Schedule of Benefits
All amounts shown are in U.S. dollars. Click the orange headers for further information.
MP+ International covers the Usual, Reasonable and Customary charges for eligible expenses in the area where treatment is received. Deductibles are per insured person per calendar year with a maximum of 2 deductibles per family per calendar year.
For eligible expenses incurred in the United States and Canada: Once the deductible has been met, the plan will pay 80% of all eligible medical expenses up to $5,000, then 100% of eligible expenses up the maximum limit.
For eligible expenses incurred outside of the U.S. and Canada: Once the deductible is met, the plan will pay 100% of eligible expenses up to the maximum limit.
| Coverage Area | Worldwide |
| Maximum Limit Per Individual | $1,000,000 lifetime (may be increased to $5,000,000) |
| Hospital Room & Board | Payable up to the average semi-private room rate, including nursing service |
| Hospital Pre-Admission Testing | Subject to deductible |
| Intensive Care Unit | Up to 3 times the average semi-private room rate |
| Second Surgical Opinion | Subject to deductible & coinsurance unless requested by the Company (payable at 100% if requested by the Company) |
| Eligible Medical Expenses | Usual, reasonable, & customary |
| Transplant Benefits | $500,000 lifetime maximum for covered transplants |
| Transplant Benefits Subject to special transplant pre-certification requirements, and only when expense treatment is provided within the Managed Transplant System Network. Covered transplants are: heart, heart/lung, lung, kidney, kidney/pancreas, liver, and allogeneic and autologous bone marrow. |
| Maternity and Newborn Care | Subject to special maternity pre-certification requirements, same as any other illness |
| Mental/Nervous Disorders | Same as any other illness 50% reimbursement |
Inpatient treatment
Limited to 15 days per calendar year per insured person
Outpatient treatment
Maximum of 40 visits per calendar year per insured person |
| Wellness Benefit | Up to $250 coverage (not subject to deductible or coinsurance) |
| For you and your spouse for a physical examination, including immunizations and mammograms every 24 months. To qualify, you must have been covered under the Mission+Plus International plan for at least 24 months and must be at least age 35 if female, or at least age 40 if male. |
| Physical Therapy | Up to $50 maximum per charge per visit |
| Chiropractic Care | $500 maximum per year, reimbursable at 50% |
| Home Health Care | Limited to 30 days per occurrence of illness |
| Extended Care Facility | Limited to 100 days per occurrence of illness |
| Hospice Benefit | $7,000 lifetime per insured person |
| Additional Benefits |
- Life Insurance
- Dental Insurance
- Emergency medical evacuation insurance
| - Required
- Optional
- Optional
|
* This Web page contains only a brief summary of current benefits, conditions, limitations and exclusions, and is subject to all the terms and conditions of the full Certificate of Insurance. The complete Certificate of Insurance with all terms, conditions and exclusions will be included in the fulfillment kit sent to approved applicants. These plans are amended, modified or replaced from time to time, and IMG reserves the right to issue the most current Certificate of Insurance 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. Samples of current Certificate wordings are available upon request.