Patriot International

Plan Detail

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

Benefits


 

Benefit LIMITS
Maximum Limits $50,000, $100,000, $500,000, $1,000,000, $2,000,000
Individual Deductible $0, $100, $250, $500, $1,000, $2,500

On the Application Form, you will be asked to circle your choice of a deductible. Your premium rate is dependent on the deductible you choose. Please see the Application Form for more information.
Coinsurance - for treatment received outside the U.S. & Canada No Coinsurance
Coinsurance - for treatment received within the U.S. & Canada In the PPO Network- The plan pays 90% of eligible expenses up to $5,000, then 100% up to the Maximum Limit

Out of the PPO Network- The plan pays 80% of eligible expenses up to $5,000, then 100% up to the Maximum Limit
Benefit Period Six months

If a covered injury or illness requires continuing treatment after the Period of Coverage expires, the six-month Benefit Period may offer continued coverage for that injury or illness. When the Certificate
expires, the Company will review the date of initial treatment for the covered injury or illness. If treatment began less than six months before the Period of Coverage expired, benefits for the covered injury or illness continues. This is subject to the Maximum Limits and the other terms of the plan until there have been six months of continuous coverage for the covered injury or illness.
MyIMGSM 24 hour secure access from anywhere in the world to manage your account at anytime
World-class Medical Benefits Coverage available for in-patient and out-patient 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
MEDICAL BENEFITS (Usual, reasonable and customary charges. Subject to deductible and coinsurance when applicable.)
Hospital Room and Board Up to the Maximum Limit for average semi-private room rate
Intensive Care Up to the Maximum Limit
Medical Expenses Up to the Maximum Limit
Out-patient Medical Expenses Up to the Maximum Limit
Local Ambulance Up to the Maximum Limit
Prescription Drugs Up to the Maximum Limit
Emergency Room Accident Up to the Maximum Limit

Charges incurred for the use of the Emergency Room due to an accident or illness are covered up to the Maximum Limit.
Emergency Room Illness with In-patient Admission Up to the Maximum Limit
Emergency Room Illness without In-patient Admission Up to the Maximum Limit with additional $250 deductible

Charges incurred for the use of the Emergency Room for treatment of an illness are subject to an additional (extra) $250 deductible if treatment does not require admission to the hospital.
Dental - Injury Due to Accident Up to the Maximum Limit

Each Patriot Travel Medical Insuranceplan covers the cost of emergency dental treatment and dental procedures necessary to restore or replace sound natural teeth lost or damaged in an accident up to the Maximum Limit.
Dental - Sudden Dental Emergency Up to $100

Each plan will pay up to $100 for the necessary treatment of sudden, unexpected pain to sound natural teeth.
Hospital Daily Indemnity

Up to $100 per night up to a maximum of 10 days

Each plan pays $100 directly to the insured person for each night of a required overnight stay in a hospital up to a maximum of 10 days. The hospital stay must be covered under this plan in order to
receive this benefit. This benefit is not available for Patriot America (non-U.S. citizens) if the hospitalization is due to the Sudden Recurrence of a Pre-existing Condition.

INTERNATIONAL EMERGENCY CARE
Emergency Medical Evacuation Up to $500,000 lifetime maximum (independent of the Maximum Limit)

The Patriot plan offer coverage for Emergency Medical Evacuation to the nearest qualified medical facility; expenses for reasonable transportation resulting from the evacuation; and the cost of returning to either the home country or the country where the evacuation occurred, up to a $500,000 lifetime maximum (independent of the Maximum Limit).
Emergency Reunion Up to $50,000

Each Patriot plan also offers Emergency Reunion coverage, up to $50,000 for a maximum of 15 days, for the reasonable travel and lodging expenses of a relative or friend during an Emergency Medical Evacuation: either the cost of accompanying the insured during the evacuation or traveling from the home country to be reunited with the insured.
Return of Mortal Remains or Cremation/Burial Up to $50,000 for Return of Mortal Remains or $5,000 for Cremation/Burial

If a covered illness/injury results in death, expenses for Repatriation of bodily remains or ashes to the home country will be covered up to a maximum of $50,000; or up to $5,000 for the preparation, local burial or cremation of your mortal remains at the place of death.
Return of Minor Children Up to $50,000

If a covered illness/injury results in a hospitalization and/or death of the insured person, and he/she is traveling alone with child(ren) 19 or under that otherwise would be left unattended, the Patriot plans will pay up to $50,000 for one way economy fare to their home country, including a chaperone, if necessary, for the safety of the child(ren).

