Each
Patriot Travel Medical Plan includes the following benefits:
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INTERNATIONAL EMERGENCY CARE
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Emergency
Evacuation
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To Policy
Maximum when coordinated through IMG
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Each Patriot
Travel Medical InsuranceSM plan also provides for Emergency
Medical Evacuations to the nearest qualified medical facility
or the country of residence (as determined by IMGSM)expenses
for reasonable travel and accommodations resulting from the evacuation;
and the cost of returning to either the country of residence or
the country where the evacuation occurred up to the policy limit.
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Emergency
Reunion
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To
US$15,000 when coordinated through IMG
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Each
PatriotSM plan includes emergency reunion coverage,
up to US$15,000 for a maximum of 10 days, for the reasonable travel
and lodging expenses of a relative or friend during an Emergency
Medical Evacuation: either the cost of accompanying the insured
during the evacuation or traveling from the country of residence
to be united with the insured.
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Repatriation
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To US$25,000
when coordinated through IMG
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If a covered
illness/injury results in death, expenses for Repatriation of
bodily remains or ashes to the country of citizenship will be
covered up to a maximum of US$25,000.
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Returning
Minor Children
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To US$5,000
when coordinated through IMG
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If an insured
person is hospitalized due to a covered illness/injury and is
traveling alone with child(ren) 19 or under that otherwise would
be left unattended, the Patriot plans will pay up to US$5,000
for one way economy fare to their home country, including a chaperone,
if necessary, for the safety of the child(ren).
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SPECIAL
COVERAGES
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Home Country
Coverage
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As described
below
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Incidental
Home Country Coverage - During the period of coverage an insured
person may return to their country of citizenship for incidental
visits of up to two weeks total, subject to: a. The insured person
must have left their country of citizenship, b. The Total Period
of Coverage must be for a minimum of 30 days, and c. The return
to the country of citizenship may not be taken to receive treatment
for a condition incurred while traveling.
End of Trip Home Country Coverage-For every six (6) months
of coverage ou purchase, you can purchase one (1) month of home
country coverage up to a maximum of 2 months.
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Trip Interruption
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To
US$5,000
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If, during
a covered trip, there is a death of an immediate family member
(spouse, child, parent or sibling) or the substantial destruction
of the insured's principal residence, the plan will pay to return
the insured to the area of principal residence. The plan will
pay for a one way air or ground transportation ticket of the same
class as the unused travel ticket, less the value of the unused
return ticket.
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Lost Luggage
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To US$50
per item; maximum of US$250
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This benefit
will be paid in the event that the Common Carrier permanently
loses an insured person's checked luggage. This coverage is secondary
to any other available coverage, including the Carrier's.
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Common
Carrier Accidental Death
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US$50,000
to Beneficiary; maximum of US$250,000 per family
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If accidental
death should occur while traveling on a commercial Common Carrier,
US$50,000 will be paid to the beneficiary to a maximum of US$250,000
per family
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MEDICAL BENEFITS
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Usual
reasonable and customary charges,subject to deductible and coinsurance
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Hospital
Room and Board
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To Policy
Maximum for average semi-private room rate
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Intensive
Care
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To Policy
Maximum
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Medical
Expenses
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To Policy
Maximum
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Outpatient
Medical
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To
Policy Maximum
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Local
Ambulance
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To Policy
Maximum
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Dental
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To Policy
Maximum
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Each
Patriot plan covers the cost of emergency dental treatment and
dental procedures necessary to restore sound natural teeth lost
or damaged in an accident
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Sports
& Activities
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To Policy
Maximum for basic sports Coverage as described below
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Each Patriot
plan covers injuries incurred during amateur athletic activities
which are non-contact and engaged in by an insured person solely
for leisure, recreation, entertainment or fitness purposes. However,
activities not covered include amateur or professional sports
or other athletic activity which is organized and/or sanctioned,
or which involves regular or scheduled practices, games or competition.
The following hazardous activities are excluded, but may be added
by the Optional Sports Rider: Scuba diving, mountain climbing
(up to 4500 meters or where ropes or guides are normally used),
jet, snow and water skiing and snowboarding, sky diving, amateur
racing, piloting an aircraft, bungee jumping and spelunking.
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Accidental
Death & Dismemberment
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US$25,000
principal sum
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Each
Patriot plan includes US$25,000 principal sum benefit for Accidental
Death and Dismemberment occurring during the period of coverage:
• Accidental Loss of life- principal sum; • Accidental Loss of
two Members- principal sum; •Accidental Loss of one Member-50%
of principal sum. "Member" means hand, foot or eye.
For more information see the Conditions of Coverage section in
the Patriot Travel Medical brochure.
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PLAN INFORMATION
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Deductible
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Your choice
of US$100, $250, $500, $1,000 or $2,500
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Coinsurance
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As described
below
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For treatment
received outside the US & Canada: No coinsurance
For treatment
receivd within the US & Canada: The plan pays 80% of eligible
expenses up to US$5,000 then 100% up to the Policy Maximum.
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Benefit
Period
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three months
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If
a covered injury or illness has continuing treatment after the
policy expires, the Benefit Period may provide continued coverage.
When the policy expires, IMG will review the date of initial treatment
for the covered injury or illness. If treatment began less than
three months before the policy expired, benefits for the covered
injury or illness will continue subject to the Policy Limits until
there has been three months of coverage. The Benefit Period serves
as an extension of benefits and does not limit the treatment time
during the Policy Period.
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Additional
Benefits for U.S. Citizens
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Sudden
Recurrence of a Pre-existing Condition
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Sudden
Recurrence of a Pre-existing Condition - Up to US$5000 will be
paid for the eligible expenses of a sudden and unexpected recurrence
of a Pre-existing Condition while traveling outside of the US.
In addition, up to US$25,000 will be paid for the eligible costs
and expenses of an Emergency Medical Evacuation arising or resulting
from a sudden and unexpected recurrence of a Pre-existing Condition.
For the definition of a Pre-existing Condition, please see Exclusion
number 1 in the Patriot Travel Medical brochure.
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Dental
Emergency
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This
plan will pay up to $100 for the necessary treatment of sudden,
unexpected pain to sound natural teeth.
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The
above outline is only a consolidated and summary description of
all current Patriot Travel Medical Insurance benefits, conditions,
limitations and exclusions. A certificate containing the complete
Policy Wording with all terms, conditions and exclusions will
be included with the fulfillment kit.
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