Global Medical Insurance

Schedule of Benefits

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

Summary of Benefits Subject to deductible and coinsurance unless otherwise noted
Lifetime Maximum Limit
Deductible (Per Period of Coverage)
Family Deductible
Treatment Outside the U.S. and Canada
Treatment Inside the U.S. (Out-Patient/In-Patient Emergency)
Treatment Inside the U.S. (In-Patient Non-Emergency))
Treatment inside the U.S.- Non-PPO Network and Canada
Hospitalization / Room & Board
Intensive Care Unit
Anesthetist's Charges Associated with Surgery
Emergency Room Illness (Additional $250 deductible if not admitted)
Emergency Room Accident
Supplemental Accident
Local Ambulance
Emergency Evacuation
Emergency Reunion
Return of Mortal Remains
Remote Transportation
Political Evacuation and Repatriation
Child Wellness (Under 18 years of age)
Adult Wellness
Rx Coverage
Other Services
Physical Therapy
Complementary Medicine
Recreational Scuba
Non-emergency Dental
Emergency Dental due to Accident
Emergency Dental due to Sudden Unexpected Pain
High School Sports Injury
Delivery, wellness, new born care & congenital disorders, Family Matters Maternity Program (*not subject to deductible or coinsurance - available after 10 months of coverage)

NA (Not Applicable) / URC (Usual, Reasonable and Customary) / SAAI (Same As Any Illness)

This invitation to inquire allows eligible applicants an opportunity to inquire further about the insurance offered and is limited to a brief description of any loss for which benefits may be payable. Benefits are offered as described in the insurance contract. Benefits are subject to all deductibles, coinsurance, provisions, terms, conditions, limitations, and exclusions in the insurance contract. The contract does contain a pre-existing condition exclusion and does not cover losses or expenses related to a pre-existing condition.