To be eligible for the Evacuation, Reunion and Return benefits, these must be recommended by the attending physician in life-threatening medical situations, and approved in advance and coordinated by IMG.
Political Evacuation

Up to $10,000

If the United States Department of State, Bureau of Consular Affairs, or similar government organization of the insured person’s Home Country, orders the evacuation of all non-emergency government personnel from the Host Country, due to political unrest, that becomes effective on or after the Insured Person’s date of arrival in the host country, the Company will pay up to a $10,000 lifetime maximum for transportation to the nearest place of safety or for repatriation to the insured person’s home country or country of residence provided that:

  1. The insured person contacts the Company within 10 days of the United States Department of State, Bureau of Consular Affairs, or similar government organization of the insured person’s Home Country, issuance of the evacuation order; and
  2. The evacuation order pertains to persons from the same Home Country as the Insured Person; and
  3. Political Evacuation and Repatriation is approved and coordinated by the Company; In no event will the Company pay for a Political Evacuation if there is a travel warning in effect on or within six (6) months prior to the insured person’s date of arrival in the host country.
Natural Disaster $100 per day for five days

This benefit is available in the event an insured person is required to depart his/her destination due to an evacuation order issued by prevailing authorities in connection with a Natural Disaster. Natural Disaster is defined as widespread disruption of human lives by disasters such as flood, drought, tidal wave, fire, hurricane, earthquake, windstorm, or other storm, landslide, or other natural catastrophe or event resulting in migration of the population for its safety.
Identity Theft Assistance Up to $500 per Period of Coverage

If an imposter obtains key personal information such as a Social Security or Driver's License number, or other method of identifying an insured person in order to impersonate or obtain credit, merchandise or services in the insured person’s name, the Patriot plans provide coverage up to $500 for the reasonable, customary and necessary costs incurred by the insured for: re-filing a loan or other credit application that is rejected solely as a result of the stolen identity event; notarization of legal documents, long distance telephone calls, and postage that has resulted solely as a result of reporting, amending and/or rectifying records as a result of the stolen identity event; up to three credit reports obtained within one year of the insured person’s knowledge of the stolen identity event; and stop payment orders placed on missing or unauthorized checks as a result of the stolen identity event.

The identity theft event must occur during the Period of Coverage.
ADDITIONAL BENEFITS
Terrorism

Up to $50,000 lifetime maximum

Each Patriot plan provides coverage for injuries and illness incurred as a result of an act of  Terrorism, limited in amount and by circumstances. If an insured person is injured as a result of an act of Terrorism, and the insured person has no direct or indirect participation in the act, the plan reimburses eligible medical claims subject to a $50,000 lifetime maximum. Terrorism includes criminal acts, including against civilians, committed with the intent to cause death or serious bodily injury, or taking of hostages, with the purpose to provide a state of terror in the general public or in a group of persons or particular persons, intimidate a population, or compel a government or international organization to do or to abstain from doing an act. However, this benefit does not cover an act of Terrorism in any country or location where the United States government has issued a travel advisory that has been in effect within the six months prior to the insured person’s date of arrival. In addition, claims incurred as a result of radiological, nuclear, chemical or biological weapons or events are not covered.

This benefit also does not cover an act of Terrorism in the event that an advisory to leave a certain country or location is issued by the United States government after the insured person’s arrival date, and the insured person unreasonably fails or refuses to heed such warning or depart the country or location.

Sports & Activities Coverage Up to the Maximum Limit for basic sports

Each Patriot plan covers injuries incurred during athletic activities which are non-organized, non-contact and engaged in by the insured person solely for leisure, recreation, entertainment or fitness purposes. Some of these sports and activities include, but are not limited to, motor cycle/motorscooter riding, recreational downhill and/or cross country snow skiing, horseback riding, sub-aquatic activities (to 10m), wakeboarding, and water skiing. However, activities not covered include amateur or professional sports or other athletic activity which is organized and/or sanctioned by the National Collegiate Athletic Association (and/or any other collegiate sanctioning or government body), or the International Olympic Committee, and or Adventure Sports. Please note this is only a summary of sports and activities and exclusions. For additional information, please refer to the Certificate of Insurance.
Sudden and Unexpected Recurrence of a Pre-existing Condition - Medical
(for U.S. citizens only)

Up to age 65 with primary health plan: URC up to plan maximum.

Up to age 65 without primary health plan: $20,000 lifetime maximum.

Age 65+: $2,500 lifetime maximum

For those up to age 65 with a primary health plan, Patriot International will pay the Usual, Reasonable and Customary charges of a sudden and unexpected recurrence of a Pre-existing
Condition (defined on page 16) up to the plan maximum. For those without a primary health plan, Patriot International will pay up to a $20,000 lifetime maximum. For those age 65 and older, with or without a primary health plan, Patriot International will pay up to a $2,500 lifetime maximum. The primary health plan must have existed prior to the effective date and during coverage of the Patriot plan, and the Pre-existing Condition must be covered under the primary health plan.

Sudden and Unexpected Recurrence of a Pre-existing Condition - Emergency Medical Evacuation

Up to $25,000 of eligible costs and expenses

In addition, up to $25,000 will be paid to U.S. citizens for the eligible costs and expenses of an Emergency Medical Evacuation arising or resulting from a sudden and unexpected recurrence of a Pre-existing Condition.

