Global Teaching Partners Dependents
Global Teaching Partners requires that all dependents purchase the Major Medical plan or Patriot Travel plan while they are outside their home country in the US.
***VERY IMPORTANT: To meet the Federal J visa insurance requirements on the Patriot Travel plan you must choose $100,000 or more in coverage and a $500 or less deductible. The Patriot Travel plan allows you to purchase coverage for as little as 5 days up to 365, it's also renewable for one additional year. Only the J2 visa holders should be on this plan- do not add yourself. ***
***VERY IMPORTANT:To meet the Federal J visa insurance requirements on the Major Medical Plan you must choose the Silver level of coverage or higher and a $500 or less deductible. The Major Medical plan is an annual, major medical plan. This plan is a good option for individuals who need the option to apply for coverage for numerous years. Only the J2 visa holders should be on this plan- do not add yourself. ***
If you have any questions on either of these plans please contact our office at 877-758-4391.
- Major Medical Plan
- Available in four levels, there is no student or scholar requirement, so dependents can be covered by themselves. This comprehensive insurance plan is annually renewable and offers up to $8 million in coverage. Depending on the plan, coverage includes doctor visits, hospitalization, maternity, wellness, vision and dental.
- Patriot Travel
- The Patriot Travel plan provides comprehensive coverage in the event of an unexpected accident or illness. It can be purchased from 5 days up to a year, with the ability to renew up to 3 years. This plan has no student or scholar eligibility requirement so dependents can buy on their own.
- Annually renewable coverage
- Worldwide coverage (including in your home country) with option to include the US
- Wellness, Maternity, Dental Vision and Mental Health
Patriot Travel | Benefits
| Worldwide, including the USA | ||
| America Plus | America Platinum | |
|---|---|---|
| Period of Coverage | 5 days up to 12 months | |
| Extensions | Up to 24 continuous months | Up to 36 continuous months |
| Period of Coverage Limit | $50,000 to $1,000,000 | $2,000,000 to $8,000,000 |
| Area of Coverage | Worldwide, excluding Country of Residence | |
| Deductible for Eligible Medical Expenses | ||
| Deductible Per Certificate Period | $0, $100, $250, $500, $1,000 or $2,500 | $0, $100, $250, $500, $1,000 or $2,500, $5,000, $10,000 or $25,000 |
| Coinsurance for Eligible Medical Expenses | ||
| Coinsurance In addition to deductible |
USA In-Network: Plan pays 100% USA Out-of-Network: Plan pays 80%, $1,000 out of pocket max International: Plan pays 100% |
USA In-Network: Plan pays 100% USA Out-of-Network: Plan pays 90%, $500 out of pocket max International: Plan pays 100% |
| Pre-Certification Requirements | ||
| Pre-certification |
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| Pre-Existing Conditions | ||
| Pre-Existing Conditions | Charges resulting directly or indirectly from or relating to any Pre-existing Condition are excluded from coverage under this insurance. | |
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Acute Onset of Pre-existing Conditions
Subject to Deductible and Coinsurance unless otherwise noted Eligible Medical Expenses are limited to Usual, Reasonable and Customary Limits per Period of Coverage unless stated as Maximum Limit |
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| Acute Onset of Pre-existing Conditions Insured Person must be under 70 years of age | Up to the Period of Coverage Limit |
United States citizens: Age 64 and under without a Primary Health Plan: Maximum Limit: $20,000 Age 64 and under with a Primary Health Plan: Maximum Limit: $1,000,000 Age 65 through age 69: Maximum Limit: $2,500 Non-United States citizens: Age 69 and under: Maximum Limit: $1,000,000 |
| Emergency Medical Evacuation | Maximum Limit: $25,000 | |
| Arises or results directly from a covered Acute Onset of a Pre-existing Condition. Insured Person must be under 70 years of age | ||
| Provider Network | ||
| Provider Network |
PPO Network U.S. Coverage — UnitedHealthcare Network International Coverage — International Provider Access |
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Inpatient or Outpatient Services
Subject to Deductible and Coinsurance unless otherwise noted Eligible Medical Expenses are limited to Usual, Reasonable and Customary Limits per Period of Coverage unless stated as Maximum Limit |
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| Eligible Medical Expenses | Up to the Period of Coverage Limit | |
| Physician Visits / Services | Up to the Period of Coverage Limit | |
| Telemedicine Services | Reimbursable Telehealth visits can be submitted for reimbursement | Included Access to Teladoc is included for no additional fee. Not subject to Deductible or Coinsurance. |
| **Coverage for a Teladoc and CareClix Consultation is not a determination that any specific condition discussed, raised or identified during such consultation is covered under this insurance. The Company reserves the right to decline future claims relating to or arising from any condition discussed, raised or identified during a Teladoc or CareClix Consultation where the Illness or Injury is directly or indirectly related to any Pre-existing Condition or is otherwise excluded under this Certificate of Insurance | ||
| Urgent Care Clinic | Copayment: $25 — Not subject to Deductible. Copayment is not applicable if the Declaration states $0 Deductible | |
| Walk-in Clinic | Copayment: $15 — Not subject to Deductible. Copayment is not applicable if the Declaration states $0 Deductible | |
| Hospital Emergency Room |
Injury: Not subject to Emergency Room Deductible Illness in the USA: Subject to a $250 Deductible for each Emergency Room visit for Treatment that does not result in a direct Hospital admission Illness outside USA: Not subject to Emergency Room Deductible |
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| Hospitalization / Room & Board | Up to the Period of Coverage Limit Average semi-private room rate Includes nursing, miscellaneous and Ancillary Services | |
| Intensive Care | Up to the Period of Coverage Limit | |
| Bedside Visit | $1,500 Maximum Limit Not subject to Deductible. Hospitalized in an Intensive Care Unit | |
| Outpatient Surgical/ Hospital Facility | Up to the Period of Coverage Limit | |
| Laboratory | Up to the Period of Coverage Limit | |
| Radiology/XRay | Up to the Period of Coverage Limit | |
| Chemotherapy/ Radiation Therapy | Up to the Period of Coverage Limit | |
| Pre-admission Testing | Up to the Period of Coverage Limit | |
| Surgery | Up to the Period of Coverage Limit | |
| Reconstructive Surgery | Up to the Period of Coverage Limit Surgery is incidental to or follows Surgery that was covered under the plan | |
| Assistant Surgeon | 20% of the primary surgeon’s eligible fee | |
| Anesthesia | Up to the Period of Coverage Limit | |
| Durable Medical Equipment | Up to the Period of Coverage Limit Standard basic hospital bed and/or a standard basic wheelchair. | |
| Chiropractic Care | Up to the Period of Coverage Limit Medical order or Treatment plan required | |
| Physical Therapy | Up to the Period of Coverage Limit Medical order or Treatment plan required | |
| Extended Care Facility | Up to the Period of Coverage Limit Upon direct transfer from acute care Hospital | |
| Home Nursing Care |
Up to the Period of Coverage Limit
Provided by a Home Health Care Agency Upon direct transfer from acute care Hospital |
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| COVID-19 / SARS-CoV-2 | COVID-19/SARS-CoV-2 shall be considered by the Company the same as any other Illness or Injury, subject to the Terms and Conditions of this insurance | |
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Prescription Drugs and Medication
Subject to Deductible and Coinsurance unless otherwise noted Eligible Medical Expenses are limited to Usual, Reasonable and Customary Limits per Period of Coverage unless stated as Maximum Limit |
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| Prescription Drugs and Medication Obtained through Retail Pharmacy, Inpatient and Outpatient Surgery, Emergency Room and Outpatient Office Visits |
In the USA: 80% International: 100% |
In the USA: 90% International: 100% |
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The following Prescription Drugs and Medication Maximum Limit accumulates toward the plan Maximum Limit per Period of Coverage. If the Certificate of Insurance Maximum Limit is $10,000, $50,000 or $100,000, the Prescription Drugs and Medications limit is up to the plan Maximum Limit. If the Certificate of Insurance Maximum Limit is $500,000 or $1,000,000, the Prescription Drugs and Medications Maximum Limit is up to $250,000 per Period of Coverage. Dispensing maximum for Retail Pharmacy: 90 days per prescription |
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Emergency Services
NOT Subject to Deductible and Coinsurance unless otherwise noted Eligible Medical Expenses are limited to Usual, Reasonable and Customary Limits per Period of Coverage unless stated as Maximum Limit |
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| Emergency Local Ambulance |
Up to the Period of Coverage Limit Injury Illness: must result in an inpatient hospital admission Subject to Deductible and Coinsurance |
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| Emergency Medical Evacuation | $1,000,000 | Up to Period of Coverage limit |
| Must be approved in advance and coordinated by the Company | ||
| Emergency Reunion |
$100,000 Maximum Limit Maximum Days: 15 Meal Maximum per day: $25 Reasonable and necessary travel costs and accommodations Must be approved in advance by the Company |
|
| Interfacility Ambulance Transfer | Up to the Period of Coverage Limit Transfer must be a result of an Inpatient Hospital admission | |
| Natural Disaster Evacuation | $25,000 Maximum Limit Must be approved in advance by the Company | |
| Political Evacuation and Repatriation | $100,000 Maximum Limit Must be approved in advance by the Company | |
| Remote Transport | $5,000 limit, $20,000 Maximum Limit Must be approved in advance by the Company | |
| Return of Minor Children | $100,000 Maximum Limit Must be approved in advance by the Company | |
| Return of Mortal Remains |
Up to the Period of Coverage Limit Local Burial/ Cremation Maximum Limit: $5,000 Return of Insured Person’s Mortal Remains to Country of Residence Must be approved in advance by the Company |
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Other Services
NOT subject to Deductible and Coinsurance unless otherwise noted Eligible Medical Expenses are limited to Usual, Reasonable and Customary Limits per Period of Coverage unless stated as Maximum Limit |
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| Accidental Death & Dismemberment |
$50,000 Maximum Limit Accidental Death: 100% of Principal Sum Dismemberment:
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| Common Carrier Accidental Death |
$100,000 Maximum Limit per Adult $25,000 Maximum Limit per Child $250,000 Maximum Limit per Family |
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| Dental Treatment Unexpected pain or Treatment due to an Accident |
In the USA: 80% International: 100% |
In the USA: 90% International: 100% |
| $300 Maximum Limit Subject to Deductible and Coinsurance | ||
| Traumatic Dental Injury |
Up to the Period of Coverage Limit
Subject to Deductible and Coinsurance Treatment at a Hospital due to an Accident Additional Treatment for the same Injury rendered by a Dental Provider will be paid at 100% |
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| Emergency Eye Exam |
In the USA: 80% International: 100% |
In the USA: 90% International: 100% |
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$150 Maximum Limit, $50 deductible per occurrence
Subject to Coinsurance (plan Deductible waived) Loss or damage to prescription corrective lenses due to Accident |
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| Hospital Indemnity |
$250 overnight limit Maximum Nights: 10 Outside Insured Person’s Country of Residence and the United States Inpatient Hospitalization only |
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| Identity Theft | $500 Maximum Limit | |
| Incidental Trip | 14 days Maximum Insured Person’s Country of Residence is not the United States | |
| Lost Luggage | $50 per item, $500 maximum limit | |
| Natural Disaster | $250 per day and maximum limit of 5 days for accommodations | |
| Non-Emergency Medical Evacuation | No Coverage |
$50,000 Max Limit
Insured Persons under age 65. Approved in Advance by the Company |
| Personal Liability Secondary to any other insurance |
Combined Limit: $25,000 Injury to third person: Per Injury Deductible $100 Damage to third person’s property: Per damage Deductible $100 No coverage for Injury to a related third party or damage to related third person’s property |
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| Pet Return | $1,000 Maximum Limit For a pet cat or dog traveling with the insured Person | |
| Small Pet Common Air Carrier Accidental Death Benefit | $500 Maximum Limit For a pet cat or dog up to 30 pounds traveling with the Insured Person | |
| Supplemental Accident Benefit | $300 Maximum Limit | |
| Terrorism | $50,000 Maximum Limit | |
| Return Travel | $10,000 Maximum Limit | |
| Travel Intelligence | Not Included | Included |
