CLAIM FORM FOR MEDICAL BENEFITS
AGVA WELFARE TRUST FUND
363 Seventh Avenue ~ 17th Floor
New York, NY 10001-3904
(212) 627-4820 ~ AGVAUSA.com


MATERNITY BENEFITS



Careallies must be informed at the beginning of your pregnancy
1-800-331-0890

Members requiring Hospitalization at any time during and through the pregnancy must contact Careallies at 1-800-331-0890

Prenatal visits paid at 80% of reasonable and customary charges

Laboratory tests, Sonograms, Ultra-sound all paid at 80%

Hospitalization - Semi-Private rate paid at 100%

Vaginal delivery and C-Section are paid at 80%

Delivered Dependents are not covered under AGVA Welfare Trust Fund