Incidental Home Country Coverage Up to a cumulative two weeks

During the Period of Coverage an insured person may return to their home country for incidental visits up to a cumulative two weeks total, subject to:

1. The insured person must have left their home country,
2. The total Period of Coverage must be for a minimum of 30 days, and
3. The return to the home country may not be taken to receive treatment for an illness or injury incurred while traveling.
End of Trip Home Country Coverage One month for every five months of travel coverage purchased, up to a maximum of two months.

For every five months of continuous coverage you purchase, you can purchase one additional month of home country coverage as an accommodation and supplemental travel benefit, up to a maximum of two months. To purchase this special home country extension coverage, please calculate your premium on the Application Form to include the additional month(s).
Trip Interruption Up to $5,000

If, during a covered trip, there is an unexpected death of an immediate family member (spouse, child, parent or sibling), a break-in at the insured’s principle residence, or the substantial destruction of the insured’s principal residence due to a fire or natural disaster, each Patriot plan  pays to return the insured to the area of principal residence. The plan pays for a one way air or ground transportation ticket of the same class as the unused travel ticket, less the value of the unused return ticket.
Common Carrier Accidental Death $50,000 to beneficiary; maximum of $250,000 per family

If accidental death should occur while traveling on a commercial Common Carrier, $50,000 payable to the designated beneficiary, to a maximum of $250,000 per family.
Accidental Death & Dismemberment

$25,000 principle sum

Each Patriot plan offers $25,000 principal sum benefit for Accidental Death and Dismemberment occurring during the Period of Coverage:

  • Accidental Loss of life - principal sum
  • Accidental Loss of two Members - principal sum
  • Accidental Loss of one Member - 50% of principal sum. “Member” means hand, foot or eye.
Lost Luggage Up to $50 per item of personal property; maximum of $250

A benefit of $50 per luggage item, up to a maximum of $250, is payable in the event that the Common Carrier permanently loses an insured person’s checked luggage while in transit. This coverage is secondary to any other available reimbursement, including the Carrier’s.
OPTIONAL RIDERS
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

The Adventure Sports Rider is available for those up to the age of 65. The following activities are covered to the lifetime maximum amounts listed on page four as long as they are engaged solely for leisure, recreation, or entertainment purposes: abseiling, BMX, bobsledding, bungee jumping, canyoning, caving, hang gliding, heli-skiing, high diving, hot air ballooning, inline skating, jet skiing, jungle zip lining, kayaking, mountain biking, parachuting, paragliding, parascending, piloting a non commercial aircraft, rappelling, rock climbing or mountaineering (ropes and guides to 4500m from ground level), scuba diving (to 50m), skydiving, snorkeling, snowboarding, snowmobiling, snow skiing, spelunking, surfing, trekking, whitewater rafting (to Class V), wildlife safaris, and  windsurfing. All such activities must be carried out in strict accordance with the rules, regulations and guidelines of the applicable Governing Body or Authority of each such activity. Certain sports activities are never covered, regardless of whether or not you purchase the Adventure Sports Rider. Please see page 16, exclusion 8. Please note this is only a summary of Adventure Sports and exclusions. For additional information, please refer to the Certificate of Insurance.
Enhanced AD&D Rider
(available to the primary insured only)
Up to an additional $400,000

This optional coverage is available for the primary insured person only. This coverage is in addition to the Accidental Death and Dismemberment already included in the Patriot plans. This rider is available with a minimum purchase of three months of medical and AD&D rider coverage.
Citizenship Return Rider Up to the Maximum Limit

When purchased at the time of application, the Citizenship Return Rider provides temporary medical coverage for non-U.S. citizens returning to their country of citizenship.
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

This optional rider is available to insureds up to age 65. It provides coverage for medical evacuations for sudden and unexpected medical conditions that are non life-threatening and where hospitalization is medically necessary. It also offers coverage for evacuations as a result of a natural disaster. This rider must be purchased for a minimum of three months regardless of the minimum number of days being traveled.

This web page contains only a consolidated and summary description of all current Patriot Travel Medical Insurance benefits, conditions, limitations and exclusions. A certificate containing the complete Certificate Wording with all terms, conditions and exclusions will be included in the fulfillment kit. The Patriot Travel Medical Insurance plans are amended, modified or replaced from time to time, and IMG reserves the right to issue the most current Certificate Wording for this insurance plan in the event this application and/or brochure has expired, is modified, or is replaced with a newer version. Current Certificate Wordings are available upon request.

This web page contains only a consolidated and summary description of all current Patriot Travel Medical Insurance benefits, conditions, limitations and exclusions. A certificate containing the complete Certificate Wording with all terms, conditions and exclusions will be included in the fulfillment kit. The Patriot Travel Medical Insurance plans are amended, modified or replaced from time to time, and IMG reserves the right to issue the most current Certificate Wording for this insurance plan in the event this application and/or brochure has expired, is modified, or is replaced with a newer version. Current Certificate Wordings are available upon request.