Plan Benefits

Global Medical Insurance^sm(GMI) covers the Usual, Reasonable and Customary (URC) charges for eligible expenses in the area where you receive treatment. Each person will only need to satisfy their deductible once per policy period (12 months) with a maximum of three deductibles per family per calendar year.

For eligible expenses incurred in the U.S. and Canada: once the deductible is met, GMI pays 80% of the next US$5000 in eligible expenses then 100% of eligible expenses up to the policy maximum.

For eligible expenses incurred outside the US and Canada: once the deductible is met, GMI will pay 100% up to the policy maximum.

Medical Benefits Subject to deductible and coinsurance	Limits & Restrictions
Coverage Area	Worldwide
Policy Maximum Per Individual	US$5,000,000 lifetime
Hospitalization Semi-private room and board l Nursing services l Prescription medication l Physician charges l Diagnostic and laboratory testing l X-rays l Chemotherapy and radiation l Durable medical equipment l Treatment, services and supplies routinely provided	URC
Intensive Care Unit	URC
Surgery Surgical care l Second surgical opinion l Anesthetics l Physician charges for surgery l Treatment, services and supplies routinely provided	URC
Transplants Limited to certain transplants and covered only within designated transplant facilities that are members of IMG's independently-contracted PPO network	US$1,000,000 lifetime
Outpatient Emergency treatment of illness or injury l Surgery l Rehabilitative treatment l Treatment, services or supplies routinely provided l Prescription medication	URC
Emergency Surgery or dental treatment following an accident l Emergency room following an accident	URC
Emergency Transportation by Ground Ambulance	URC
Emergency Medical Evacuation Included with the emergency Medical Evacuation is an Emergency Reunion Benefit of US$10,000 lifetime	Up to policy maximum
Repatriation	US$25,000
Supplemental Accident The first US$300 will be covered fop each accidental injury	US$300 per occurance (not subject to deductible or coinsurance)
Maternity Available after 12 months of coverage \| Pre and Post-natal care l Normal delivery or C-section l Well baby care and treatment of newborn for first 31 days	US$50,000 lifetime (maximum of US$5,000 for each normal delivery for each pregnancy; maximum of US$7,500 for C-section delivery for each pregnancy)
Newborns Eligible newborn children may be added without evidence of insurability under certain circumstances \| An application form must be submitted within 31 days of birth	URC
Mental/Nervous Care Inpatient and outpatient care by a licensed psychiatrist	US$10,000 per period, US$25,000 lifetime (after 12 months of coverage)
Wellness Females age 35 and over after 12 months of continuous coverage. Routine physicals l Mammogram, ob/gyn visit, etc. (exams must be separated by 12 months) Males age 35 and over, after 12 months of continuous coverage \| Routine physicals (exams must be separated by 12 months)	US$250 per period of coverage (not subject to deductible or coinsurance)
Complementary Medicine Acupuncture Aroma Therapy Herbal Therapy Magnetic Therapy Massage Therapy Vitamin Therapy	(Each per period of coverage) US$150 US$50 US$50 US$75 US$150 US$100
Pre-existing Conditions After 24 months of continuous coverage	US$50,000 lifetime (maximum of $5,000 per period of coverage)
Other Chiropractor when referred by a physician l Radiation treatment l Home nursing care l Hospice care l Physical therapy (maximum US$50 per visit) l Prosthetic devices	URC

Global Medical Insurance

Overview

At-a-Glance

Benefits

Exclusions

About the Insurer

L icensing & Legal | Privacy Statement

Customer Service Assistance is Available from 9:00am-5:00 pm Eastern Standard Time
US Calls: 1-877-982-5200 | International Calls: 1-781-982-5200 |

Plan Benefits

Medical Benefits Subject to deductible and coinsurance

Limits & Restrictions

Medical Benefits
Subject to deductible and coinsurance