Maine Maritime Academy

DETAILED EXPLANATION OF MMA INSURANCE POLICY | FAQ | HOW TO GUIDE: FILLING OUT YOUR CLAIM FORM

Student-athletes must have proof of health insurance on file in the Athletic Training Room in order to play a varsity sport at Maine Maritime Academy. An athlete can be covered by their own insurance, that of a spouse/partner/parent, or they can purchase the Basic Student Health Insurance Plan that Maine Maritime Academy offers its students. If the athlete is insured by his or her own plan/parents/spouse/partner, he/she should read the policy to see whether athletic injuries are discussed. If they are excluded the athlete may not be covered.

It is the responsibility of the student-athlete to report all injuries to the Maine Maritime Academy Athletic Training Staff as soon as possible. The athletic training staff will complete the necessary injury report form to keep records up to date.

The Sports Plan at Maine Maritime Academy is an excess/secondary Accident Medical Expense Plan. It does not cover sickness or disease of any kind. The Sports Plan does have a $500 deductible. As an excess/secondary plan, the plan will pay only the amount the student athlete is responsible for after their primary carrier has paid. A primary carrier is any health and accident group or individual plan the student athlete may be covered under as a dependent. If there is coverage under the HMO, PPO or any other similar plan, and the insured does not use an authorized medical provider under the HMO or PPO, the MMA Basic Sports Insurance Plan will pay the expenses incurred that it would have honored had the Insured Person used the proper medical provider.

The Basic Student Health Insurance Plan through Maine Maritime Academy, will cover intercollegiate athletics accidents up to $500. Once the $500 deductible has been paid under the Basic Student Health Insurance Plan the Sports Insurance Plan is triggered.

To report claims please follow these instructions:

• Only ONE PERSON for each claim form
• Only ONE ACCIDENT per claim form
• Complete the claim form, including the signature section. Answer all the questions on the front of the claim form and make sure to sign the medical authorization.
• The Athletic Trainer must sign the claim form in the appropriate section confirming an intercollegiate injury. If you have already paid the provider, please include a paid receipt or a copy of your canceled check.
• Attach ORIGINAL ITEMIZED BILLS to the claim form (keep copies for your records).

An itemized bill must include:

• Provider's name and address
• Provider's Tax ID Number
• Diagnosis Code (ICD-10)
• Date of service
• Type(s) of service or procedure code (CPT code)
• Provider cost for each procedure

Mail completed form to: 

Be sure to attach original itemized bills to the claim form. KEEP COPIES OF ALL CLAIM FORMS, BILLS, AND CORRESPONDENCE FOR YOUR OWN RECORDS UNTIL YOUR CLAIM HAS BEEN PROCESSED. Please do not send bills without a complete claim form. The insurance carrier will not process the bills until it has all the information required on the claim form. If you have any questions about the claim form processes contact the Athletic Training Staff.