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PATRIOT TRAVEL MEDICAL INSURANCESM
PREMIUMS: EXPATRIOT PLUS®
Premiums: ExPatriot Plus® Benefits |Buy
Now | Exclusions
ExPatriot Plus® provides coverage for US citizens
AND non-US citizens traveling outside their country of citizenship for a
minimum of six months up to a maximum of two years. ExPatriot Plus must be
purchased for a minimum initial period of six months, and is renewable for
a total of two years by those traveling outside the US. For non-US
citizens traveling within the US, ExPatriot Plus may be renewed for up to
one year of total coverage. A new Deductible and Coinsurance will apply
for each Period of Coverage.
Policy Premiums ExPatriot Plus® Policy Monthly Premiums for Citizens
traveling outside their country of citizenship.
|
EXPATRIOT
PLUS® POLICY PREMIUMS |
|
500,000
MAX |
1,000,000
MAX |
500,000
MAX |
1,000,000
MAX |
|
US CITIZEN |
US CITIZEN |
NON-US CITIZEN |
NON-US CITIZEN |
|
option
10 |
option11 |
option
12 |
option
13 |
|
AGE
|
One Month |
One Month |
One Month |
One Month |
|
18-29
|
$43.00 |
$48.00 |
$64.00 |
$75.00 |
|
30-39
|
$57.00 |
$63.00 |
$84.00 |
$97.00 |
|
40-49
|
$73.00 |
$81.00 |
$126.00 |
$142.00 |
|
50-59
|
$122.00 |
$136.00 |
$178.00 |
$205.00 |
|
60-64
|
$153.00 |
$180.00 |
$207.00 |
$248.00 |
|
65-69
|
$158.00 |
$189.00 |
$226.00 |
$270.00 |
|
DEP CHILD
|
$27.00 |
$28.00 |
$28.00 |
$39.00 |
|
CHILD ALONE
|
$41.00 |
$45.00 |
$49.00 |
$66.00 |
All premium rates are in US dollars and are effective through
6/30/2002. Rates include 2.5% surplus lines tax. A dependent child is your
child shown on the Enrollment Form over 14 days and under 18 years of age,
traveling with you, and for whom premium has been paid.
Benefit Period. If a covered injury or illness requires continuing
treatment after the policy expires, the Benefit Period may provide
continued coverage. When the policy expires, IMG will review the date of
the initial treatment for the covered injury or illness. If treatment
began less than six months before the policy expired, benefits for the
covered injury or illness will continue subject to the Policy Limits until
there has been six months of coverage. The Benefit Period serves as an
extension of benefits and does not limit the treatment time during the
Policy Period.
Refund of Premium............................
IMG will refund premium only if a written request is received prior to the
policy's effective date. The premium is non-refundable after that date.
For Precertification, Emergency Evacuation and Repatriation..............
Please call IMG
in the U.S. 1.800.628.4664
Outside the U.S. 01.317.655.4500
(collect if necessary).
IMG must be notified prior to treatment or within 48 hours of an
emergency.
To Report Claims...............................
Please mail to IMG
International Medical Group, Inc.
407 Fulton Street
Indianapolis, IN 46202 U.S.A.
Please include Identification Number in all correspondence.
The information here 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. In support of Patriot Travel Medical InsuranceSM,
IMG has established the Global Medical Services Group Insurance Trust, in
Indiana. The trust owns a master group international travelers insurance
policy. Individual certificates of insurance are issued from the master
policy.
Underwritten by: Sirius International Insurance Corporation
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