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Plan Information |
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Deductible
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US$250 per Period of Coverage
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Coinsurance
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As Described Below
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For treatment received outside the U.S. & Canada: No coinsurance
For treatment received within the U.S. & Canada:
In the PPO Network: The plan pays
90% of eligible expenses up to US$5,000, then 100% up to the Policy Maximum
Outside the PPO Network: 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 certificate expires,
the 3-Month Benefit Period may provide continued coverage. When the certificate
expires, the Company will review the date of initial treatment for the covered injury
or illness. If treatment began less than three months before the certificate expired,
benefits for the covered injury or illness will continue subject to the Policy Limits
until there has been three months of coverage for the covered injury or illness. |
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Policy Maximum |
US$50,000 |
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The Patriot Extreme plan has a Policy Maximum of US$50,000. |
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International Emergency Care |
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Emergency Evacuation |
To Policy Maximum when coordinated through the Plan Administrator
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Patriot Extreme includes coverage for Emergency Medical Evacuations from a medical
facility to the nearest qualified medical facility; 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$10,000 when coordinated through the Plan Administrator
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Patriot Extreme also provides emergency reunion coverage, up to US$10,000 for a
maximum of 15 days, for the reasonable travel and lodging expenses of a relative
or friend during an emergency medical evacuation of the insured person: either the
cost of accompanying the insured during the evacuation or traveling from the country
of residence to be reunited with the insured. |
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Repatriation
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To US$15,000 when coordinated through the Plan Administrator
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If a covered illness/injury results in death, expenses for Repatriation of bodily
remains or ashes to the country of residence will be covered up to a maximum of
US$15,000.
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Political Evacuation
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To US$10,000 when coordinated through the Plan Administrator
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If the United States Department of State, Bureau of Consular Affairs
issues a travel advisory that becomes effective on or after the Insured Person’s
date of arrival in the Host Country, the Company will pay up to US$10,000 for transportation
to the nearest place of safety or for repatriation to the Insured Person’s
home country or country of residence provided that:
- The Insured Person contacts the Company within 10 days of the
United States Department of State, Bureau of Consular affairs issues the travel
advisory;
- Political Evacuation and Repatriation is approved and coordinated
by the Company.
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Medical Benefits |
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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Patriot Extreme 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 |
To Policy Maximum for Basic and Extreme Sports as described below
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Subject to the terms of the complete policy wording, Patriot Extreme covers injuries
incurred during non-contact amateur athletic activities and certain Extreme Sports
(see page 7 of the Patriot Extreme brochure). Activities may be organized and include
scheduled practices, games, and/or competitions.
Activities not covered include contact sports, professional sports and any athletic
activities that are organized and/or sanctioned by the National Collegiate Athletic
Association (or any other collegiate sanctioning body) or the International Olympic
Committee.
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Additional Coverages |
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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, each Patriot 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 designated beneficiary to a maximum of US$250,000
per family.
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This web page contains 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. IMG reserves the right
to issue the most current Policy Wording for this insurance plan in the event this
application and/or brochure has expired, is modified, or is replaced with a newer
version. Current Policy Wordings are available upon request.
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