact the insurance company by calling 203-399-5130 or emailing Claimhelp@culturalinsurance.com. Please include your au pair ID number in the email along with your host family’s name and address. (If you call you may wait a while on hold with no music or sound, this is normal.)

Finding a Doctor, Clinic, or Hospital 

    • The best place to start for any illness or injury is an Urgent Care clinic. 
    • They are typically open daily from 8 am until 10 pm. 
    • For most urgent care clinics an appointment is not required.
    • You can just walk in, but for ones who offer appointment booking online or by phone, that can reduce your wait time once you arrive. 
    • Search for urgent care clinics who accept your insurance here. Choose “Passport to Healthcare Primary PPO Network”.

Note: I do NOT recommend AllCare Family Medicine & Urgent Care. They force au pairs to pay upfront in violation of the contract with our insurance company. We have many other local options like Patient First, Med Express, and Concentra where they will bill the insurance before charging an au pair.


Hospital Emergency Room

Only go to the Emergency Room at the hospital for a serious medical issue requiring immediate care. (For example, anything serious enough that you consider calling 911 for an ambulance or asking someone to take you to get care immediately.) For anything less than a true emergency, it is best to be seen by a doctor at an Urgent Care Clinic. If Urgent Care directs you to the Emergency Room, then it should be covered as an emergency.

If you go to the Emergency Room at the hospital for anything less than a true emergency, you will be charged an extra $500 non-emergency deductible by the insurance company

If you truly think you are having a life-threatening emergency, then go directly to the nearest hospital. Any hospital in our local area should take your insurance.


Medical Specialists

If you need to see a specialist please search this database for a doctor who takes your insurance: click here. After you enter your zip code, you will be asked to Select a Plan, choose “Passport to Healthcare Primary PPO Network”).

Tell the doctor/care provider that you have Aetna Health Insurance when you call to make your appointment or check in at the office. Always confirm that they still take your insurance. Immediately call or email the insurance company if a listed provider states that they do not take your insurance.


Counseling 

Counseling services are covered with a limit of $500. If you have the basic plan, you would need to pay your $50 deductible, then a 20% co-pay and the insurance pays 80% (up to a maximum of $500).

To find a counselor who accepts your insurance, search this database: After you enter your zip code, you will be asked to Select a Plan, choose “Passport to Healthcare Primary PPO Network”. Under “Find what you need by category”, select “Behavioral Health”.

Tell the doctor/care provider that you have Aetna Health Insurance when you call to make your appointment or check in at the office. Always confirm that they still take your insurance. Immediately call or email the insurance company if a listed provider states that they do not take your insurance.

If you use up your counseling benefit and would like to continue seeing someone – Below is a clinic that provides discounted services based on your income. Print your participation letter in your au pair portal for proof of income to show.


Prescription Medicine

You will need to pay upfront at the pharmacy. Before you go the get your prescription filled, I strongly recommend you compare the prices of your medication using GoodRX or WellRX. Both of these websites will compare prices of local pharmacies and you will need to give the code or prescription card from the website to receive the discounted price.

    • You will need to pay the full cost for the prescription medication at the pharmacy.
    • Then, you send the insurance company:
      • A completed claim form
      • Your pharmacy receipt (the one usually stapled to the bag with your name, name of medicine, and cost)
    • Note: The cash register receipt on its own WILL NOT be enough, you must have the detailed receipt described above.) They will reimburse you for their share of the prescription cost, (80% or 100% depending on your insurance plan). It will come in the mail in about 4 weeks as a check payable to you.
    • Make copies (or take photos with your phone) of the receipt and your claim form before sending. Keep those for your records until you receive payment for your claim.
    • You may monitor the status of your claim on the CISI website or app.

COVID-19 Testing

  • Your medical insurance covers COVID-19 testing if there is a medical reason (known exposure or symptoms), but it is subject to your deductible and co-pay, so not free.
  • You can visit this website to find testing locations.
  • Free at home test kits are sometimes available through local health departments or HERE by mail.

COVID-19 Vaccine

  • Because your medical insurance plan doesn’t cover vaccines, you should not present your insurance card at a location offering COVID-19 vaccines. Instead you should visit the CDC website to search for locations offering free vaccines for those without insurance through the CDC’s Bridge Access Program.

Services That are Not Covered 

  • High-Risk Sports – Your insurance will not cover ice skating, skiing, snowboarding, or other “high-risk sports” unless you add sports insurance. (Snow tubing does not require sports insurance.)
    • You can add sports insurance at any time during your year.
    • Sports Insurance costs $115 for 12 months.
    • It takes 48 hours to take effect and will cover you for 12 months from your date of enrollment.
    • To enroll in sports insurance, use the link found in the email sent to you with the subject “Au Pair in America Sports Insurance Upgrade Option”. Ask your community counselor if you are having trouble finding the email with the sports insurance enrollment link.
  • Preventive Care – Your health insurance does NOT cover preventive care, like the following:
    • Dental Care* (CISI medical upgrade plan includes some emergency dental coverage. Basic plan does not include dental.)
    • Physicals/Check-ups
    • Preventive Gynecology Care/Birth Control*
    • Vision Care (glasses and contacts)*
    • Vaccines (See info above on free COVID vaccine boosters and check THIS blog post for information on the seasonal flu vaccine.)

*See below for information on low-cost options for some of these services.


Women’s Health Issues 

  • Your medical insurance DOES cover medical problems (testing for a suspected STD, infections, and other gynecological conditions) as long as they are not pre-existing conditions. For gynecology problems, you will give them your insurance card and it will be handled like any other injury or illness.
  • Your insurance DOES NOT cover preventive care (annual gynecology exam, preventive screening tests, or birth control). For preventive care, you should tell them you do NOT have insurance coverage for that and you are requesting the sliding scale or low-cost services.
  • These are three women’s health clinics offering low-cost health services:

**For birth control and other preventive care (annual exam, pap smear, breast exam, birth control of any kind), you will need to pay for the care you receive at Planned Parenthood, but you can ask for the “Sliding Scale” which charges you a cheaper price based on your income level. You should bring your participation letter that includes stipend information.

Please visit the individual links above to make an appointment for one of these locations.


Dental Care 

Au pairs with medical upgrade insurance have $500 emergency dental coverage. This would include services like filling a cavity or repairing a chipped tooth, as long as the tooth was in good health at the time of her arrival to the U.S.

For preventive dental care (cleaning) and/or au pairs with basic insurance needing any dental care, these are some affordable options. The following clinics offer a variety of dental care including preventive care and treatment for issues. Services vary from clinic to clinic. Discounts are available based on your income. Print your participation letter in your au pair portal for proof of income to show.


Vision Care 

These are some companies known for providing eye exams and glasses or contacts for a reasonable price.


Other Important Information

  • Do not panic if you receive a crazy high bill.  It often takes a month for the doctor to correctly bill the health insurance.  If you do receive a crazy bill, please contact CISI support at (800) 303-8120, prompt 5 or 203-399-5130.
  • Take care of yourself.  Don’t delay going to the doctor if you are sick.  I know this is intimidating, but you can figure it out. Perhaps ask a friend to come with you.