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Incidental Services
Combined Maximum Limit: $50,000
NOT subject to Deductible and Coinsurance unless otherwise noted Eligible Medical Expenses are limited to Usual, Reasonable and Customary Limits per Period of Coverage unless stated as Maximum Limit |
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| Emergency Treatment While Traveling Through the United States | No Coverage | |
| Emergency Medical Evacuation to the United States and Associated Treatment | No Coverage | |
| Emergency Treatment During Incidental Trip to Country of Residence | No Coverage | |
| Worldwide, excluding the USA | ||
| International Lite | International Platinum | |
|---|---|---|
| Period of Coverage | 5 days up to 12 months | |
| Extensions | Up 24 continuous months | Up to 36 continuous months |
| Period of Coverage Limit | $50,000 to $1,000,000 | $2,000,000 to $8,000,000 |
| Area of Coverage | Worldwide, excluding Country of Residence and the United States | |
| Deductible for Eligible Medical Expenses | ||
| Deductible Per Certificate Period | $0, $100, $250, $500, $1,000 or $2,500 | $0, $100, $250, $500, $1,000 or $2,500, $5,000, $10,000 or $25,000 |
| Coinsurance for Eligible Medical Expenses | ||
| Coinsurance In addition to deductible | Plan pays 100% | |
| Pre-Certification Requirements | ||
| Pre-certification |
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| Pre-Existing Conditions | ||
| Pre-Existing Conditions | Charges resulting directly or indirectly from or relating to any Pre-existing Condition are excluded from coverage under this insurance. | |
|
Acute Onset of Pre-existing Conditions
Subject to Deductible and Coinsurance unless otherwise noted Eligible Medical Expenses are limited to Usual, Reasonable and Customary Limits per Period of Coverage unless stated as Maximum Limit |
||
| Acute Onset of Pre-existing Conditions Insured Person must be under 70 years of age |
United States citizens: Age 64 and under without a Primary Health Plan: Maximum Limit: $20,000 Age 64 and under with a Primary Health Plan: Up to the Period of Coverage limit Age 65 through age 69: Maximum Limit: $2,500 Non-United States citizens: Age 69 and under: Maximum Limit: Up to Period of Coverage limit or $1,000,000 (whichever is lower) |
United States citizens: Age 64 and under without a Primary Health Plan: Maximum Limit: $20,000 Age 64 and under with a Primary Health Plan: Maximum Limit: $1,000,000 Age 65 through age 69: Maximum Limit: $2,500 Non-United States citizens: Age 69 and under: Maximum Limit: $1,000,000 |
| Emergency Medical Evacuation | Maximum Limit: $25,000 | |
| Arises or results directly from a covered Acute Onset of a Pre-existing Condition. Insured Person must be under 70 years of age | ||
| Provider Network | ||
| Provider Network |
PPO Network U.S. Coverage — UnitedHealthcare Network International Coverage — International Provider Access |
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|
Inpatient or Outpatient Services
Subject to Deductible and Coinsurance unless otherwise noted Eligible Medical Expenses are limited to Usual, Reasonable and Customary Limits per Period of Coverage unless stated as Maximum Limit |
||
| Eligible Medical Expenses | Up to the Period of Coverage Limit | |
| Physician Visits / Services | Up to the Period of Coverage Limit | |
| Telemedicine Services | Reimbursable Telehealth visits can be submitted for reimbursement | Included Access to CareClix is included for no additional fee. Not subject to Deductible or Coinsurance. |
| **Coverage for a Teladoc and CareClix Consultation is not a determination that any specific condition discussed, raised or identified during such consultation is covered under this insurance. The Company reserves the right to decline future claims relating to or arising from any condition discussed, raised or identified during a Teladoc or CareClix Consultation where the Illness or Injury is directly or indirectly related to any Pre-existing Condition or is otherwise excluded under this Certificate of Insurance | ||
| Urgent Care Clinic | Copayment: $25 — Not subject to Deductible. Copayment is not applicable if the Declaration states $0 Deductible | |
| Walk-in Clinic | Copayment: $15 — Not subject to Deductible. Copayment is not applicable if the Declaration states $0 Deductible | |
| Hospital Emergency Room |
Injury: Not subject to Emergency Room Deductible Illness in the USA: Subject to a $250 Deductible for each Emergency Room visit for Treatment that does not result in a direct Hospital admission Illness outside USA: Not subject to Emergency Room Deductible |
|
| Hospitalization / Room & Board | Up to the Period of Coverage Limit Average semi-private room rate Includes nursing, miscellaneous and Ancillary Services | |
| Intensive Care | Up to the Period of Coverage Limit | |
| Bedside Visit | $1,500 Maximum Limit Not subject to Deductible. Hospitalized in an Intensive Care Unit | |
| Outpatient Surgical/ Hospital Facility | Up to the Period of Coverage Limit | |
| Laboratory | Up to the Period of Coverage Limit | |
| Radiology/XRay | Up to the Period of Coverage Limit | |
| Chemotherapy/ Radiation Therapy | Up to the Period of Coverage Limit | |
| Pre-admission Testing | Up to the Period of Coverage Limit | |
| Surgery | Up to the Period of Coverage Limit | |
| Reconstructive Surgery | Up to the Period of Coverage Limit Surgery is incidental to or follows Surgery that was covered under the plan | |
| Assistant Surgeon | 20% of the primary surgeon’s eligible fee | |
| Anesthesia | Up to the Period of Coverage Limit | |
| Durable Medical Equipment | Up to the Period of Coverage Limit Standard basic hospital bed and/or a standard basic wheelchair. | |
| Chiropractic Care | Up to the Period of Coverage Limit Medical order or Treatment plan required | |
| Physical Therapy | Up to the Period of Coverage Limit Medical order or Treatment plan required | |
| Extended Care Facility | Up to the Period of Coverage Limit Upon direct transfer from acute care Hospital | |
| Home Nursing Care |
Up to the Period of Coverage Limit
Provided by a Home Health Care Agency Upon direct transfer from acute care Hospital |
|
| COVID-19 / SARS-CoV-2 | COVID-19/SARS-CoV-2 shall be considered by the Company the same as any other Illness or Injury, subject to the Terms and Conditions of this insurance | |
|
Prescription Drugs and Medication
Subject to Deductible and Coinsurance unless otherwise noted Eligible Medical Expenses are limited to Usual, Reasonable and Customary Limits per Period of Coverage unless stated as Maximum Limit |
||
| Prescription Drugs and Medication Obtained through Retail Pharmacy, Inpatient and Outpatient Surgery, Emergency Room and Outpatient Office Visits | 100% | 100% |
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The following Prescription Drugs and Medication Maximum Limit accumulates toward the plan Maximum Limit per Period of Coverage. If the Certificate of Insurance Maximum Limit is $10,000, $50,000 or $100,000, the Prescription Drugs and Medications limit is up to the plan Maximum Limit. If the Certificate of Insurance Maximum Limit is $500,000 or $1,000,000, the Prescription Drugs and Medications Maximum Limit is up to $250,000 per Period of Coverage. Dispensing maximum for Retail Pharmacy: 90 days per prescription |
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Emergency Services
NOT Subject to Deductible and Coinsurance unless otherwise noted Eligible Medical Expenses are limited to Usual, Reasonable and Customary Limits per Period of Coverage unless stated as Maximum Limit |
||
| Emergency Local Ambulance |
Up to the Period of Coverage Limit Injury Illness: must result in an inpatient hospital admission Subject to Deductible and Coinsurance |
|
| Emergency Medical Evacuation | $1,000,000 | Up to Period of Coverage limit |
| Must be approved in advance and coordinated by the Company | ||
| Emergency Reunion |
$100,000 Maximum Limit Maximum Days: 15 Meal Maximum per day: $25 Reasonable and necessary travel costs and accommodations Must be approved in advance by the Company |
|
| Interfacility Ambulance Transfer | Up to the Period of Coverage Limit Transfer must be a result of an Inpatient Hospital admission | |
| Natural Disaster Evacuation | $25,000 Maximum Limit Must be approved in advance by the Company | |
| Political Evacuation and Repatriation | $100,000 Maximum Limit Must be approved in advance by the Company | |
| Remote Transport | $5,000 limit, $20,000 Maximum Limit Must be approved in advance by the Company | |
| Return of Minor Children | $100,000 Maximum Limit Must be approved in advance by the Company | |
| Return of Mortal Remains |
Up to the Period of Coverage Limit Local Burial/ Cremation Maximum Limit: $5,000 Return of Insured Person’s Mortal Remains to Country of Residence Must be approved in advance by the Company |
|
|
Other Services
NOT subject to Deductible and Coinsurance unless otherwise noted Eligible Medical Expenses are limited to Usual, Reasonable and Customary Limits per Period of Coverage unless stated as Maximum Limit |
||
| Accidental Death & Dismemberment |
$50,000 Maximum Limit Accidental Death: 100% of Principal Sum Dismemberment:
|
|
| Common Carrier Accidental Death |
$100,000 Maximum Limit per Adult $25,000 Maximum Limit per Child $250,000 Maximum Limit per Family |
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| Dental Treatment Unexpected pain or Treatment due to an Accident | 100% | 100% |
| $300 Maximum Limit Subject to Deductible and Coinsurance | ||
| Traumatic Dental Injury |
Up to the Period of Coverage Limit
Subject to Deductible and Coinsurance Treatment at a Hospital due to an Accident Additional Treatment for the same Injury rendered by a Dental Provider will be paid at 100% |
|
| Emergency Eye Exam | 100% | 100% |
|
$150 Maximum Limit, $50 deductible per occurrence
Subject to Coinsurance (plan Deductible waived) Loss or damage to prescription corrective lenses due to Accident |
||
| Hospital Indemnity |
$250 overnight limit Maximum Nights: 10 Outside Insured Person’s Country of Residence and the United States Inpatient Hospitalization only |
|
| Identity Theft | $500 Maximum Limit | |
| Incidental Trip | No Coverage | |
| Lost Luggage | $50 per item, $500 maximum limit | |
| Natural Disaster | $250 per day and maximum limit of 5 days for accommodations | |
| Non-Emergency Medical Evacuation | No Coverage |
$50,000 Max Limit
Insured Persons under age 65. Approved in Advance by the Company |
| Personal Liability Secondary to any other insurance |
Combined Limit: $25,000 Injury to third person: Per Injury Deductible $100 Damage to third person’s property: Per damage Deductible $100 No coverage for Injury to a related third party or damage to related third person’s property |
|
| Pet Return | $1,000 Maximum Limit For a pet cat or dog traveling with the insured Person | |
| Small Pet Common Air Carrier Accidental Death Benefit | $500 Maximum Limit For a pet cat or dog up to 30 pounds traveling with the Insured Person | |
| Supplemental Accident Benefit | $300 Maximum Limit | |
| Terrorism | $50,000 Maximum Limit | |
| Return Travel | $10,000 Maximum Limit | |
| Travel Intelligence | Not Included | Included |
|
Incidental Services
Combined Maximum Limit: $50,000
NOT subject to Deductible and Coinsurance unless otherwise noted Eligible Medical Expenses are limited to Usual, Reasonable and Customary Limits per Period of Coverage unless stated as Maximum Limit |
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| Emergency Treatment While Traveling Through the United States | 14 Max Consecutive Days (in addition to the combined Maximum Limit) Must be Pre-certified and coordinated by the Company 100% | |
| Emergency Medical Evacuation to the United States and Associated Treatment | 14 Max Consecutive Days (in addition to the combined Maximum Limit) Must be Pre-certified and coordinated by the Company 100% | |
| Emergency Treatment During Incidental Trip to Country of Residence | 14 Max Consecutive Days (in addition to the combined Maximum Limit) Must be Pre-certified and coordinated by the Company 100% | |
Please note: The benefit table listed above is a consolidated version of the full plan benefits.
Please view the plan certificate for the Patriot America plans
( Plus | Platinum) and Patriot International plans
( Lite | Platinum) for the full benefits and limitations of the plan. Limits apply to all benefits.
Optional Plan Riders
Available to add additional coverage to your plan.
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Adventure Sports: If you’re a thrill-seeking traveler who enjoys life’s more adventurous activities, you may want to consider adding supplemental coverage to your plan. The Adventure Sports Rider provides coverage for injuries sustained during certain extreme sports that would otherwise be excluded from your travel insurance policy.
Lifetime Maximum- Age 0–49: $50,000
- Age 50–59: $30,000
- Age 60–64: $15,000
Patriot Travel | Exclusions
Charges for certain services, treatments and/or conditions, among others, are excluded from coverage under the Patriot plans and include but are not limited to:
- Economic Sanctions: The Company will not cover any person as an Insured Person if such cover would result in the Company being exposed to any sanction, prohibition or restriction under United Nations resolutions or the trade or economic sanctions, laws, or regulations of the European Union, United Kingdom or the United States of America.
