Patriot Group Travel Medical Insurance

Schedule of Benefits

All amounts shown are in U.S. dollars. Click the orange headers for further information.

PLAN INFORMATION
Deductible Your choice of $0, $100, $250, $500, $1,000 or $2,500
Coinsurance Click for more information
MEDICAL BENEFITS Usual, reasonable and customary charges, subject to deductible and coinsurance
Hospital Room and Board Up to Policy Maximum for average semi-private room rate
Intensive Care Up to Policy Maximum
Medical Expenses Up to Policy Maximum
Outpatient Medical Up to Policy Maximum
Local Ambulance Up to Policy Maximum
Prescription Drugs Up to Policy Maximum
Emergency Room Accident Up to Policy Maximum
Emergency Illness - with in-patient admission Up to Policy Maximum
Emergency Illness - without in-patient admission Up to Policy Maximum
Dental Click for more information
INTERNATIONAL EMERGENCY CARE (when coordinated through the Plan Administrator)
Emergency Evacuation Up to $500,000 lifetime maximum (independent of policy maximum)
Emergency Reunion Up to $50,000
Return of Mortal Remains Up to $50,000
Returning Minor Children Up to $50,000
Political Evacuation Up to $10,000
ADDITIONAL BENEFITS
Benefit Period Six months
Incidental Home Country Coverage Up to a cumulative two weeks
End of Trip Home Country Coverage Click for more information
Common Carrier Accidental Death $50,000 to Beneficiary; maximum of $250,000 per family
Sports & Activities Coverage Up to Policy Maximum for basic sports Coverage as described below
Accidental Death & Dismemberment $25,000 principal sum
Terrorism Coverage Up to $50,000 lifetime maximum
Identity Theft Assistance Up to $500 per Period of Coverage
Natural Disaster $100 per day for five days
Trip Interruption Up to $5,000
Lost Luggage Up to $50 per item of personal property; maximum of $250 per Period of Coverage
Additional Benefits for U.S. Citizens
Indemnity Click for more information
Sudden Recurrence of a Pre-existing Condition Click for more information

* This Web page contains only a consolidated and summary description of all current benefits, conditions, limitations and exclusions. A certificate containing the complete Certificate Wording with all terms, conditions and exclusions will be included in the fulfillment kit. IMG reserves the right to issue the most current Certificate Wording for this insurance plan in the event this Web page, application, and/or brochure has expired, is modified, or is replaced with a newer version. Current Certificate Wordings are available upon request.