Comprehensive medical coverage for non-U.S. citizens traveling from 15 days to one year
Patriot America provides coverage for non-US citizens traveling outside their country of citizenship for a minimum of 15 days up to a maximum of one year. Although the Patriot America plan is not renewable, it can be rewritten for succeeding or subsequent coverage periods. New Deductible, Coinsurance, Eligibility, Conditions of Coverage and Pre-Existing Condition Exclusions apply to any succeeding or subsequent Period of Coverage. A new application also must be completed. If you or other family members applying for coverage are age 65 or older, please see the Eligibility section of the Patriot brochure for additional information.
If you are traveling for six (6) months or
more, please review the ExPatriot PlusŪ plan, which offers a 10% discount on
rates and is renewable.
|
PATRIOT AMERICASM - For Non-U.S. Citizens |
||||
| 50,000 MAX | 100,000 MAX | 500,000 MAX | 1,000,000 MAX |
|
| option 1 | option 2 | option 3 | option 4 | |
|
AGE |
One Month | One Month | One Month | One Month |
|
18-29 |
$48.00
|
$56.00
|
$72.00
|
$84.00
|
|
30-39 |
$62.00
|
$74.00
|
$94.00
|
$108.00
|
|
40-49 |
$94.00
|
$106.00
|
$140.00
|
$158.00
|
|
50-59 |
$134.00
|
$164.00
|
$198.00
|
$228.00
|
|
60-64 |
$158.00
|
$194.00
|
$230.00
|
$276.00
|
|
65-69 |
$180.00
|
$232.00
|
$252.00
|
$300.00
|
|
70-79 |
$244.00
|
N/A
|
N/A
|
N/A
|
|
80 PLUS* |
$424.00
|
N/A
|
N/A
|
N/A
|
|
DEP CHILD |
$28.00
|
$32.00
|
$40.00
|
$44.00
|
|
CHILD ALONE |
$44.00
|
$52.00
|
$66.00
|
$74.00
|
| *US$10,000 limit | ||||
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.
*See specific policy for age limit.
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.
This is 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 Insurance SM, 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