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War; Military Action: The Company shall not be liable for and will not provide coverage or benefits for any claim or Charges incurred with respect to any Illness, Injury, death and dismemberment, or other consequence, whether directly or indirectly, proximately or remotely occasioned by, contributed to by, or traceable to or arising or incurred in connection with or as a result of any of the following acts or occurrences:
- war, invasion, act of foreign enemy hostilities, warlike operations (whether war be declared or not), or civil war
- mutiny, riot, strike, military or popular uprising, insurrection, rebellion, revolution, military or usurped power
- any act of any person acting on behalf of or in connection with any organization with activities directed towards the overthrow by force of the Government de jure or de facto or to the influencing of it by violence of any type
- martial law or state of siege or any events or causes which determine the proclamation or maintenance of martial law or state of siege
- any use of radiological, chemical, nuclear or biological weapons or any other radiological, chemical, nuclear or biological events of any type (including in connection with an act of Terrorism).
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Terrorism: The Company shall not be liable for and will not provide coverage or benefits for any claim or Charges, Illness, Injury or other consequence, whether directly or indirectly, proximately or remotely occasioned by, contributed to by, or traceable to or arising in connection with any act of Terrorism. Further, the Company shall not be liable for and will not provide any coverage or benefits for any claim, Charges, Illness, Injury or other consequence, whether directly or indirectly, proximately or remotely occasioned by, contributed to by, or traceable to or arising in connection with the following:
- the Insured Person’s active and voluntary planning or coordination of or participation in any act of Terrorism
- any act of Terrorism that takes place in a location, post, area, territory or country for which a Travel Warning or Emergency Travel Advisory was issued or in effect on or within six (6) months prior to the Insured Person’s date of arrival in said location, post, area, territory or country
- any act of Terrorism that takes place in a location, post, area, territory or country for which a Travel Warning or Emergency Travel Advisory becomes effective or is in effect on or after the Insured Person’s date of arrival in said location, post, area, territory or country, and the Insured Person unreasonably fails or refuses to heed such warning and thereafter remains in said location, post, area, territory or country.
- Pre-existing Conditions: Charges resulting directly or indirectly from or relating to any Pre-existing Condition are excluded from coverage under this insurance except and unless the Charges resulted directly from an Acute Onset of Pre-existing Condition in which case the Charges will be covered only according to the terms of the Acute Onset of Pre-Existing Condition definition of the specific plan; and
- Maternity and Newborn Care: Charges for pre-natal care, delivery, post-natal care, and care of Newborns, including complications of Pregnancy, miscarriage, complications of delivery and/or of Newborns are excluded from this insurance.
- Mental or Nervous Disorders: Charges for Treatment of Mental or Nervous Disorders are excluded from coverage under this insurance.
- Preventative Care: Charges for Routine Physical Examinations and immunizations are excluded from coverage under this insurance.
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Charges for any Treatment or supplies that are:
- not incurred, obtained or received by an Insured Person during the Period of Coverage
- not presented to the Company for payment by way of a completed Proof of Claim within one hundred eighty (180) days from the date such Charges are incurred
- not administered or ordered by a Physician
- not Medically Necessary for the diagnosis, care or Treatment of the physical or mental condition involved. This also applies when and if they are prescribed, recommended or approved by the attending Physician
- provided at no cost to the Insured Person or for which the Insured Person is not otherwise liable
- in excess of Usual, Reasonable, and Customary
- related to Hospice care
- incurred by an Insured Person who was HIV + on or before the Initial Effective Date of this insurance, whether or not the Insured Person had knowledge of his/her HIV status prior to the Effective Date, and whether or not the Charges are incurred in relation to or as a result of said status. This exclusion includes Charges for any Treatment or supplies relating to or arising or resulting directly or indirectly from HIV, AIDS virus, AIDS related Illness, ARC Syndrome, AIDS and/or any other Illness arising or resulting from any complications or consequences of any of the foregoing conditions
- provided by or at the direction or recommendation of a chiropractor, unless ordered in advance by a Physician
- performed or provided by a Relative of the Insured Person
- not expressly included in the ELIGIBLE MEDICAL EXPENSES provision
- provided by a person who resides or has resided with the Insured Person or in the Insured Person's home
- required or recommended as a result of complications or consequences arising from or related to any Treatment, Illness, Injury, or supply excluded from coverage or which is otherwise not covered under this insurance
- for Congenital Disorders and conditions arising out of or resulting therefrom
- Charges incurred for failure to keep a scheduled appointment
- Charges incurred for Surgeries, Treatment or supplies which are Investigational, Experimental and for research purposes
- Charges incurred related to genetic medicine, genetic testing, surveillance testing and/or wellness screening procedures for genetically predisposed conditions indicated by genetic medicine or genetic testing, including, but not limited to amniocentesis, genetic screening, risk assessment, preventive and prophylactic surgeries recommended by genetic testing, and/or any procedures used to determine genetic pre-disposition, provide genetic counseling, or administration of gene therapy
- Charges incurred for testing that attempts to measure aspects of an Insured Person’s mental ability, intelligence, aptitude, personality and stress management. Such testing may include but is not limited to psychometric, behavioral and educational testing
- Charges incurred for Custodial Care
- Charges incurred for Educational or Rehabilitative Care that specifically relates to training or retraining an Insured Person to function in a normal or near-normal manner. Such care may include but is not limited to job or vocational training, counseling, occupational therapy and speech therapy
- Charges for weight modification or any Inpatient, Outpatient, Surgical or other Treatment of obesity (including without limitation morbid obesity), including without limitation wiring of the teeth and all forms or procedures of bariatric Surgery by whatever name called, or reversal thereof, including without limitation intestinal bypass, gastric bypass, gastric banding, vertical banded gastroplasty, biliopancreatic diversion, duodenal switch, or stomach reduction or stapling
- Charges for modification of the physical body in order to change or improve or attempt to change or improve the physical appearance or psychological, mental or emotional well-being of the Insured Person (such as but not limited to sex-change Surgery or Surgery relating to sexual performance or enhancement thereof)
- Charges or Treatment for cosmetic or aesthetic reasons, except for reconstructive Surgery when such Surgery is Medically Necessary and is directly related to and follows a Surgery which was covered under this insurance
- elective Surgery or Treatment of any kind
- Charges incurred for any Treatment or supply that either promotes or prevents or attempts to promote or prevent conception, insemination (natural or otherwise) or birth, including but not limited to: artificial insemination; oral contraceptives; Treatment for infertility or impotency; vasectomy; reversal of vasectomy; sterilization; reversal of sterilization; surrogacy or abortion
- Charges incurred for any Treatment or supply that either promotes, enhances or corrects or attempts to promote, enhance or correct impotency or sexual dysfunction
- any Illness or Injury sustained while taking part in, practicing or training for: Amateur Athletics; Professional Athletics; or athletic activities that are sponsored by any Governing Body or Authority, including the National Collegiate Athletic Association, any other collegiate sanctioning or Governing Body or the International Olympic Committee
- any Illness or Injury sustained while taking part in activities designated as Adventure Sports, which are limited to the following: abseiling; BMX; bobsledding; bungee jumping; canyoning; caving; hot air ballooning; jungle zip lining; parachuting; paragliding; parascending; rappelling; skydiving; spelunking; wildlife safaris; and windsurfing
- any Illness or Injury sustained while taking part in activities designated as Extreme Sports, which include but are in no way limited to the following (and include any combination or derivative of the following): BASE jumping; cave diving; cliff diving; downhill mountain biking and racing; extreme skiing; freediving; free flying; free running; free skiing; freestyle scootering; gliding; heli-skiing; ice canoeing; ice climbing; kitesurfing; mixed martial arts; motocross; motorcycle racing; motor rally; mountaineering above elevation of 4500 meters from GROUND LEVEL, ground level: The lowest point at the bottom of a mountain; parkour; piloting a commercial or non-commercial aircraft; powerbocking; scuba diving or sub aqua pursuits below a depth of 50 meters; snowmobile racing; truck racing; whitewater kayaking or whitewater rafting Class VI and higher difficulty; and wingsuit flying
- any Illness or Injury sustained while taking part in snow skiing, snowboarding or snowmobiling where the Insured Person is in violation of applicable laws, rules or regulations of a ski resort, out of bounds or in unmarked or unpatrolled areas
- any Illness or Injury sustained while taking part in backcountry skiing
- any Illness or Injury sustained while taking part in skiing off-piste
- any Illness or Injury sustained while taking part in Collision Sports. Collision Sports: A sport in which the participants purposely hit or collide with each other or inanimate objects, including the ground, with great force and limited to the following (or other similar style) sports: American football, boxing, ice hockey, lacrosse, full contact martial arts, rodeo, rugby and wrestling.
- any Illness or Injury sustained while taking part in athletic or recreational activities where the Insured Person is not physically or medically fit or does not hold the necessary qualifications to engage in said activities
- any Illness or Injury sustained while participating in any sporting, recreational or adventure activity where such activity is undertaken against the advice or direction of any local authority or any qualified instructor or contrary to the rules, recommendations and procedures of a recognized Governing Body for the sport or activity
- any Illness or Injury sustained while participating in any activity where such activity is undertaken in disregard of or against the recommendations, Treatment programs, or medical advice of a Physician or other healthcare provider
- any Injury or Illness sustained as a result of being under the influence of or due wholly or partly to the effects of alcohol, liquor, intoxicating substance, narcotics or drugs other than drugs taken in accordance with Treatment prescribed and directed by a Physician but not for the Treatment of Substance Abuse
- any Injury or Illness sustained while operating a moving vehicle after consumption of intoxicating liquor or drugs in excess of the applicable blood/alcohol legal limit, other than drugs taken in accordance with Treatment prescribed and directed by a Physician. For purposes of this exclusion, “vehicle” shall include motorized devices regardless of whether or not a driver or operator license is required (including watercraft and aircraft) and non-motorized bicycles and scooters for which no permit or license is required
- any willfully Self-inflicted Injury or Illness
- any sexually transmitted or venereal disease
- any testing for the following when not Medically Necessary: HIV, seropositivity to the AIDS virus, AIDS-related Illnesses, ARC Syndrome, AIDS
- any Illness or Injury resulting from or occurring during the commission of a violation of law by the Insured Person, including, without limitation, the engaging in an illegal occupation or act, but excluding minor traffic violations
- any Substance Abuse
- biofeedback, acupuncture, music, occupational, recreational, sleep, speech, or vocational therapy
- orthoptics, visual therapy or visual eye training
- any non-surgical Illness or Treatment of the feet, including without limitation: orthopedic shoes; orthopedic prescription devices to be attached to or placed in shoes; Treatment of weak, strained, flat, unstable or unbalanced feet; metatarsalgia, bone spurs, hammer toes or bunions; and any Treatment or supplies for corns, calluses or toenails; except as otherwise expressly set forth
- hair loss, including without limitation wigs, hair transplants or any drug that promises to promote hair growth, whether or not prescribed by a Physician
- any sleep disorder, including without limitation sleep apnea
- any exercise and/or fitness program or equipment, whether or not prescribed or recommended by a Physician
- any exposure to any non-medical nuclear or atomic radiation, and/or radioactive material(s)
- any organ or tissue or other transplant or related services, Treatment or supplies
- any artificial or mechanical devices designed to replace human organs temporarily or permanently after termination of Inpatient status
- any efforts to keep a donor alive for a transplant procedure
-
any Illness or Injury incurred in the Destination Country, Affected Area or Country of Residence as a result of a Public Health Emergency of International Concern, Epidemic, Pandemic, other disease outbreak, or Natural Disaster, that may affect an Insured Person’s health, unless coverage is expressly provided under the PUBLIC HEALTH EMERGENCY provision of this insurance.
