GlobeHopper® Senior Multi-Trip
GlobeHopper® Senior Multi-Trip

All amounts shown are in U.S. dollars. URC - Usual, Reasonable and Customary charges.
Limit/Other Limit/Amount for Eligible Medical Expenses
Period of Coverage 12 Months with maximum of 30 days per trip
Area of Coverage Outside the United States
Maximum Limit per Period of Coverage
Age: 65-79
$1,000,000
Maximum Limit per Period of Coverage
Age: 80+
$100,000
Deductible $250 per Illness/ Injury
Coinsurance No coinsurance
Sudden & Unexpected Reoccurrence of Pre-existing Condition Eligible medical expenses: $5,000 maximum limit.
Emergency medical evacuation: $25,000 maximum limit.
Inpatient/Outpatient Benefits
Charges for
Maximum Limits per Period of Coverage, or if indicated, per lifetime
Hospital Room & Board Average semi-private room rate
Intensive Care Unit Up to maximum limit
Surgery Up to maximum limit
Physician Visits Up to maximum limit
Radiology/X-Ray UUp to maximum limitRC
Prescription Medication Up to maximum limit
(Dispensing limit per prescription: 90 days)/td>
Home Nursing Care Up to maximum limit
Durable Medical Equipment Up to maximum limit
Continuation of Treatment Period $5,000 maximum limit and up to 30 days per injury or illness
Evacuation Benefits
(Must be approved in advance and coordinated by the company. Not subject to the deductible)
LIMITS PER PERIOD OF COVERAGE UNLESS STATED AS MAXIMUM LIMIT
Emergency Medical Evacuation $250,000 maximum limit
Emergency Reunion $50,000 maximum limit
Non-Emergency Medical Evacuation N/A (only offered under Evacuation Plus rider)
Return of Mortal Remains $50,000 maximum limit
Local Burial/Cremation $5,000 maximum limit
Political Evacuation $50,000 maximum limit
Interfacility Transportation $2,500 maximum limit
Natural Disaster $100 per day for five days, $5,000 maximum limit for evacuations
Additional Benefits Limits per Period of Coverage unless stated as Maximum Limit
Terrorism $50,000 maximum limit. Not subject to the deductible
Accidental Death and Dismemberment $25,000 principal sum. Not subject to deductible
Common Carrier Accidental Death $100,000 per adult/ $250,000 maximum limit per family
Trip Interruption $5,000 maximum limit
Lost Luggage $50 per item, $500 maximum limit. Not subject to deductible
Hospital Indemnity $250 per overnight inpatient confinement, maximum limit of 5 overnights. Not subject to deductible
Identity Theft $500 maximum limit. Not subject to deductible
Felonious Battery maximum limit. Not subject to deductible
Emergency Local Ambulance
(Injury or illness resulting in an inpatient hospital admission)
Up to the maximum limit
Hospital Emergency Room Injury not subject to emergency room deductible. Illness: Subject to a $250 deductible for each emergency room visit for treatment that does not result in direct inpatient hospital admission. Up to the maximum limit
Traumatic Dental Injury
(Treatment at a hospital due to an accident)
Up to the maximum limit. Additional treatment for the same injury rendered by a dental provider will be paid at 100%. Subject to deductible and coinsurance
Dental Treatment $100 maximum limit due to dental accident or unexpected pain to sound natural teeth. Subject to deductible and coinsurance

This invitation to inquire allows eligible applicants an opportunity to inquire further about the insurance offered and is limited to a brief description of any loss for which benefits may be payable. Benefits are offered as described in the insurance contract. Benefits are subject to all deductibles, coinsurance, provisions, terms, conditions, limitations, and exclusions in the insurance contract. The contract does contain a pre-existing condition exclusion and does not cover losses or expenses related to a pre-existing condition.