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

* 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.