This exclusion DOES NOT apply to Charges resulting from COVID-19/SARS-CoV-2. - Charges incurred for eyeglasses, contact lenses, hearing aids or hearing implants and Charges for any Treatment, supply, examination or fitting related to these devices, or for eye refraction for any reason, except as otherwise expressly provided for hereunder
- Charges incurred for eye Surgery, such as but not limited to radial keratotomy, when the primary purpose is to correct or attempt to correct nearsightedness, farsightedness, or astigmatism
- Charges incurred for Treatment or supplies for temporomandibular joint (TMJ) including but not limited to TMJ syndrome, craniomandibular syndrome, chronic TMJ pain, orthognathic Surgery, Le-Fort Surgery or splints
- Charges incurred in the Insured Person’s Country of Residence, except as otherwise expressly provided for in this insurance
- Charges incurred within the United States, except as otherwise expressly provided for hereunder (this exclusion does not apply if your plan was purchased to include coverage in the United States).
- Charges incurred for any travel, meals, transportation and/or accommodations, except as otherwise expressly provided for in this insurance
- Charges or expenses incurred for nonprescription drugs, medicines, vitamins, food extracts, or nutritional supplements; IV vitamin or herbal therapy; drugs or medicines not approved by the United States Food and Drug Administration or which are considered “off-label” drug use; and for drugs or medicines not prescribed by a Physician
- any Treatment for an Illness or Injury requring an unapproved U.S. Food and Drug Administration (FDA) medical product, services, Surgery, Surgical Procedure, prescription medication, drug, biological product, Durable Medical Equipment (DME) or device when an Emergency Use Authorization (EUA) is in place issued by the U.S. Food and Drug Administration (FDA)
- Charges incurred at a Hospital or Facility when the Insured Person checks himself or herself out Against Medical Advice of their Physician and leaves before reaching a Medically Necessary specified endpoint of Treatment
- Charges incurred for the Worsening of an Illness or Injury after the Insured Person left a Hospital or Facility Against Medical Advice or was a Discharge Against Medical Advice
- any infection of the urinary tract (including, without limitation, infection of the kidney, ureter, bladder, prostate or urethra) and any complication, medical condition or other Illness directly or indirectly arising therefrom, that occurs within ninety (90) days of the Effective Date of this Insurance and that requires Treatment of the Insured Person in a Hospital as an Inpatient
- Charges and all costs related to or arising from or in connection with all trips to the Destination Country undertaken for the purpose of securing medical Treatment or supplies
- Charges incurred for Dental Treatment, except as specifically provided for hereunder
- Wear and tear of teeth due to cavities and chewing or biting down on hard objects, such as but not limited to pencils, ice cubes, nuts, popcorn, and hard candies
- Dental Injury without associated face, skull, neck and/or jaws Injury or that can be evaluated and Treated in a dental office
- Dental Treatment for services which provide oral care maintenance including tooth repair by fillings, root canals, tooth removal and x-rays
- Charges for Treatment of an Illness or Injury for which payment is made or available through a workers' compensation law or a similar law
- Charges incurred for massage therapy
-
The Company will not provide cover for any legal responsibility, injury, loss or damage:
- to members of the Insured Person’s family, household, or a person the Insured Person employs
- that results from or is connected to the Insured Person’s trade, profession or business
- that results from the Insured Person owning, using or living on any land or in buildings (except temporarily for the trip)
- that results from the Insured Person owning or using mechanically propelled vehicles (including e-bikes and drones), watercraft or aircraft, animals (other than horses and pet cats or dogs), guns or weapons (other than guns that are used for sport
- that results from the Insured Person infecting any other person with any sexually transmitted disease or condition
- that results from punitive damages assessed against the Insured Person which is the result of intentionally inflicting bodily injury, damage to, or loss of personal property of somebody else’s property
-
Accidental Death or Dismemberment when the Insured Person’s death or dismemberment is caused directly or indirectly by, results from, or where there is a contribution from, any of the following:
- bodily or mental infirmity, Illness or disease
- infection, other than infection occurring simultaneously with, and as a direct result of, the accidental Injury.
Patriot Travel | FAQ
Underwriter
Eligibility
Application Help
Understanding Your Coverage
- What are the differences between the Patriot plans?
- Can I use Telemedicine with my plan?
- What is the Travel Intelligence Mobile App?
- Does this plan have dental or vision coverage?
- What does URC mean?
- What is pre-certification?
- What is a deductible?
- What is coinsurance?
- What does “in-network” mean?
- What is the Universal Rx Discount Card?
Underwriter
Who underwrites the Patriot Travel Series?
SiriusPoint Specialty Insurance Corporation is the underwriter for the Patriot International Lite, Patriot America Plus, and Patriot Platinum plans. The underwriter is rated A (excellent) by A.M. Best and A- by Standard & Poor'sEligibility
Am I eligible for the Patriot plans?
You are eligible for coverage under the Patriot International Lite, Patriot America Plus, and Patriot Platinum plans as long as you are outside your country of residence, not have established a Habitual Residency in the Destination Country, and as long as you are at least 14 days old. This includes international students (including those on OPT), visiting scholars, exchange students, dependents, travelers, chaperons, international business groups, etc.Where will this plan cover me?
You are eligible for coverage under the Patriot America Plus & America Platinum plans if you plan on traveling to the US, outside of your country of residence. The Patriot International Lite & International Platinum will cover you outside your country of residence outside the US. The country of residence is the country in which you maintain your current primary residence or usual place of abode and any country to which you pay income taxes based upon employment in that country.Application Help
When can I purchase my plan online?
You may purchase the Patriot plans at any time, up to 6 months in advance of your selected policy start date, and begin receiving coverage as soon as the next day. Please note that the full premium will be charged immediately at the time of the application.When does my coverage become effective?
Your coverage becomes effective on the start date that you select at the time of application (if you are applying online), the moment you depart your residence country, or at 12:01 am EST on the date you request on your paper application.When does my coverage end?
Your coverage ends on 12:01 am EST on the date you select at the time of application (if you are applying online), or the moment you depart your trip for your residence country.Will I get my documents immediately?
Yes! When you apply online, you will instantly receive a confirmation email with your policy documents that include links to both your ID card and Visa Letter. You may print these pages to show proof of coverage and will satisfy the requirements of most embassies and consulates.Will I get my ID card and documents in the mail?
Electronic fulfillment is the only option available for the Patriot Travel plans. You will receive your policy documents via email, after you purchase the plan. You may also access your documents online through your MyIMG account.How do I get a visa letter?
Your Visa Letter will be included in the confirmation email you receive upon purchase. You may also access your visa letter online through your MyIMG account.What forms of payment do you accept?
We accept Visa, MasterCard, American Express, and Discover cards. If you would prefer to use pay via echeck, please contact us for assistance.How can I manage my account?
Upon purchase, you’ll have access to your MyIMG account. Through this online portal, you’ll have immediate access to many important resources, including 24/7/365 service centers, plan document access, claims management tools, Explanations of Benefits, and much more.Understanding Your Coverage
What are the differences between the Patriot plans?
Some of the main differences between the plans are outlined below:
| America Plus | Platinum America | |
|---|---|---|
| Maximum Limits | $50,000 to $1,000,000 | $2,000,000 to $8,000,000 |
| Deductible Options | $0 to $2,500 | $0 to $25,000 |
| Maximum Coverage Period | Up to 24 continuous months | Up to 36 continuous months |
| Emergency Medical Evacuation | $1,000,000 | Up to maximum limit |
| Coinsurance (in-network) | 100% | 100% |
| Coinsurance (out-network) | 80% up to $5,000, then 100% | 90% up to $5,000, then 100% |
| Acute Onset of Pre-existing Conditions | Under 70 years of age, up to the maximum limit. $25,000 maximum limit for medical evacuation | Under 70 years of age, with varying limits by age up to $1,000,000. $25,000 maximum limit for medical evacuation |
| International Lite | International Platinum | |
|---|---|---|
| Maximum Limits | $50,000 to $1,000,000 | $2,000,000 to $8,000,000 |
| Deductible Options | $0 to $2,500 | $0 to $25,000 |
| Maximum Coverage Period | Up to 24 continuous months | Up to 36 continuous months |
| Emergency Medical Evacuation | $1,000,000 | Up to maximum limit |
| Coinsurance | 100% | 100% |
| Acute Onset of Pre-existing Conditions | Under 70 years of age, with varying limits by age up to the maximum limit. $25,000 maximum limit for medical evacuation. | Under 70 years of age, with varying limits by age up to $1,000,000. $25,000 maximum limit for medical evacuation. |
| Incidental emergency in the US | Up to 2 weeks | Up to 2 weeks |
Can I use Telemedicine with my plan?
If you’ve purchased the Patriot America Plus or Patriot International Lite plans, you are free to use any telemedicine service that you’d like. You will need to pay for this service directly, keep copies of all of your receipts, and file a claim to be reimbursed for any eligible expenses per the plan policy conditions and exclusions.
If you’ve purchased the Patriot America Platinum plan, your plan includes access to Teladoc Virtual Medicine at no additional cost. You can learn more about this service through our Teladoc page here.
If you’ve purchased the Patriot International Platinum plan, your plan includes access to CareClix Virtual Medicine at no additional cost. You can learn more about this service through our CareClix page here.
What is the Travel Intelligence Mobile App?
The Patriot America Platinum and International Platinum plans include access to IMG’s Travel Intelligence, giving you peace of mind before, during, and after your travel. This service provides location-specific insights about travel, safety, security, and health incidents before departure and while abroad. To access this, please login to your MyIMG account and select Travel Intelligence to utilize this service.Does this plan have dental or vision coverage?
The Patriot International Lite, America Plus, and Platinum plans do not provide coverage for routine or preventative care, like dental or vision exams. However, the plans provide coverage for dental treatment due to a covered accident or unexpected pain up to a $300 limit, as well as coverage up to the maximum limit for treatment due to a traumatic dental injury. The Patriot plans also include coverage for an emergency eye exam up to a $150 maximum limit for loss or damage to prescription corrective lenses due to a covered accident.What does URC mean?
URC stands for the Usual, Reasonable, and Customary amount. This amount is the average cost of a specific treatment or prescription in a specific geographic area. For example, if a particular procedure costs $5,000 on average in New York City, the insurance company will not pay your provider in New York City $10,000 for the same exact procedure. Instead, they will limit their payment to "Usual Reasonable and Customary" — in this example, $5,000 and you’d be responsible for paying the remaining amount.What is pre-certification?
Pre-certification is when you contact the insurance company prior to getting treatment for a specific procedure. Pre-certification must take place within forty-eight (48) hours after the admission, or as soon as is reasonably possible. If the following treatments are not pre-certified, there will be a 50% reduction in the coverage of eligible medical expenses.- Chemotherapy
- Extended Care Facility
- Home Nursing Care
- Inpatient Hospitalization
- Radiation Therapy
- Surgery or Surgical procedure
- Interfacility Ambulance Transfer
- Emergency Medical Evacuation
- Emergency Treatments new on International plans
- Inside the United States: +1.800.628.4664
- Outside the United States: +1.317.655.4500 (Collect if necessary)
- E-mail: acm@imglobal.com
- Online: www.imglobal.com/member/precertification
- Through your MyIMG account
What is a deductible?
The deductible is the dollar amount you must pay to your provider before the insurance company will cover a percentage of eligible expenses. Please note that the deductible is per person, and is only paid once per year. On the Patriot International Lite and America Plus plan, you can choose between the following deductibles: $0, $100, $250, $500, $1,000 or $2,500. On the Patriot Platinum plans, you can choose between the following deductibles: $0, $100, $250, $500, $1,000, $2,500, $5,000, $10,000, or $25,000.What is coinsurance?
Coinsurance is the “cost-sharing” between you and the insurance company. After you satisfy the deductible, the insurance company will pay a percentage of remaining eligible expenses. The coinsurance on this plan will depend on which level you choose, where you are traveling, and if you go to an in-network or out-of-network provider. You can search the network for providers online.
The coinsurance on the Patriot International Lite and International Platinum plans is as follows:
Outside the United States: 100% of eligible expenses, after the deductible is met, up to the policy maximum.
The coinsurance on the Patriot America Plus plan is as follows:
In-Network in the United States: 100% of eligible expenses, after the deductible is met, up to the policy maximum.
Out-of-Network in the United States: 80% of eligible expenses, after the deductible is met, for the first $5,000, and then 100% coverage up to the policy maximum.
The coinsurance on the Patriot America Platinum plan is as follows:
In-Network in the United States: 100% of eligible expenses, after the deductible is met, up to the policy maximum.
Out-of-Network in the United States: 90% of eligible expenses, after the deductible is met, for the first $5,000, and then 100% coverage up to the policy maximum.
What does “in-network” mean?
