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