Liaison Travel | Benefits
| Benefits | Economy | Choice | Elite |
|---|---|---|---|
| Lifetime Maximum | $5,000,000 | ||
| Medical Maximum Options injury/illness | |||
| Worldwide/Inside the US |
Ages 14 days-69: $50,000; $100,000; $500,000; $1,000,000 ; $2,000,000; $5,000,000 Ages 70-79: $50,000 Ages 80+: $15,000 |
Ages 14 days-69: $50,000; $100,000; $500,000; $1,000,000 ; $2,000,000; $5,000,000 Ages 70-79: $50,000 Ages 80+: $20,000 |
|
| Worldwide/Excluding the US |
Ages 14 days-69: $50,000; $100,000; $500,000; $1,000,000 ; $2,000,000; $5,000,000 Ages 70-79: $50,000 or $100,000 Ages 80+: $15,000 |
Ages 14 days-69: $50,000; $100,000; $500,000; $1,000,000 ; $2,000,000; $5,000,000 Ages 70-79: $50,000 or $100,000 Ages 80+: $20,000 |
|
| Deductible options | |||
| Per period of coverage | $0, $100, $250, $500, $1,000, $2,500, $5,000 | ||
| Coinsurance | |||
| In-network, inside the US | 80% of expenses up to $5,000, then 100% up to Medical Maximum | 90% of expenses up to $5,000, then 100% up to Medical Maximum | 100% up to Medical Maximum |
| Out-of-network, inside the US | 70% of expenses up to $5,000, then 100% up to Medical Maximum | 80% of expenses up to $5,000, then 100% up to Medical Maximum | 90% of expenses up to $5,000, then 100% up to Medical Maximum |
| Outside the US | 100% Up to Medical Maximum | ||
| Hospital Services Subject to Deductible and Coinsurance unless otherwise stated. | |||
| Hospital Room & Board | Up to Medical maximum | ||
| Inpatient | Up to Medical maximum | ||
| Outpatient | Up to Medical maximum | ||
| Emergency Room | Up to Medical maximum | ||
| Doctor Office Visits | Up to Medical maximum | ||
| Coma Benefit | $10,000 | $25,000 | $50,000 |
| Hospital Indemnity (outside the US and Canada) | $100 per day to a maximum of 30 days | $150 per day to a maximum of 30 days | $250 per day to a maximum of 30 days |
| Home Healthcare | $2,500 | ||
| Local Ambulance | $5,000 | $10,000 | Up to Medical Maximum |
| Prescription Drugs | Up to Medical Maximum | ||
| Dental Treatment | |||
| Due to accident | $500 | $5,000 | Up to Medical Maximum |
| Alleviate onset of pain | $100 | $200 | $250 |
| Pre-existing Conditions | |||
|
Coverage for Pre-existing conditions US Residents outside of the US |
Age 0-69: $25,000 Age 70+: $5,000 |
Age 0-69: $50,000 Age 70+: $10,000 |
Age 0-64 with primary health plan: Medical Maximum Age 0-64 without primary health plan: $50,000 Age 65+: $2,500 |
|
Acute onset of Pre-existing condition Non-US traveling to the US |
Age 0-69: $15,000 Age 70+: $2,500 |
Age 0-69: $30,000 Age 70+: $5,000 |
Age 0-69: $50,000 Age 70+: $10,000 |
| Home Country | |||
| Extension of Benefits | $5,000 | $10,000 | $20,000 |
| Incidental Trips to Home Country | $5,000 | $10,000 | $50,000 |
| Additional Benefits | |||
| 24/7 Travel Assistant | Included | ||
| Loss of Checked Luggage | Up to $50 per article; $250 maximum | Up to $50 per article; $500 maximum | Up to $50 per article; $1,000 maximum |
| Trip Interruption | $2,500 | $5,000 | $10,000 |
| Terrorism | $25,000 | $50,000 | Up to Medical Maximum |
| Felonious Assault | $5,000 | $10,000 | $20,000 |
| International Emergency Care | |||
| Emergency Medical Evacuation | $250,000 | $500,000 | $1,000,000 |
| Emergency Medical Reunion | Up to $200 per day/ $25,000 maximum limit | Up to $200 per day/ $50,000 maximum limit | Up to $200 per day/ $100,000 maximum limit |
| Return of Child(ren) | $25,000 | $50,000 | $100,000 |
| Return of Mortal Remains | $25,000 | $50,000 | $100,000 |
| Political Evacuation and Repatriation | $10,000 | ||
| Local Burial or Cremation | $5,000 | ||
| Natural Disaster | |||
| Evacuation | $25,000 | $50,000 | $100,000 |
| Daily Benefit | $50 per day / 5 day limit | $100 per day / 5 day limit | $250 per day / 10 day limit |
| Accidental Death and Dismemberment | |||
| Primary or Travel Companion | $10,000 | $25,000 | $50,000 |
| Child | $2,500 | $5,000 | $10,000 |
| Total for Insureds | $250,000 | ||
| Common Carrier Accidental Death and Dismemberment | |||
| Primary or Travel Companion | $20,000 | $50,000 | $100,000 |
| Child | $5,000 | $10,000 | $20,000 |
| Total for Insureds | $250,000 | ||
| Personal Liability | $25,000 | $50,000 | $100,000 |
| Hazardous Activities | Up to Medical maximum | ||
Please note: The benefit table listed above is a consolidated version of the full plan benefits. Please view the plan certificates for the Liaison Travel Medical Economy, Liaison Travel Medical Choice, Liaison Travel Medical Elite for the full benefits and limitations of the plan. Limits apply to all benefits.
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