“In-network” is a list of providers (hospitals, physicians, clinics and urgent care centers) that have agreed to contract with the insurance company. This plan uses a PPO Network (or Preferred Provider Organization) which means that you can go to any provider you’d like, however those inside the network have agreed to accept payment directly from the insurance company at discounted rates. This will allow you to pay less out-of-pocket if you go to an in-network provider.What is the Universal Rx Discount Card?
The Universal Rx Discount Card is a discount savings program that allows you to purchase prescriptions from one of 35,000 participating pharmacies in the U.S. and receive the lower of 1) Universal Rx contract price or 2) the pharmacy regular retail price. This program is not insurance coverage; it provides reduced rates at participating pharmacies.Renewability, Extensions and Cancellations
Can I extend or renew my insurance plan?
Yes! You are able to extend your coverage. If you purchase this plan for less than 365 days, you may extend your Patriot International Lite, Patriot America Plus and Platinum plans up until you have fulfilled the full 365 days of coverage. From there, you may renew your plan up to one additional year on the Patriot International Lite and America Plus, and an additional two years on the Platinum levels in your MyIMG account.My plan has expired, how can I reinstate it?
Unfortunately, once a plan has expired, it cannot be reinstated. However, you may purchase a new Patriot plan. Please keep in mind that if you had coverage for a condition during your first plan or if any condition occurred during the lapse in coverage, it would not be covered on a new plan because it would now be considered a pre-existing condition.Can I cancel my Patriot plan?
You will have three days from the initial effective date of coverage, called the Review Period, in which you can review the benefits, conditions, limitations, exclusions, and all other terms of the plan. If you are not completely satisfied, you can cancel the plan for a full refund. After the Review Period, the following conditions will apply:- If any claims have been filed with the Company, the Premium is fully earned and is non-refundable.
-
If no claims have been filed with the Company:
- a cancellation fee of $50.00 USD will be charged regardless of the reason for cancellation
- only Premium covering time periods after cancellation are refundable
Seeking Treatment
Which doctors or hospitals can I go to?
You may visit any doctor or hospital and receive coverage under your Patriot plan. However, when in the United States, it is always best to choose a provider that accepts the contracted Preferred Provider Network (PPO).
If you’ve purchased your plan after May 1st, 2019, you’ll want to find a provider in your area that accepts the UnitedHealthcare Network, as you will have less out of pocket expenses. You can find providers through the UnitedHealthcare search tool.
If you’ve purchased your plan prior to May 1st, 2019, you’ll want to find a provider in your area that accepts the First Health Network. You can find providers that accept the First Health Network.
When outside of the United States, IMG offers their International Provider Access search tool to make it easier for you to find providers in the area that you are located. You can find providers in your area through our online provider search tool.
If you are unsure of where to seek treatment, please feel free to contact us and we’d be happy to help you locate the correct doctor to visit.
How are claims paid?
Claims will be paid depending on where you are located and where you seek treatment:
- In-network while inside the USA
- When you visit a provider that is part of the plan network your insurance bill is typically paid directly, so you would just need to pay your deductible at the time of treatment. To confirm direct billing, it is important to check with the provider before you seek treatment.
- Out-of-network while inside the USA
- Generally, when you visit a provider that is outside the network, you will need to pay for all services up front and then submit a claim form, along with any bills and receipts from your visit, for reimbursement.
- Outside the USA
- When visiting a provider around the world, please pay for the services up front and then submit a claim form for reimbursement.
If you're hospitalized for an emergency or planned hospitalization, you'll need to call the 24-hour emergency assistance number located on the back of your insurance ID card, and they'll assist you further with settling the hospital bills.
No matter where you seek treatment, you'll want to complete a claim and/or accident form within 180 days of the illness/accident and email it to CustomerCare@imglobal.com. If you were required to pay anything out of pocket at the time of treatment, make sure to send your itemized receipts and any bills so that your claim is processed as quickly as possible. You can access the claim and accident form and submit your claims through your MyIMG account. Tip: Please ask for all your medical documents at the time of treatment, including your medical records, in case they are requested at a later date.Patriot Travel | Premiums
Patriot America Plus Rates
The Patriot America Plus plan is available for those needing coverage in the US, and allows you to choose your coverage and deductible.
Price indicated is the rate per day.
| Age | $50,000$50k | $100,000$100k | $500,000$500k | $1,000,000$1M |
|---|---|---|---|---|
| 0–17 | $1.35 / day | $1.73 / day | $2.42 / day | $2.69 / day |
| 18–29 | $1.35 / day | $1.73 / day | $2.46 / day | $2.69 / day |
| 30–39 | $1.85 / day | $2.54 / day | $3.23 / day | $3.42 / day |
| 40–49 | $2.49 / day | $3.12 / day | $4.24 / day | $4.58 / day |
| 50–59 | $4.03 / day | $5.07 / day | $7.20 / day | $7.57 / day |
| 60–64 | $4.68 / day | $6.14 / day | $9.11 / day | $9.52 / day |
| 65–69 | $5.37 / day | $6.88 / day | N/A | N/A |
| 70–79 | $8.00 / day | N/A | N/A | N/A |
| 80+* | $21.21 / day | N/A | N/A | N/A |
| * $10,000 Maximum Limit | ||||
Patriot America Platinum Rates
The Patriot America Platinum plan is available for those needing coverage in the US, and allows you to choose your coverage and deductible.
Price indicated is the rate per day.
| Age | $2,000,000$2M | $5,000,000$5M | $8,000,000$8M |
|---|---|---|---|
| 0–17 | $3.21 / day | $4.06 / day | $5.53 / day |
| 18–29 | $3.22 / day | $4.07 / day | $5.63 / day |
| 30–39 | $4.26 / day | $5.89 / day | $7.33 / day |
| 40–49 | $5.56 / day | $7.04 / day | $9.35 / day |
| 50–59 | $8.99 / day | $11.49 / day | $16.00 / day |
| 60–64 | $10.65 / day | $13.86 / day | $20.18 / day |
| 65–69 | $11.89 / day | N/A | N/A |
| 70–79* | $17.59 / day | N/A | N/A |
| 80+** | $46.26 / day | N/A | N/A |
| *$100,000 limit **$20,000 limit | |||
Patriot International Lite Rates
The Patriot International Lite plan is available for those needing coverage outside the US, and allows you to choose your coverage and deductible.
Price indicated is the rate per day.
| Age | $50,000$50k | $100,000$100k | $500,000$500k | $1,000,000$1M |
|---|---|---|---|---|
| 0–17 | $0.86 / day | $1.05 / day | $1.23 / day | $1.34 / day |
| 18–29 | $0.90 / day | $1.10 / day | $1.28 / day | $1.42 / day |
| 30–39 | $1.06 / day | $1.28 / day | $1.62 / day | $1.69 / day |
| 40–49 | $1.79 / day | $2.09 / day | $2.38 / day | $2.40 / day |
| 50–59 | $3.02 / day | $3.48 / day | $3.68 / day | $3.75 / day |
| 60–64 | $3.79 / day | $4.14 / day | $4.47 / day | $4.52 / day |
| 65–69 | $4.45 / day | $4.83 / day | N/A | N/A |
| 70–79 | $6.64 / day | N/A | N/A | N/A |
| 80+* | $11.76 / day | N/A | N/A | N/A |
| * $10,000 Maximum Limit | ||||
Patriot International Platinum Rates
The Patriot International Platinum plan is available for those needing coverage outside the US, and allows you to choose your coverage and deductible.
Price indicated is the rate per day.
| Age | $2,000,000$2M | $5,000,000$5M | $8,000,000$8M |
|---|---|---|---|
| 0–17 | $1.52 / day | $1.91 / day | $2.19 / day |
| 18–29 | $1.60 / day | $2.00 / day | $2.29 / day |
| 30–39 | $1.88 / day | $2.33 / day | $2.89 / day |
| 40–49 | $3.13 / day | $3.79 / day | $4.25 / day |
| 50–59 | $5.30 / day | $6.27 / day | $6.53 / day |
| 60–64 | $6.64 / day | $7.44 / day | $7.92 / day |
| 65–69 | $7.79 / day | N/A | N/A |
| 70–79* | $11.61 / day | N/A | N/A |
| 80+** | $20.59 / day | N/A | N/A |
| *$100,000 limit **$20,000 limit | |||
Optional Plan Riders
Available to add additional coverage to your plan.
-
Adventure Sports Rider:
- 20% increase in base premium
Global Medical | Benefits
Bronze
- Lifetime Maximum Limit $1 million per individual
- Deductible Per Period of Coverage $250 to $10,000
- Provider Network UnitedHealthcare Network
- Treatment outside the U.S. 50% of deductible waived, up to a maximum of $2,500. No coinsurance
- Treatment inside the U.S. Using Medical Concierge 50% of deductible waived, up to a maximum of $2,500. No coinsurance
- Treatment inside the U.S. PPO Network Subject to deductible No coinsurance
- Treatment inside the U.S. Non-PPO Network Subject to deductible — Plan pays 80% of the next $5,000 of eligible expenses, then 100% to the overall maximum per period of coverage.
-
Coinsurance
International — 100%
U.S. In-Network — 100%
U.S. Out of Network — 80% up to $5,000 then 100% -
Outpatient
$300 maximum per visit — lab tests; $250 maximum per visit – diagnostic X-rays
$500 maximum limit — specialists/ physician charges (pre-inpatient / post-inpatient)
Subject to deductible and coinsurance - Teleconsultation N/A
- Mental/Nervous N/A
- Hospital Emergency Room Injury Subject to deductible and coinsurance
- Hospital Emergency Room Illness Subject to deductible and coinsurance. Covered only if admitted as inpatient.
- Hospitalization / Room & Board Subject to deductible and coinsurance for average semi-private room rate.
- Intensive Care Unit Subject to deductible and coinsurance
- CAT Scans, MRI, Echocardiography, Endoscopy, Gastroscopy, Cystoscopy Subject to deductible and coinsurance. $600 maximum limit per examination
- Surgery Subject to deductible and coinsurance.
- Assistant Surgeon 20% of primary surgeon’s charge
- Chemotherapy or Radiation Therapy Subject to deductible and coinsurance.
- Ancillary Services Covered under Hospitalization room & board/professional fees
- Maternity Delivery, preventative care, newborn care & congenital disorders, Family Matters Maternity Program No Coverage
- Podiatry Care NA
-
Physical Therapy
Available for 90 days following inpatient treatment or outpatient surgery
Maximum limit per visit: $40
Maximum visits: 10 - Transplants $250,000 lifetime max.
- Prescription Drugs, Dressing, and Durable Medical Equipment Subject to deductible and coinsurance. Available for 90 days following related inpatient treatment or outpatient surgery. $600 maximum limit per event (includes dressing and durable medical equipment)
- Expatriate Prescription Services Program N/A
-
Orphan or Biologic Drugs
Available when all conditions are met:
- Approved in writing by company
- Medically necessary
- Not experimental or investigational
Max limit applies towards lifetime max.Inpatient Treatment maximum limit: $250,000.
Outpatient Surgery: up to the maximum limit.
Subject to deductible and coinsurance.
Does not apply to maximum limit per event - Healthy Travel Preventative Coverage $250 lifetime maximum. Not subject to deductible or coinsurance. Applies to vaccinations and preventative prescription drugs administered by a physician within 30 days prior to the Insured person's initial effective date and before departing to any destination.
- Vision Optional Rider
- Emergency Local Ambulance (Injury or illness resulting in hospitalization) $1,500 maximum limit per event Not subject to deductible or coinsurance
- Emergency Evacuation $50,000 maximum per period of coverage. Not subject to deductible or coinsurance
-
Emergency Reunion
Lifetime Maximum: $10,000
Maximum days: 15
Meal Maximum Limit per day: $25 Not subject to deductible or coinsurance - Interfacility Ambulance Transfer (Transfer from one licensed health care facility to another licensed health care facility- Applies only in the U.S.) $1,500 maximum limit per event. Not subject to deductible or coinsurance
- Political Evacuation and Repatriation N/A
- Remote Transportation N/A
-
Return of Mortal Remains
Maximum Limit: $25,000
Local Burial / Cremation Maximum Limit: $5,000 Not subject to deductible or coinsurance - Complementary Medicine N/A
- Dental Treatment No Coverage
- Traumatic Dental Injury No Coverage
- Non-Emergency Dental Optional Rider
-
Hospital Indemnity
(Outside the U.S. only)
Private Hospital: $400 maximum limit per overnight and $4,000 maximum limit per period of coverage.
