Plan Detail

Plan Administrator: Seven Corners | AM Best Rating: A "Excellent" | Underwriter: Lloyd's

• Available to non-U.S. citizens who are 60 to 95 years of age.
• Quick online purchase process - immediate ID card upon completion.
• No medical history questions or underwriting.
• Members can remain in the U.S. throughout the entire coverage period.
• Coverage length can vary from 5 to 364 days. At the end of 364 days, the member can purchase a new policy. Pay for as little as 5 days at a time.
• Applicants can arrive in the U.S. up to 5 years before purchasing.
• Network availability to ensure lowest cost health care.

Green Cover® offers several plan options in an easy-to-understand format. You may choose Part A, Part B, or both.

Part A

Hospitalization Benefits include: Semi-private room & board, general nursing, miscellaneous hospital services & supplies, drugs, x-rays, lab tests, operating room expenses. Treatment is covered at these facilities:

• Hospitals — standard hospitalization and emergency treatment
• Hospice Facilities — both inpatient and outpatient
• Skilled Nursing Facilities — 30 day limit per coverage period
  1. Must follow a hospital confinement of 3 or more days
  2. Admission must be within 30 days of hospital confinement
• Home Health Care Services — 30 days limit per coverage period

Part B

• Physician and Surgeon Benefits for inpatient and outpatient Care
• Supplies, Therapy, and Ambulance Services

Included with all Options at No Extra Cost

International Travel Coverage (automatically included) – This coverage follows you anywhere outside of the United States. If you are 60 to 74 years of age, you have a $5,000 limit of protection. If you are 75 to 95 years, your limit is $2,500.

SPECIALIZED BENEFITS

Protection For	Coverage Amount
Alzheimer’s Disease	$25,000 Lifetime Maximum
Cardiac and/or Cancer	$25,000*
Cataract Surgery	$2,000
Dental (Accident Coverage)	$500 per Accident
Skilled Nursing Facilities**	30 Days per Coverage Period
Home Health Care**	30 Days per Coverage Period

* After 180 days of coverage, benefits are paid up to your policy maximum.

**Covered under Part A only

Deductible Options — There are five deductible options: $1,000, $1,500, $2,500, $5,000, or $10,000. Availability varies by age. You are responsible for paying your deductible first.

Coinsurance — This is paid after the deductible. We pay 80% of the next $10,000 in expenses, and you pay 20%. We then pay 100% of any remaining expenses up to your policy maximum.

POLICY MAXIMUM

The maximum for your policy is determined by your age.

• Ages 60-74: $250,000
• Ages 75-79: $100,000
• Ages 80-89: $50,000
• Ages 90-95: $25,000

IMPORTANT INFORMATION REGARDING YOUR COVERAGE

Please be aware that this is not a general health insurance policy, but an interim, limited benefit period program.

This brochure is intended as a brief summary of benefits and services. It is not your policy. If there is any difference between this brochure and your policy, the provisions of the policy will prevail. Benefits and premiums are subject to change.

Patient Protection and Affordable Care Act: This insurance is not subject to, and does not provide certain insurance benefits required by the United States Patient Protection and Affordable Care Act (“PPACA”). The insurance benefits provided by this policy are stated in your policy documents and do not include additional benefits required by PPACA. The PPACA requires certain U.S. residents and citizens to obtain PPACA compliant insurance coverage. In certain circumstances penalties may be imposed on U.S. residents and citizens who do not maintain PPACA compliant insurance coverage. You should consult your attorney, insurance agent or tax professional to determine if the PPACA’s requirements are applicable to you.