Patriot Exchange Program - Basic

Plan Detail

Plan Administrator: International Medical Group | AM Best Rating: A "Excellent" | Underwriter: Sirius International



Each proposed hospital admission, in-patient or out-patient surgery, and other procedures as noted in the Certificate Wording must be Precertified for medical necessity, which 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. In case of an Emergency Admission, the Precertification call must be made within 48 hours of the admission, or as soon as reasonably possible. If a hospital admission or a surgery is not Precertified, eligible claims and expenses will be reduced by 50%. It is important to note that Precertification is only a determination of medical necessity, not an assurance of coverage, verification of benefits or a guarantee of payment. All medical expenses must meet usual, reasonable, customary, and eligible payment guidelines. Please refer to the Certificate Wording for full details of the Precertification requirements.

Send completed claim documents to International Medical Group
Download Claim Forms Email Fax Mail Claim Enquiry

Claim Form

Accident Questionnaire 1 (317) 655-4505

P.O. Box 88500, Indianapolis, IN 46208-0500 USA



1 (317) 655-4500

For Precertification, emergency evacuation and repatriation, please call: IMG in the U.S.: 1 (800) 628-4664 (toll free) or 1 (317) 655-4500. Call IMG outside the U.S.: 001 (317) 655-4500 (collect if necessary). This information will also be provided on your ID card.
Note: You may begin the Precertification process through MyIMG or the Client Resources section of our website, Simply look for the Precertification option. You will be asked to provide the required information, which can then be submitted electronically to IMG. Once we have confirmed receipt of your request, our utilization management and review team will review the information provided and respond to the insured person or the provider within 2 business days. Please note that this online service will only initiate the Precertification process, and it should not be used to Precertify emergency admissions, procedures, or evacuations.
All benefits payable under Patriot Exchange Program are subject to the provisions described in this brochure and as contained in the Certificate Wording and certificate of coverage. To make claim processing efficient, claims may be paid in two ways:
  • Eligible claims that have been paid by or on behalf of the Insured Person will be reimbursed by check directly to the Insured Person.
  • Eligible claims that have not yet been paid by the Insured Person will, at the option of IMG, be paid either to the Insured Person or  directly to the provider.

Universal Rx Pharmacy Discount Savings

This is a discount savings program available to every certificate holder of the Patriot Exchange Program plans. This program allows card members to purchase prescriptions at one of over 35,000 participating pharmacies in the U.S. and receive the lower of 1) Universal Rx contract price or 2) the pharmacy regular retail price.

This discount program is not insurance coverage. It is purely a discount program to purchasers of the Patriot Exchange Program plans. Use of the discount card does not guarantee that prescribed medication is covered under the insurance benefit plan.