Public Hospital: $500 maximum limit per overnight and $5,000 maximum limit per period of coverage.
Not subject to deductible or coinsurance - Supplemental Accident N/A
- Adult Preventative Care (Age 19 or older) N/A
- Child Preventative Care (Through age 18) N/A
- Pre-Existing Conditions
- Known Disclosed Conditions No Coverage
- Non-disclosed Conditions No Coverage
- Unknown Conditions After 24 months of continuous coverage No Coverage
- Lifeworks Consultation N/A
- Optional Coverage
-
Individual Term Life Insurance
(Amounts shown are the Principal Sums per unit)
Age 31 days – 18 years: $5,000
Age 19–29 years: $75,000
Age 30–39 years: $50,000
Age 40–44 years: $35,000
Age 45–49 years: $25,000
Age 50–54 years: $20,000
Age 55–59 years: $15,000
Age 60–64 years: $10,000
Age 65–69 years: $7,500 -
Accidental Death & Dismemberment (AD&D)
Included with Individual Term Life Insurance
Accidental Loss of Life: Principal Sum*
Accidental Total Loss of 2 body parts**: Principal Sum*
Accidental Total Loss of 1 body part**: 50% of Principal Sum* (Benefit based on age at time of death** ”body part” means hand, foot, or eye) - Terrorism (Platinum plan option) $50,000 lifetime maximum for Eligible Medical Expenses arising out of injury or illness incurred by the Insured as a result of or in connection with an act of terrorism (Refer to rider for more details)
-
Sports
(Gold and Platinum plan options)
(Refer to rider for a comprehensive list of sports excluded)
$10,000 lifetime maximum for amateur athletics
Adventure Sports:- Through age 49 years: $50,000 lifetime maximum
- Age 50 years – age 59 years: $30,000 lifetime maximum
- Age 60 years – age 64 years: $15,000 lifetime maximum
-
Dental Rider
$750 per period of coverage
$50 deductible (max. 2 per family)
Routine services: 90% (deductible is waived)
Minor restorative: 70%
Major restorative: 50%
6-month waiting period -
Vision Rider
Exams: up to $100 per 24 months
Materials: up to $150 per 24 months - Remote Mental Health Service N/A
- Bereavement Counseling N/A
- Universal Rx Drug Card N/A
- The Family Matters Program N/A
Silver
- Lifetime Maximum Limit $5 million per individual
- Deductible Per Period of Coverage $250 to $10,000
- Provider Network UnitedHealthcare Network
- Treatment outside the U.S. 50% of deductible waived, up to a maximum of $2,500. No coinsurance
- Treatment inside the U.S. Using Medical Concierge 50% of deductible waived, up to a maximum of $2,500. No coinsurance
- Treatment inside the U.S. PPO Network Subject to deductible No coinsurance
- Treatment inside the U.S. Non-PPO Network Subject to deductible — Plan pays 80% of the next $5,000 of eligible expenses, then 100% to the overall maximum per period of coverage.
-
Coinsurance
International — 100%
U.S. In-Network — 100%
U.S. Out of Network — 80% up to $5,000 then 100% -
Outpatient
$300 maximum per visit — lab tests; $250 maximum per visit — diagnostic X-rays
25 combined maximum visits
$70 per visit/examination — specialists/physician charges
$50 per visit/examination — chiropractor charges (medical order or treatment plan required)
$500 per consultation — surgery intervention consultation charges
Subject to deductible and coinsurance - Teleconsultation N/A
- Mental/Nervous Subject to deductible and coinsurance. Outpatient after 12 months of continuous coverage
- Hospital Emergency Room Injury Subject to deductible and coinsurance
- Hospital Emergency Room Illness Subject to deductible and coinsurance. Additional $250 deductible if not admitted as an inpatient.
- Hospitalization / Room & Board Subject to deductible and coinsurance for average semi-private room rate. All subject to $600 per day; 240 day maximum
- Intensive Care Unit Subject to deductible and coinsurance. $1,500 limit per day — 180 days of coverage per event
- CAT Scans, MRI, Echocardiography, Endoscopy, Gastroscopy, Cystoscopy Subject to deductible and coinsurance. $600 maximum limit per examination
- Surgery Subject to deductible and coinsurance.
- Assistant Surgeon 20% of primary surgeon’s charge
- Chemotherapy or Radiation Therapy Subject to deductible and coinsurance.
- Ancillary Services $400 per day
- Maternity Delivery, preventative care, newborn care & congenital disorders, Family Matters Maternity Program No Coverage
- Podiatry Care NA
-
Physical Therapy
Maximum limit per visit: $40
Maximum visits per day: 1
Maximum visits: 30 - Transplants $250,000 lifetime max.
-
Prescription Drugs, Dressing, and Durable Medical Equipment
Subject to deductible and coinsurance.
90 day supply per prescription following related covered event.
U.S Retail Pharmacy out-of-network: 80%
International Retail Pharmacy: 100% -
Expatriate Prescription Services Program
Copay per 30-day supply: $20 for generic/$40 for non-preferred brand name. Must enroll via provider website: www.expatps.com
Dispensing maximum: 180 days -
Orphan or Biologic Drugs
Available when all conditions are met:
- Approved in writing by company
- Medically necessary
- Not experimental or investigational
Max limit applies towards lifetime max.Outpatient and Emergency Department Treatment maximum limit: $250,000.
Subject to deductible and coinsurance. - Healthy Travel Preventative Coverage $250 lifetime maximum. Not subject to deductible or coinsurance. Applies to vaccinations and preventative prescription drugs administered by a physician within 30 days prior to the Insured person's initial effective date and before departing to any destination.
- Vision Optional Rider
- Emergency Local Ambulance (Injury or illness resulting in hospitalization) $1,500 maximum limit per event Not subject to deductible or coinsurance
- Emergency Evacuation $50,000 maximum per period of coverage. Not subject to deductible or coinsurance
- Emergency Reunion No Coverage
- Interfacility Ambulance Transfer (Transfer from one licensed health care facility to another licensed health care facility- Applies only in the U.S.) $1,500 maximum limit per event. Not subject to deductible or coinsurance
- Political Evacuation and Repatriation N/A
- Remote Transportation N/A
-
Return of Mortal Remains
Maximum Limit: $25,000
Local Burial / Cremation Maximum Limit: $5,000 Not subject to deductible or coinsurance - Complementary Medicine N/A
- Dental Treatment No Coverage
- Traumatic Dental Injury No Coverage
- Non-Emergency Dental Optional Rider
-
Hospital Indemnity
(Outside the U.S. only)
Private Hospital: $400 maximum limit per overnight and $4,000 maximum limit per period of coverage.
Public Hospital: $500 maximum limit per overnight and $5,000 maximum limit per period of coverage.
Not subject to deductible or coinsurance - Supplemental Accident N/A
- Adult Preventative Care (Age 19 or older) N/A
- Child Preventative Care (Through age 18) $70 maximum per visit, 3 visit limit per period of coverage. Not subject to deductible or coinsurance
- Pre-Existing Conditions
- Known Disclosed Conditions Covered the same as any conditions unless excluded by rider
- Non-disclosed Conditions No Coverage
-
Unknown Conditions
After 24 months of continuous coverage
Period of coverage: $5,000
Lifetime Maximum: $50,000 - Lifeworks Consultation N/A
- Optional Coverage
-
Individual Term Life Insurance
(Amounts shown are the Principal Sums per unit)
Age 31 days – 18 years: $5,000
Age 19–29 years: $75,000
Age 30–39 years: $50,000
Age 40–44 years: $35,000
Age 45–49 years: $25,000
Age 50–54 years: $20,000
Age 55–59 years: $15,000
Age 60–64 years: $10,000
Age 65–69 years: $7,500 -
Accidental Death & Dismemberment (AD&D)
Included with Individual Term Life Insurance
Accidental Loss of Life: Principal Sum*
Accidental Total Loss of 2 body parts**: Principal Sum*
Accidental Total Loss of 1 body part**: 50% of Principal Sum* (Benefit based on age at time of death** ”body part” means hand, foot, or eye) - Terrorism (Platinum plan option) $50,000 lifetime maximum for Eligible Medical Expenses arising out of injury or illness incurred by the Insured as a result of or in connection with an act of terrorism (Refer to rider for more details)
-
Sports
(Gold and Platinum plan options)
(Refer to rider for a comprehensive list of sports excluded)
$10,000 lifetime maximum for amateur athletics
Adventure Sports:- Through age 49 years: $50,000 lifetime maximum
- Age 50 years – age 59 years: $30,000 lifetime maximum
- Age 60 years – age 64 years: $15,000 lifetime maximum
-
Dental Rider
$750 per period of coverage
$50 deductible (max. 2 per family)
Routine services: 90% (deductible is waived)
Minor restorative: 70%
Major restorative: 50%
6-month waiting period -
Vision Rider
Exams: up to $100 per 24 months
Materials: up to $150 per 24 months - Remote Mental Health Service N/A
- Bereavement Counseling Lifetime Max: $300
- Universal Rx Drug Card N/A
- The Family Matters Program N/A
Gold
- Lifetime Maximum Limit $5 million per individual
- Deductible Per Period of Coverage $250 to $25,000
- Provider Network UnitedHealthcare Network
- Treatment outside the U.S. 50% of deductible waived, up to a maximum of $2,500. No coinsurance
- Treatment inside the U.S. Using Medical Concierge 50% of deductible waived, up to a maximum of $2,500. No coinsurance
- Treatment inside the U.S. PPO Network Subject to deductible No coinsurance
- Treatment inside the U.S. Non-PPO Network Subject to deductible — Plan pays 80% of the next $5,000 of eligible expenses, then 100% to the overall maximum per period of coverage.
-
Coinsurance
International — 100%
U.S. In-Network — 100%
U.S. Out of Network — 80% up to $5,000 then 100% - Outpatient Subject to deductible and coinsurance
- Teleconsultation Covered
- Mental/Nervous Subject to deductible and coinsurance. $10,000 maximum. Available after 12 months of continuous coverage
- Hospital Emergency Room Injury Subject to deductible and coinsurance
- Hospital Emergency Room Illness Subject to deductible and coinsurance. Additional $250 deductible if not admitted as an inpatient.
- Hospitalization / Room & Board Subject to deductible and coinsurance for average semi-private room rate.
- Intensive Care Unit Subject to deductible and coinsurance
- CAT Scans, MRI, Echocardiography, Endoscopy, Gastroscopy, Cystoscopy Subject to deductible and coinsurance
- Surgery Subject to deductible and coinsurance.
- Assistant Surgeon 20% of primary surgeon’s charge
- Chemotherapy or Radiation Therapy Subject to deductible and coinsurance.
- Ancillary Services Covered under Hospitalization room & board/professional fees
- Maternity Delivery, preventative care, newborn care & congenital disorders, Family Matters Maternity Program No Coverage
- Podiatry Care $750 max limit
-
Physical Therapy
Maximum limit per visit: $50
Maximum visits per day: 1
Medical order required - Transplants $1 million lifetime max.
-
Prescription Drugs, Dressing, and Durable Medical Equipment
Subject to deductible and coinsurance.
90 day supply per prescription following related covered event.
U.S Retail Pharmacy out-of-network: 80%
International Retail Pharmacy: 100% -
Expatriate Prescription Services Program
Copay per 30-day supply: $20 for generic/$40 for non-preferred brand name. Must enroll via provider website: www.expatps.com
Dispensing maximum: 180 days -
Orphan or Biologic Drugs
Available when all conditions are met:
- Approved in writing by company
- Medically necessary
- Not experimental or investigational
Max limit applies towards lifetime max.Inpatient & Outpatient Treatment maximum limit: $250,000.
Subject to deductible and coinsurance. - Healthy Travel Preventative Coverage $250 lifetime maximum. Not subject to deductible or coinsurance. Applies to vaccinations and preventative prescription drugs administered by a physician within 30 days prior to the Insured person's initial effective date and before departing to any destination.
