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Patriot America® Plus
Patriot America® Plus

Summary of Benefits

All amounts shown are in U.S. dollars.

PLAN INFORMATION
Maximum Limit Per Period of Coverage Options $50,000, $100,000, $500,000
Individual Deductible Options Your choice of $0, $100, $250, $500, $1,000 or $2,500
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 medical expenses up to $5,000, then 100%
Out of the PPO Network -The plan pays 80% of eligible medical expenses up to $5,000, then 100%
Continuation of Treatment Period Earlier of 6 months per Injury or Illness or upon return to Home Country
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
INPATIENT/OUTPATIENT BENEFITS Subject to the coinsurance and deductible when applicable and Usual, Reasonable, and Customary (URC)
Hospital Room and Board Average semi-private room rate up to the maximum limit
Intensive Care Unit Up to the maximum limit
Eligible Medical Expenses Up to the maximum limit
Acute Onset of Pre-existing Condition prior to age 70 - Medical Expenses Up to the maximum limit
Local Ambulance Up to the maximum limit
Prescription Medication Up to the maximum limit
Emergency Room Accident Up to the maximum limit
Emergency Illness - with In-patient Admission Up to the maximum limit
Emergency Illness - without In-patient Admission Up to the maximum limit. Additional $250 deductible
Dental - Treatment related to an Accident Up to the maximum limit
Dental - Emergency $100 maximum
Hospital Daily Indemnity $100 per overnight, up to a maximum of 10 overnights
Terrorism $50,000 lifetime maximum
Recreational Sports & Activities URC for non-organized, non-contact, and non-collision activities
EVACUATION BENEFITS Not subject to a deductible or coinsurance.
Emergency Medical Evacuation $500,000 lifetime maximum (independent of the Maximum Limit)
Acute Onset of Pre-existing Condition prior to age 70 - Emergency Medical Evacuation $25,000 lifetime maximum
Emergency Reunion $50,000 lifetime maximum
Return of Mortal Remains or
Cremation/Burial
$50,000 for Return of Mortal Remains or
$5,000 for Cremation/Burial
Return of Minor Children $50,000 lifetime maximum
Political Evacuation $10,000 lifetime maximum
ADDITIONAL BENEFITS Not subject to a deductible or coinsurance.
Incidental Trips Up to a cumulative two weeks
End of Trip Home Country Coverage One month for every six months of continuous coverage, up to two months maximum
Trip Interruption $5,000 maximum
Common Carrier Accidental Death $50,000 to beneficiary; maximum of $250,000 per family
Accidental Death & Dismemberment $25,000 principal sum
Lost Luggage $50 per item; maximum of $250
Natural Disaster $100 per day for five days maximum
Identity Theft $500 maximum

* This Web page contains only a consolidated and summary description of all current 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. IMG reserves the right to issue the most current Certificate Wording for this insurance plan in the event this Web page, application, and/or brochure has expired, is modified, or is replaced with a newer version. Current Certificate Wordings are available upon request.