Patriot America Plus

IMG

Addresses the insurance needs of non-U.S. citizens who need temporary medical insurance while traveling for business or pleasure to the United States.
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%

Coverage and benefits are subject to the deductible and coinsurance, and all terms of the Certificate of Insurance and Master Policy.

General

Coinsurance
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%
Inpatient

Hospital Room and Board
Average semi-private room rate up to the maximum limit. (Subject to coinsurance & deductible)
Surgical Treatment
Up to the Maximum Limit(Usual, reasonable and customary charges, subject to coinsurance & deductible)
Intensive Care
Up to the Maximum Limit(Usual, reasonable and customary charges, subject to coinsurance & deductible)
Outpatient

Physician Visits
Up to the Maximum Limit(Usual, reasonable and customary charges, subject to coinsurance & deductible)
Urgent Care
Up to the Maximum Limit(Usual, reasonable and customary charges, subject to coinsurance & deductible)
Surgical Treatment
Up to the Maximum Limit(Usual, reasonable and customary charges, subject to coinsurance & deductible)
Prescription Medication
Up to the Maximum Limit(Usual, reasonable and customary charges, subject to coinsurance & deductible)
Diagnostic Procedures
Up to the Maximum Limit(Usual, reasonable and customary charges, subject to coinsurance & deductible)
Dental

Acute, Unexpected
$100 Maximum
Accidental Emergency
Up to maximum limit (Subject to coinsurance & deductible)
Life

Accidental Death & Dismemberment
$25,000 principal sum
Common Carrier AD&D
$50,000 to beneficiary; maximum of $250,000 per family
Emergency Services

Ambulance Expenses
Up to maximum limit
Emergency Room
Up to maximum limit (Subject to coinsurance & deductible)
Travel

Emergency Medical Evacuation
$500,000 maximum limit
Return of Mortal Remains or Cremation/Burial
Up to $50,000 for return of mortal remains or $5,000 for cremation/burial. Not subject to deductible.
Emergency Reunion
Up to $50,000 Lifetime Maximum
Return of Minor Children
$50,000 lifetime maximum
Trip Interruption
Up to $5,000
Loss Luggage
$50 per item; maximum of $250
Other Services

Pre-Existing Conditions
Acute Onset of Pre-existing Condition prior to age 70 - Medical Expenses.Usual, Reasonable, and Customary
Maternity
No Coverage
Routine physical checkup
No Coverage
Terrorism Coverage
$50,000 lifetime maximum
Physical Therapy
Hospital Indemnity
$100 per overnight. Up to a maximum limit of 10 overnights

Disclaimer
Plan features listed here are high level, provided for your convenience and information purpose only. Please review the Evidence of Coverage and Plan Contract (Policy) for a detailed description of Coverage Benefits, Limitations and Exclusions. Must read the Policy Brochure and Plan Details for complete and accurate details. Only the Terms and Conditions of Coverage Benefits listed in the policy are binding.

Plan Type
Comprehensive
Acute Onset
Yes
Cancelable
Yes
Renewable
Yes
Adventure
No
Dependent Eligible
Yes