- Vision Optional Rider
- Emergency Local Ambulance (Injury or illness resulting in hospitalization) Subject to deductible or coinsurance
- Emergency Evacuation Up to lifetime maximum limit. Not subject to deductible or coinsurance
-
Emergency Reunion
Lifetime Maximum: $10,000
Maximum days: 15
Meal Maximum Limit per day: $25 Not subject to deductible or coinsurance - Interfacility Ambulance Transfer (Transfer from one licensed health care facility to another licensed health care facility- Applies only in the U.S.) Subject to deductible and coinsurance
- Political Evacuation and Repatriation N/A
- Remote Transportation N/A
-
Return of Mortal Remains
Maximum Limit: $25,000
Local Burial / Cremation Maximum Limit: $5,000 Not subject to deductible or coinsurance - Complementary Medicine $500 maximum limit per period of coverage
- Dental Treatment Max. Limit: $100 (treatment due to unexpected pain to sound natural teeth) Max. Limit: $500 (non-emergency treatment at a dental provider’s office due to an accident)
- Traumatic Dental Injury Covered
- Non-Emergency Dental Optional Rider
-
Hospital Indemnity
(Outside the U.S. only)
Private Hospital: $400 maximum limit per overnight and $4,000 maximum limit per period of coverage.
Public Hospital: $500 maximum limit per overnight and $5,000 maximum limit per period of coverage.
Not subject to deductible or coinsurance - Supplemental Accident $300 of eligible medical expenses following an accident. Not subject to deductible or coinsurance
- Adult Preventative Care (Age 19 or older) $250 per period of coverage. Not subject to deductible or coinsurance
- Child Preventative Care (Through age 18) $200 per period of coverage. Not subject to deductible or coinsurance
- Pre-Existing Conditions
- Known Disclosed Conditions Covered the same as any conditions unless excluded by rider
- Non-disclosed Conditions No Coverage
-
Unknown Conditions
After 24 months of continuous coverage
Period of coverage: $5,000
Lifetime Maximum: $50,000 - Lifeworks Consultation N/A
- Optional Coverage
-
Individual Term Life Insurance
(Amounts shown are the Principal Sums per unit)
Age 31 days – 18 years: $5,000
Age 19–29 years: $75,000
Age 30–39 years: $50,000
Age 40–44 years: $35,000
Age 45–49 years: $25,000
Age 50–54 years: $20,000
Age 55–59 years: $15,000
Age 60–64 years: $10,000
Age 65–69 years: $7,500 -
Accidental Death & Dismemberment (AD&D)
Included with Individual Term Life Insurance
Accidental Loss of Life: Principal Sum*
Accidental Total Loss of 2 body parts**: Principal Sum*
Accidental Total Loss of 1 body part**: 50% of Principal Sum* (Benefit based on age at time of death** ”body part” means hand, foot, or eye) - Terrorism (Platinum plan option) $50,000 lifetime maximum for Eligible Medical Expenses arising out of injury or illness incurred by the Insured as a result of or in connection with an act of terrorism (Refer to rider for more details)
-
Sports
(Gold and Platinum plan options)
(Refer to rider for a comprehensive list of sports excluded)
$10,000 lifetime maximum for amateur athletics
Adventure Sports:- Through age 49 years: $50,000 lifetime maximum
- Age 50 years – age 59 years: $30,000 lifetime maximum
- Age 60 years – age 64 years: $15,000 lifetime maximum
-
Dental Rider
$750 per period of coverage
$50 deductible (max. 2 per family)
Routine services: 90% (deductible is waived)
Minor restorative: 70%
Major restorative: 50%
6-month waiting period -
Vision Rider
Exams: up to $100 per 24 months
Materials: up to $150 per 24 months - Remote Mental Health Service N/A
- Bereavement Counseling Lifetime Max: $300
- Universal Rx Drug Card N/A
- The Family Matters Program N/A
Platinum
- Lifetime Maximum Limit $8 million per individual
- Deductible Per Period of Coverage $100 to $25,000
- Provider Network UnitedHealthcare Network
- Treatment outside the U.S. 50% of deductible waived, up to a maximum of $2,500. No coinsurance
- Treatment inside the U.S. Using Medical Concierge 50% of deductible waived, up to a maximum of $2,500. No coinsurance
- Treatment inside the U.S. PPO Network Subject to deductible No coinsurance
- Treatment inside the U.S. Non-PPO Network Subject to deductible — Plan pays 80% of the next $5,000 of eligible expenses, then 100% to the overall maximum per period of coverage.
-
Coinsurance
International — 100%
U.S. In-Network — 100%
U.S. Out of Network — 80% up to $5,000 then 100% - Outpatient Subject to deductible and coinsurance
- Teleconsultation Covered
- Mental/Nervous Subject to deductible and coinsurance. $50,000 lifetime maximum. Available after 12 months of continuous coverage.
- Hospital Emergency Room Injury Subject to deductible and coinsurance
- Hospital Emergency Room Illness Subject to deductible and coinsurance. Additional $250 deductible if not admitted as an inpatient.
- Hospitalization / Room & Board Subject to deductible and coinsurance for average semi-private room rate.
- Intensive Care Unit Subject to deductible and coinsurance
- CAT Scans, MRI, Echocardiography, Endoscopy, Gastroscopy, Cystoscopy Subject to deductible and coinsurance
- Surgery Subject to deductible and coinsurance.
- Assistant Surgeon 20% of primary surgeon’s charge
- Chemotherapy or Radiation Therapy Subject to deductible and coinsurance.
- Ancillary Services Covered under Hospitalization room & board/professional fees
-
Maternity
Delivery, preventative care, newborn care & congenital disorders, Family Matters Maternity Program
Available after 10 months of continuous coverage.
Maternity deductible: $2,000 (in addition to plan deductible)
Lifetime Maximum: $50,000 - Podiatry Care $750 max limit
-
Physical Therapy
Maximum limit per visit: $50
Maximum visits per day: 1
Medical order required - Transplants $2 million lifetime max.
-
Prescription Drugs, Dressing, and Durable Medical Equipment
U.S Retail Pharmacy: prescription drug card required.
Copay per 30-day supply: $20 for generic/ $40 for brand name where generic is not available.
International Retail Pharmacy (subject to deductible): $100% -
Expatriate Prescription Services Program
Copay per 30-day supply: $20 for generic/$40 for non-preferred brand name. Must enroll via provider website: www.expatps.com
Dispensing maximum: 180 days -
Orphan or Biologic Drugs
Available when all conditions are met:
- Approved in writing by company
- Medically necessary
- Not experimental or investigational
Max limit applies towards lifetime max.Maximum limit: $250,000.
U.S. Retail Pharmacy & expatriate prescription services program: Subject to copayments.
International retail pharmacy: Subject to deductible and coinsurance.
Inpatient & Outpatient medical Treatment: Subject to deductible and coinsurance. - Healthy Travel Preventative Coverage $250 lifetime maximum. Not subject to deductible or coinsurance. Applies to vaccinations and preventative prescription drugs administered by a physician within 30 days prior to the Insured person's initial effective date and before departing to any destination.
-
Vision
Exams: up to $100 per 24 months
Materials: up to $150 per 24 months - Emergency Local Ambulance (Injury or illness resulting in hospitalization) Not subject to deductible or coinsurance
- Emergency Evacuation Up to lifetime maximum limit. Not subject to deductible or coinsurance
-
Emergency Reunion
Lifetime Maximum: $10,000
Maximum days: 15
Meal Maximum Limit per day: $25 Not subject to deductible or coinsurance - Interfacility Ambulance Transfer (Transfer from one licensed health care facility to another licensed health care facility- Applies only in the U.S.) Not subject to deductible and coinsurance
- Political Evacuation and Repatriation $10,000 lifetime maximum
- Remote Transportation $5,000 per period of coverage up to $20,000 lifetime maximum. Not subject to deductible or coinsurance
- Return of Mortal Remains $50,000 lifetime maximum. Not subject to deductible or coinsurance
- Complementary Medicine $500 maximum limit per period of coverage
-
Dental Treatment
$750 per period of coverage; $50 deductible (max. 2 per family)
Routine services: 90% (deductible waived)
Minor restorative: 70%
Major restorative: $50%
6 month waiting period - Traumatic Dental Injury Covered
- Non-Emergency Dental $750 maximum per period of coverage; $50 individual deductible, applies to minor restorative and major restorative services.
-
Hospital Indemnity
(Outside the U.S. only)
Private Hospital: $400 maximum limit per overnight and $4,000 maximum limit per period of coverage.
Public Hospital: $500 maximum limit per overnight and $5,000 maximum limit per period of coverage.
Not subject to deductible or coinsurance - Supplemental Accident $500 maximum limit per accident. Not subject to deductible or coinsurance
- Adult Preventative Care (Age 19 or older) $500 per period of coverage. Not subject to deductible or coinsurance
- Child Preventative Care (Through age 18) $400 per period of coverage. Not subject to deductible or coinsurance
- Pre-Existing Conditions
- Known Disclosed Conditions Covered if disclosed and not excluded by rider
- Non-disclosed Conditions Covered if disclosed and not excluded by rider
- Unknown Conditions After 24 months of continuous coverage Covered if disclosed and not excluded by rider
- Lifeworks Consultation LifeWorks will provide 24/7 counseling services through a master’s level counselor. Through virtual counseling services, individuals are able to get immediate counseling in crisis situations. Additional services available through the EAP program include an in-person counseling option while within the United States, LifeWorks services, legal and financial advice, management consultations, and access to many other support resources.
- Optional Coverage
-
Individual Term Life Insurance
(Amounts shown are the Principal Sums per unit)
Age 31 days – 18 years: $5,000
Age 19–29 years: $75,000
Age 30–39 years: $50,000
Age 40–44 years: $35,000
Age 45–49 years: $25,000
Age 50–54 years: $20,000
Age 55–59 years: $15,000
Age 60–64 years: $10,000
Age 65–69 years: $7,500 -
Accidental Death & Dismemberment (AD&D)
Included with Individual Term Life Insurance
Accidental Loss of Life: Principal Sum*
Accidental Total Loss of 2 body parts**: Principal Sum*
Accidental Total Loss of 1 body part**: 50% of Principal Sum* (Benefit based on age at time of death** ”body part” means hand, foot, or eye) - Terrorism (Platinum plan option) $50,000 lifetime maximum for Eligible Medical Expenses arising out of injury or illness incurred by the Insured as a result of or in connection with an act of terrorism (Refer to rider for more details)
-
Sports
(Gold and Platinum plan options)
(Refer to rider for a comprehensive list of sports excluded)
$10,000 lifetime maximum for amateur athletics
Adventure Sports:- Through age 49 years: $50,000 lifetime maximum
- Age 50 years – age 59 years: $30,000 lifetime maximum
- Age 60 years – age 64 years: $15,000 lifetime maximum
- Dental Rider Dental treatment benefit already included; no rider required
- Vision Rider Vision Care benefit already included; no rider required
- Remote Mental Health Service Covered
- Bereavement Counseling Lifetime Max: $300
-
Universal Rx Drug Card
Generic: $20
Brand: (when generic is unavailable): $40
Copayments are per 30-day supply
Dispensing maximum per prescription: 90 days - The Family Matters Program Provides educational information on pregnancy and provides suggestions for a healthy lifestyle
Pre-existing Conditions
Pre-existing conditions coverage is excluded from the Bronze level of the plan. On the Silver, Gold, and Platinum plan options, conditions that are fully disclosed on the application and have not been excluded or restricted by a rider will be covered the same as any illness. Conditions, including any complications therefrom, that are known and not fully disclosed on the application will not be covered.
On the Silver, Gold, and Platinum plan options, unknown pre-existing conditions that existed at or prior to the effective date can be covered after 24 months of continuous coverage. These levels will provide a $50,000 lifetime benefit for eligible pre-existing conditions, subject to a maximum of $5,000 per period of coverage.
On the Silver and Gold levels, if applicants can verify their prior comprehensive health insurance, with no significant break in coverage (63 days), IMG may accept this as Creditable Coverage and provide a pre-existing conditions waiver (final decision is subject to Underwriter approval). Creditable Coverage is defined as a group health plan provided by a U.S. employer or Health Insurance Issuer, individual major medical health insurance provided by a Health Insurance Issuer, or other Public Health Plan. (any comprehensive health plan established or maintained by a State or the U.S. government).
The following illnesses which existed, manifest themselves, or are treated, or have treatment recommended prior to or during the first 180 days of coverage from the initial effective date are considered pre-existing conditions and are subject to the waiting period and other limitation of coverage described above: acne, asthma, allergies, tonsillectomy, back conditions, adenoidectomy, hemorrhoids or hemorrhoidectomy, disorders or the reproductive system, hysterectomy, hernia, gall bladder or gall stones and kidney stones, any condition of the breast, and any condition of the prostate.
