India Network Health Insurance, USA provides convenient on-line claim processing, insurance renewals, membership updates, print friendly forms to mail or fax, MultiPlan Network providers and Consult a Doctor to the India Network Foundation members. Links are provided in the Members Area for accessing the membership benefits. To contact India Network Health Insurance call 877-204-0222 or from outside the United States or Canada, you can call collect at 01-715-295-9966 (24 hours a day, 7 days a week).

Additional services are also available including:

- Discount Cards for Dental, Vision and RX through Aetna or the Careington network of providers
- Increased maximum medical coverage from $250,000 to $1,000,000 through Trawick International.

Claims
Chartis settles claims with the provider directly if the provider bill for covered services as per your program chosen or to you (the insured) if you file claim. Contact information is provided below.

The Insurance Company of the State of Pennsylvania
Chartis Claims Services
A&H Claims Department
PO Box 25987
Shawnee Mission, KS 66225
Phone: 877-204-0222

Submit On-line Claim Form

Insurance Renewals
Please use the on-line Insurance Renewal form for renewal of existing insurance. Complete the form in its entirety. The last step will produce a Certificate of Insurance. If the php forms give you trouble, please access the html form by replace the php at the end of secure form link with html or contact our office for assistance at 407-243-8760.

Standard Insurance Renewal Form

Premier Insurance Renewal Form

Comprehensive Insurance Renewal Form

Membership Updates
Please use the on-line links to add existing visitors, update a membership or to change your address. If your membership has expired and you want to purchase health insurance for a visitor, use the Online Health Insurance Enrollment form and check "Please Renew my India Network membership ($10)" when prompted in Step 1 of the online application form. Contact our office for assistance at 407-243-8760 if you have questions.

MultiPlan Network
India Network Health Plan is the most flexible plan available, allowing policy holders to choose the doctor or hospital of their choice. To help our insured to find a provider participating in a network, India Network through Chartis Insurance entered a special agreement to access to MULTIPLAN Network for all India network policy holders. Click on the link below to search for providers within the MultiPlan Network or contact MultiPlan at 888-342-7427.

MultiPlan Network Provider Search

Consult a Doctor
The purpose of this program is to help visiting parents and others who need to consult a physician during their stay in the United States or Canada for minor medical problems or pre-existing ailments such as Diabetic, Blood Pressure, Pain management etc. or refilling prescription. This service is provided for the benefit of the India Network community and is NOT A PART OF THE HEALTH INSURANCE PROGRAM SPONSORED BY INDIA NETWORK. Anyone can make use of the services under this program. No insurance is required. However, India Network Membership is required. Learn more about the program under the FAQ > Consult a Doctor menu.

Click here to learn more about the participating doctors.

Dental and Vision Discount Cards
Aetna offers a discount card for dental, vision and RX benefits for US and Non US Citizens. The discount card is priced at a very low affordable level of $7.99 per month. If you wish to review and apply for the Aetna Discount Card, please click on the Vital Savings by Aetna link.

Careington offers a discount card program for RX, Dental, Vision, Chiropractic, HearPO and Diabetic supplies. It has a large network of participating dentists and discounts vary. Cost is only $15.95 per month for the entire household. To apply, click on the Careington Discount Medical Plan Application link.

Vital Savings by AETNA

Careington Discount Medical
Plan Application

Trawick International
Trawick International is ideal for travelers going outside their home country looking for medical coverage from $250,000 up to $1 million. This program is designed for trips of 5 days up to a maximum of one year and provides coverage for emergency evacuation, medical expense, and trip interruption. Safe Travels USA is for travelers to the USA and Safe Travels International is for worldwide travel outside the USA and is recommended for travelers applying for a Schengen Visa. A Group Health Insurance for travel outside the USA is also available through Safe Travels Groups.

Safe Travels USA
Safe Travels International
Safe Travels Groups

Membership Forms  

Membership (pdf) -  Membership (doc)

Insurance Enrollment Form

Insurance (pdf) -  Insurance (doc)

Insurance Renewal Form

Renewal (pdf)  - Renewal (doc)

Print the required form(s) and mail the completed documents to:
India Network Services
7065 Westpointe Blvd, Suite 209
Orlando, FL 32835-8758

Include (2) checks. One for Insurance Premium to India Network Services and one for
$10 membership fee payable to 'India Network Foundation' or Fax Completed Forms to 407-479-3289

Applicable only if cancellation occurs before start date of coverage.

Cancellation Form (pdf)

Insured must complete the first page of claim form (according to policy number) and  file with Chartis Claims Office either directly or along with provider office. A notarized affidavit duly signed by visitor to authorize US person to discuss claim status/questions with Chartis.

Claim Form (pdf)

Please complete and fax this form if you wish to discuss claim status on behalf of the visitor.

HIPPA Form (pdf)