PLAN INFORMATION
Maximum Limits	$50,000, $100,000, $500,000
Individual Deductible	$0, $100, $250, $500, $1,000, $2,500
Coinsurance - for treatment received outside the U.S. & Canada	No Coinsurance
Coinsurance - for treatment received outside the U.S. & Canada	In the PPO Network- The plan pays 90% of eligible medical expenses up to $5,000, then 100% Out of the PPO Network - The plan pays 80% of eligible medical expenses up to $5,000, then 100%
Continuation of Treatment Period	Earlier of 6 months per Injury or Illness or upon return to Home Country
MyIMGSM	24 hour secure access from anywhere in the world to manage your account at anytime
World-class Medical Benefits	Coverage available for eligible inpatient and outpatient medical expenses
International Emergency Care	A wide range of international emergency benefits available including emergency evacuation, emergency reunion, return of mortal remains, return of minor children and more
INPATIENT/OUTPATIENT BENEFITS Subject to the coinsurance and deductible when applicable and Usual, Reasonable, and Customary (URC)
Hospital Room and Board	URC average semi-private room rate
Intensive Care Unit	URC
Eligible Medical Expenses	URC
Acute Onset of Pre-existing Condition prior to age 70 - Medical Expenses	URC
Local Ambulance	URC
Prescription Medication	URC
Emergency Room Accident	URC
Emergency Room Illness with In-patient Admission	URC
Emergency Room Illness without In-patient Admission	URC with additional $250 deductible
Dental - Treatment related to an Accident	URC
Dental - Emergency	$100 maximum
Hospital Daily Indemnity	$100 per overnight, up to a maximum of 10 overnights
Terrorism	$50,000 lifetime maximum
Recreational Sports & Activities	URC for non-organized, non-contact, and non-collision activities
EVACUATION BENEFITS Not subject to a deductible or coinsurance.
Emergency Medical Evacuation	$500,000 lifetime maximum (independent of the Maximum Limit)
Acute Onset of Pre-existing Condition prior to age 70 - Emergency Medical Evacuation	$25,000 lifetime maximum
Emergency Reunion	$50,000 lifetime maximum
Return of Mortal Remains or Cremation/Burial	$50,000 for Return of Mortal Remains or $5,000 for Cremation/Burial
Return of Minor Children	$50,000 lifetime maximum
Political Evacuation	$10,000 lifetime maximum
ADDITIONAL BENEFITS Not subject to a deductible or coinsurance.
Incidental Trips	Up to a cumulative two weeks
End of Trip Home Country Coverage	One month for every six months of continuous coverage, up to two months maximum
Trip Interruption	$5,000 maximum
Common Carrier Accidental Death	$50,000 to beneficiary; maximum of $250,000 per family
Accidental Death & Dismemberment	$25,000 principal sum
Lost Luggage	$50 per item; maximum of $250
Natural Disaster	$100 per day for five days maximum
Identity Theft	$500 maximum
OPTIONAL RIDERS Other than the Enhanced AD&D Rider, optional riders can be requested and apply to all eligible individuals listed on the Application.
Adventure Sports Rider (available to insureds up to age 65)	Age Lifetime Maximum 0 - 49 $50,000 50 - 59 $30,000 60 - 64 $15,000
Enhanced AD&D Rider (available to the primary insured only)	Up to the Maximum Limit
Evacuation Plus Rider (available to insureds up to age 65)	Non Life-threatening Medical Evacuation: Up to a maximum of $25,000. Natural Disaster Evacuation: Up to a maximum of $5,000

You may seek treatment under Patriot Travel Medical Insurance Plan worldwide, including in the United States , with the hospital or doctor of your choice. When seeking treatment in the U.S., you may use the independent Preferred Provider Organization (PPO) contracted by IMG, a separately organized network (First Health Group) of approximately 500,000 physicians and 4,700 privately owned and operated hospitals. * This PPO network includes a large number of hospitals including some of the most well recognized university medical centers and transplant facilities.

Using this provider network could significantly reduce your out-of-pocket expenses.

PRECERTIFICATION: Each proposed hospital admission, inpatient or outpatient surgery, and certain other medical procedures must be Pre-certified for medical necessity. This means the insured person or their attending physician must call the number listed on the IMG identification card prior to admittance to a hospital or performance of a surgery, or medical procedure. In the case of an emergency hospital admission, the Pre-certification call must be made within 48 hours of the admission, or as soon as reasonably possible. For a complete list of procedures requiring Pre-certification, please refer to your certificate wording. If Pre-certification guidelines are not followed, eligible claims and expenses will be reduced by 50%.