The above is a summary schedule of benefits. Benefits are subject to the deductible and coinsurance unless otherwise noted. NA (Not Applicable); URC (Usual, Reasonable and Customary); SAAI (Same As Any Illness). For a further description of benefits, please refer to the Master Certificates of the plan.
Global Medical | Exclusions
For a full list of exclusions, please refer to the certificates of the plan below.
- Economic Sanctions
- War; Military Action
- Terrorism
-
Pre-existing conditions: Under Bronze level, charges relating directly or indirectly to medical conditions existing at the time of Application, whether known or unknown at the time of Application and whether or not disclosed on the Application, are excluded from coverage under this insurance. Under Silver and Gold level, the Company will not pay for Treatment for a Pre-existing Condition:
- that is not disclosed on the Insured Person’s Application
- that is the subject of a special exclusion provided in a Rider to the Certificate of Insurance
- Illness or Surgery within 180 days: Charges for Treatment of the following Illnesses or Surgeries which manifest themselves and/or involve procedures which take place and/or are recommended during the first one-hundred eighty (180) days of coverage under this insurance plan, beginning on the Initial Effective Date: acne, asthma, allergies, any condition of the breast, any condition of the prostate, tonsillectomy, adenoidectomy, hemorrhoids or hemorrhoidectomy, disorders of the reproductive system, diverticulitis, hysterectomy, hernia, intervertebral disc disease, gall bladder disease or gall stones and kidney stones. Note: Coverage and/or benefits for these Illnesses or Surgeries (or for similar or different Illnesses or Surgeries) may be separately or further limited
- Maternity and Newborn care unless included in the plan
- Mental or nervous disorders unless included in the plan
- Preventative care in the Bronze level
-
Charges for any Treatment or supplies that are:
- not incurred, obtained or received by an Insured Person during the Period of Coverage
- not presented to the Company for payment by way of a completed Proof of Claim within one hundred eighty (180) days from the date such Charges are incurred
- not administered or ordered by a Physician
- not Medically Necessary for the diagnosis, care or Treatment of the physical condition involved. This also applies when and if they are prescribed, recommended or approved by the attending Physician
- provided at no cost to the Insured Person or for which the Insured Person is not otherwise liable
- in excess of Usual, Reasonable, and Customary
- related to Hospice Care (only applies to the Bronze level)
- incurred by an Insured Person who was HIV + on or before the Initial Effective Date of this insurance, whether or not the Insured Person had knowledge of their HIV status prior to the Effective Date, and whether or not the Charges are incurred in relation to or as a result of said status. This exclusion includes Charges for any Treatment or supplies relating to or arising or resulting directly or indirectly from HIV, AIDS virus, AIDS related Illness, ARC Syndrome, AIDS and/or any other Illness arising or resulting from any complications or consequences of any of the foregoing conditions
- provided by or at the direction or recommendation of a chiropractor, unless ordered in advance by a Physician
- performed or provided by a Relative of the Insured Person
- not expressly included in the ELIGIBLE MEDICAL EXPENSES provision
- provided by a person who resides or has resided with the Insured Person or in the Insured Person's home
- required or recommended as a result of complications or consequences arising from or related to any Treatment, Illness, Injury, or supply received prior to coverage under this insurance or that is excluded from coverage or which is otherwise not covered under this insurance
- for Congenital Disorders and conditions arising out of or resulting therefrom
- incurred, obtained or received by an Insured Person for a Non-disclosed Condition (only applies to the Platinum level)
Please note: The exclusions listed above are a consolidated version of the plan exclusions. Please view the plan certificate for the full list and limitations of the plan.
Global Medical | FAQ
Who is the insurer?
The Global Medical plan is insured by Sirius International Insurance Corporation. Sirius offers financial security and a worldwide reputation, This well-established insurance company is rated 'A' (Excellent) by A.M. Best Company and 'A-' by Standard & Poor's.
What's the difference between the Bronze, Silver, Gold, and Platinum level of the Global Medical?
The Global Medical plan is available in four levels so that you can choose the coverage level that’s right for you.
- Platinum — The Platinum level is the most comprehensive offering medical coverage, dental, vision, wellness, political evacuation, remote transportation, and maternity coverage. The Platinum provides $8 million lifetime coverage per insured and is considered to be the “Cadillac” insurance plan due to its comprehensive benefit structure.
- Gold — The Gold level is the second most comprehensive health insurance plan, offering $5 million lifetime coverage per insured person. The plan covers doctor visits, hospitalization, prescription medication, medical evacuation, repatriation, mental health, wellness, and more.
- Silver — The Silver level is a capped benefit plan offering an affordable option for those concerned about their budget, but also wanting international coverage. This plan is well designed for those individuals traveling to countries with affordable health treatment.
- Bronze — The Bronze level is also a capped benefit plan offering the most economical pricing of the four plan levels. This plan also provides worldwide coverage to meet the tightest budgets and is designed to cover accidents and illnesses that happen on your plan.
Which coverage is right for me?
The Global Medical Plan is available in four different levels — Bronze, Silver, Gold, and Platinum — all of which offers two areas of coverage: including or excluding the US, Canada, China, Hong Kong, Japan, Macau, Singapore and Taiwan. If you do not need coverage in these countries, you may obtain lower premiums by selecting the "Worldwide Excluding" option.
Am I eligible for the Global Medical insurance plan?
The Global Medical plan is available to individuals and families from around the world who are at least age 14 days and not over age 74 and meet the following requirements:
- US citizens: Must be residing outside of the United States as of the Effective Date (or renewal date) and plan to reside outside of the United States for at least six (6) of the next twelve (12) months thereafter
- Non-US citizens: Eligible for new business and renewal if considered a non-resident alien or has an exempted Visa type (A, F, G, J, M, R, Q)
- Non-US citizens: Not eligible for new business or renewal if they meet the substantial presence test or if resident alien with non-exempted Visa.
The following is a link to information regarding the substantial presence test:
http://www.irs.gov/Individuals/International-Taxpayers/Substantial-Presence-Test
Is coverage under the Global Medical Plan renewable?
Yes. Global Medical products are annually renewable. There are no medical questions at renewal. Renewal is subject to your continued eligibility and timely payment of premiums. Members will receive a renewal notice via email 45 days prior to their anniversary date that will include more information about the renewal and subsequent premium increase.
What should I expect during the underwriting process?
The Global Medical is a medically underwritten plan, which means that your family's medical status and history will be used to determine your eligibility for coverage. Once you have submitted your application it will be reviewed within 5 business days by an underwriter. Within that period you will hear back from the underwriters and they will either:
- Issue coverage and complete your application
- Request further documentation regarding your past medical history
- Apply a rider to your coverage that limits or excludes certain medical conditions
- Apply a premium increase due to your medical and/or family history
- Deny coverage
You will be notified on the status of your application once complete or if further information is needed. If a rider or premium increase is added to your plan you will be notified. If you are issued a rider you will be provided with a 30 day ‘free look’ period. If you do not like our counter offer, you can simply cancel coverage within the 30 day free look and we’ll refund 100% of your premium.
Preferred Provider Network (PPO) & Medical Concierge
The Global Medical plan also allows you to take advantage of the Medical Concierge program in the United States to assist you with finding providers and to give you more information on provider ratings, past outcomes and general costs in the area where you plan to seek treatment. By utilizing the Medical Concierge services, your deductible will be 50% waived (to a maximum of $2,500) and your coinsurance will be waived.
Simply present your identification card at the provider's office so that they may contact us to verify benefits and billing information. For your convenience, there is also an international network and both networks are searchable through the Student Zone, which is accessible with your Certificate number and date of birth once coverage has been approved.
In addition to the extensive PPO network in the US, the Global Medical plan offers an International Provider Access network of over 17,000 physicians, clinics, and hospitals worldwide. These providers have agreed to accept direct payment to make it easier for you so that you don’t have to pay upfront.
Telemedicine
The Global Medical plan in the levels Gold and Platinum now includes CareClix as a new option for seeking medical treatment inside the U.S. This telemedicine platform provides access to a network of board-certified medical and mental health providers, and is available 24 hours a day, seven days a week for many non-emergency medical issues via phone or online video consultations.
How do I file a claim?
Filing a claim is easy. Once your Application is accepted, you will receive a kit which contains Claimant's Statement and Authorization forms. Complete this Claimant's Statement and Authorization form, attach original, itemized bills, and forward them for processing. Be sure to complete your Claimant's Statement entirely and sign it. If you have already paid certain expenses, attach copies of your payment receipts. You will be reimbursed for eligible medical or dental expenses. In many cases, payments will be made directly to the hospital or physician that treated you. Remember, you are responsible for the deductible, coinsurance, and any ineligible charges.
Is there a waiting period for maternity?
Maternity benefits are only available on the Platinum level of the Global Medical plan with a waiting period of 12 months. Coverage on the Platinum level includes prenatal, delivery, postnatal, child wellness, congenital disorders, etc. There is an additional $2,500 deductible per pregnancy and the plan will cover maternity up to a lifetime maximum of $50,000. Please note that you cannot be pregnant at the time of application.
What other optional coverage can I get with this plan?
There are five optional coverage options that you can add to your Global Medical plan and they include:
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Global Term Life Insurance (Amounts shown are the Principal Sums per unit)
- Age 31 days – 18 years: $5,000
- Age 19–29 years: $75,000
- Age 30–39 years: $50,000
- Age 40–44 years: $35,000
- Age 45–49 years: $25,000
- Age 50–54 years: $20,000
- Age 55–59 years: $15,000
- Age 60–64 years: $10,000
- Age 65–69 years: $7,500
-
Accidental Death & Dismemberment (AD&D) – Included with Global Term Life Insurance
- Accidental Loss of Life: Principal Sum*
- Accidental Total Loss of 2 Members**: Principal Sum*
- Accidental Total Loss of 1 Member**: 50% of Principal Sum (*Benefit based on age at time of death; **Member means hand, foot, or eye)
- Dental & Vision (available on the Bronze, Silver, and Gold plan options) — Dental is covered up to $750 lifetime maximum with a $50 deductible (max. 2 per family) after a 6 month waiting period. Routine Services – 90% (deductible is waived); Minor restorative – 70%; Major restorative – 50%. Vision will cover routine eye exams up to $100 per 24 month; Materials covered up to $150 per 24 months.
- Terrorism Rider (available on the Platinum only) — If injured as a result of an act of Terrorism, and the insured person has no direct or indirect participation in the act, the plan will reimburse eligible medical claims subject to a $50,000 lifetime maximum. This benefit does not cover an act of Terrorism in the event that an advisory to leave a certain country or location is issued by the United States government after the insured person's arrival date, and the insured person unreasonably fails or refuses to depart the country or location.
-
Sports Rider (available on the Gold and Platinum only) — Provides up to $10,000 lifetime maximum for amateur athletics
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Adventure Sports:
- Through age 49 years: $50,000 lifetime maximum
- Age 50–59 years: $30,000 lifetime maximum
- Age 60–64 years: $15,000 lifetime maximum
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Adventure Sports:
For more information about these riders, please see the Global Medical Brochure
How can I pay for this plan?
The Global Medical plan can be purchased online using a credit card or debit card. When applying for the plan, you will be able to choose your frequency of payment from paying annually, semi-annually, quarterly, or monthly. Keep in mind that there are higher administrative costs the more frequent the payment. While your payment details are required to be included on your online application, your card will not be charged until the underwriting review process has been completed.
What does Usual Reasonable and Customary (URC) mean?
Usual Reasonable and Customary is a term that insurance companies use to describe a limitation on their responsibility to pay for eligible medical expenses. Basically, URC refers to the fee typically charged by a provider for a specific procedure in a specific geographic area. So if a particular procedure typically costs $5,000 in the New York City area, and most providers customarily charge about $5,000 for that procedure, the insurance company will not pay your provider in New York City $10,000 for the same exact procedure. Instead, they will limit their payment amount to "Usual Reasonable and Customary" - in this example, $5,000.
What is Liferworks?
LifeWorks will provide 24/7 counseling services through a master’s level counselor. Through virtual counseling services, individuals are able to get immediate counseling in crisis situations. Additional services available through the Employment Assistance program include an in-person counseling option while within the United States, LifeWorks services, legal and financial advice, management consultations, and access to many other support resources
