Short term international travel medical plan for leisure, missionary or business travel.
- Eligibility Requirements
- Home Country is the U.S.; and
- You must be under Age 85 and;
- Enrolled in a Primary Plan*; and
- For Children under age 6, must be enrolled with a parent and;
- Initial purchase must be made in home country prior to departing on trip.
- Pre-existing Condition Limitation Pre-existing conditions are covered under this plan as any other condition, subject to the terms and exclusions listed in the policy
|Medical Limits and Deductibles|
|Maximum Benefit per Insured Person per policy period||Options include $50,000; $100,000; $500,000; $1,000,000|
|Deductible per insured Person per policy period||Options $0, $100, $250, $500|
|Benefits are paid for Covered Expenses as follows up to the Medical Limit|
|Inpatient Hospital Servies||Insurer Pays After Deductible is Met|
|a. surgery, anesthesia, radiation theraphy, in-house doctor visits, diagnostic X-ray and lab||100%|
|b. In-patient medical emergency||100%|
|Ambulance Service (non-Medical Evacuation)||$100% up to $1000|
|Prescriptions, DentalCare and Physical Therapy||Insurer Pays After Deductible is Met|
|Outside the U.S Outpatient prescription drugs||100% of Covered Expenses up to $5,000|
|Dental Care required due to an injury||100% of Reasonable Charges with a maximum benefit of $500 per Trip Period|
|Dental Care for Relief of Pain||100% of Reasonable charges with a maximum payment per visit.|
|Physical and Occupational Therapy||6 visits per Period of insurance $100 maximum benefit of $250 per visit|
|Travel Assistance Benefits||Insurer Waives Deductible|
|Accidental Death and Dismemberment||Maximum Benefit Principal sum up to $50,000|
|Repatriation of Remains||Maximum Benefit up to $25,000|
|Emergency Medical Transportation||Maximum Benefit per Trip Period for all Evacuations up to $500,000|
|Emergency Family Travel Arrangements||Maximu Benefit per Trip Period up to $2,500 for the cost of one economy round trip air fare ticket to the place of the Hospital confinement for one(1) person|
|Baggage and Personal effects coverage||Maximum benefit of $500 per Trip Period and limited to $100 maximum benefit per bag or personal effect|
|Post Departure rip interrupton||Maximum benefit of $500 per Trip Period|
|Hazardous Activities||Insurer Pays After Deductible is Met|
|Benefits for claims resulting from downhill (alpine) skiing and scuba diving (certification by the Professional Association of Diving Instructor (PADI) or the National Association of Underwater instructors (NAUI) required or diving under the supervision of a certified instructor).||Maximum Benefit up to $10,000|
Notice of Claim: Written notice of any event which may lead to a claim under the Certificate must be given to the Insurer or to the Administrator within 60 days after the event, or as soon thereafter as is reasonably possible.
Claim Forms: Upon receipt of a written notice of claim, the Insurer will furnish to the claimant such forms as are usually furnished by it for filing Proofs of Loss. If these forms are not furnished within 15 days after the notice is sent, the claimant may comply with the Proof of Loss requirements of the Certificate by submitting, within the time fixed in the Certificate for filing proofs of loss, written proof showing the occurrence, nature and extent of the loss for which claim is made.
Proof of Loss: Written proof of loss must be furnished to the Insurer or to its Administrator within 90 days after the date of loss. However, in case of claim for loss for which the Certificate provides any periodic payment contingent upon continuing loss, this proof may be furnished within 90 days after termination of each period for which the Insurer is liable. Failure to furnish proof within the time required will not invalidate nor reduce any claim if it is not reasonably possible to give proof within 90 days, provided
- It was not reasonably possible to provide proof in that time; and
- The proof is given within one year from the date proof of loss was otherwise required. This one year limit will not apply in the absence of legal capacity.
- Original claim determination from the Common Carrier, if applicable.
- Original police report or other report from local authorities.
- Original receipts and list of stolen, lost or damaged items.
- Proof of loss providing amount of loss, date, time and cause of loss.
Post Departure Trip Interruption Claims
- Any appropriate documentation that officially explains the cause of Your Trip cancellation or interruption. Any explanation of diagnosis along with Your original itemized bills, receipts, and proof of other insurance payments.
- Original unused tickets, copies of invoices, proof of payments, and other documents that substantiate the cost or occurrence of the Trip cancellation or interruption.
- Documentation of Refunds received from the travel supplier(s) and/or Common Carrier(s).
- Copy of the supplier’s literature that describes penalties. A letter from the tour operator or an itemized bill from the travel agent stating the non-refundable amounts of the Trip costs.
Time for Payment of Claim:
Benefits payable under the Certificate will be paid immediately upon receipt of satisfactory written proof of loss.
Payment of Claims:
Benefits for Accidental Death & Dismemberment will be payable in accordance with the beneficiary designation and the provisions of the Certificate which are effective at the time of payment. If no beneficiary designation is then effective, the benefits will be payable to the estate of the Covered Person for whom claim is made. Any other accrued benefits unpaid at the Covered Person’s death may, at the Insurer’s option, be paid either to his/her beneficiary or to his/her estate. Benefits payable under any of the other benefits may be payable to the provider of the service.
If any benefits are payable to the estate of a Covered Person, or to a Covered Person’s beneficiary who is a minor or otherwise not competent to give valid release, the Insurer may pay up to $1,000 to any relative, by blood or by marriage, of the Covered Person or beneficiary who is deemed by the Insurer to be equitably entitled to payment. Any payment made by the Insurer in good faith pursuant to this provision will fully discharge the Insurer of any obligation to the extent of the payment. Physical Examination and Autopsy: The Insurer may, at its expense, examine a Covered Person, when and as often as may reasonably be required during the pendency of a claim under the Certificate and, in the event of death, make an autopsy in case of death, where it is not forbidden by law.