The RPCV Short-term Health Insurance Plan was designed for you and your dependents. It provides coverage for worldwide medical treatment as well as an emergency medical evacuation benefit. The plan covers current and future medical treatment, all at a competitive price.
Your Coverage – When you close service, Peace Corps automatically enrolls you in RPCV Short-Term Health Insurance and pays for your first month of coverage. All volunteers are guaranteed to receive this. If you would like to extend your coverage, you can purchase 2 additional months.
Protect Your Dependents – If you like, you may buy this plan to cover your spouse and other dependents. To do this, you must enroll them within the first month of your coverage.
|pdf RPCV Short-term Health Insurance For Transition and Travel - Sample Insurance Contract - A sample certificate for the RPCV Shot-term Health Insurance For Transition & Travel plan. Please note that upon enrollment, you will be provided with an official certificate.||Download|
|pdf Injury and Accident Form - If medical treatment was sought due to an injury or accident, you will need to submit this form to IMG in order for us to process the related claims.||Download|
|pdf ACH Wire Transfer Form - If you wish to have any reimbursements payable to you to be directly deposited into your account, you may fill out this form, and the information will be securely kept on file. If you need to make a change, simply submit a new form.||Download|
|pdf Privacy and Confidentiality Release Form - In order for IMG to discuss your claims activity with anyone other than you and your physician(s) or provider(s) of service, for example a parent or spouse, you must complete this form and submit it to us.||Download|
|pdf RPCV Short-term Health Insurance Brochure - This guide provides an outline of the RPCV Short-term Health Insurance program and enrollment/extensions guidelines.||Download|
|pdf RPCV Health Benefit Plan Claim Form - If you are covered under the Health Benefit Plan and you have paid for medical services out-of-pocket, this form must be completed and returned to IMG along with a detailed bill and/or payment receipts.||Download|