GeoBlue Trekker Essential

Plan Detail

Benefits


Medical Benefits

Essential

Choice

Maximum International Benefits per Insured Person per period of coverage $50,000 $250,000*
Deductible per Insured Person per period of coverage $50 $50
After the Deductible is satisfied, benefits are paid for Covered Expenses as follows up to the Medical Limit:

Benefits

Insurer Pays **

Professional Services:
a. Surgery, anesthesia, radiation therapy, in-hospital doctor visits, diagnostic X-ray and lab
100%
b. Office Visits: including X-rays and lab work billed by the attending physician 100%
Inpatient Hospital Services:
a. Surgery, X-rays, In-hospital doctor visits
100%
b. Inpatient medical emergency 100%
Ambulatory Surgical Center 100%
Ambulance Service (non-medical evacuation) 100% up to $1,000
Benefits for claims resulting from downhill (alpine) skiing and scuba diving Maximum Benefit up to $10,000
Outside the U.S. Outpatient prescription drugs:
Limit of $2500 (Essential) and $5000 (Choice)
100% of Covered Expenses
Dental Care required due to an injury 100% of Covered Expenses up to $200 maximum per Trip Period
Dental care for Relief of Pain 100% of Covered Expenses up to $100 maximum per Trip Period
Physical and Occupational Therapy 6 visits per Period of Insurance $100 Maximum payment per visit.

Other Benefits

Insurer Pays***

Essential Choice
Accidental Death and Dismemberment $0 $25,000
Repatriation of Mortal Remains $15,000 $25,000
Emergency Medical Transportation $250,000 $500,000
Emergency Family Travel Arrangements Maximum Benefit per Trip Period up to $2,500 for the cost of one economy roundtrip airfare ticket to the place of the Hospital Confinement for one (1) person.

The benefits outlined in the table show the payment percentages for Covered Expenses after the Insured Person has satisfied his or her Deductible. This plan includes a Deductible of $50 per Insured Person per Trip Coverage Period, which can be waived under certain circumstances. Covered Expenses are based on Reasonable Charges which may be less than actual billed charges. Providers can bill the Insured Person for amounts exceeding Covered Expenses. Contracted Providers are contracted to accept reasonable charges.

Available to U.S. residents, age 84 or younger, if they apply from the U.S. Individuals aged 70-84 are eligible only for a $100,000 medical limit. See Eligibility Requirements. Covers all international trips (up to 70 days duration per trip) in a 364 day period. Participants must be enrolled in a Primary Health Plan.

* For Individuals aged 70 – 84, the Maximum International Medical Benefit for Trekker Choice is $100,000.

** After Medical Benefit Deductible Is Paid

*** Without a Deductible Being Applicable