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Plan E Plus Explorer Travel Medical Insurance®
Plan E Plus Explorer Travel Medical Insurance®

All amounts shown are in U.S. dollars.

Click here to view the benefits for non-U.S. residents traveling outside of their home country

Benefits for U.S. Citizens

Coverage Limit / Maximum Amount for Eligible Medical Expenses
Period of Coverage 5 days up to 12 months
Benefit Period
  • Charges incurred in the United States are not eligible for coverage during the Benefit Period
  • Refer to the BENEFIT PERIOD provision for further details and requirements
3 months
Per Injury or Illness Maximum Limit
  • As indicated on the Declaration
  • Through age 64: $50,000, $100,000, $250,000, $500,000 or $1,000,000
  • Ages 65 to 69: $100,000
  • Ages 70 to 79: $50,000
Area of Coverage Worldwide excluding the Insured Person’s Country of Residence and the United States
Deductible for Eligible Medical Expenses
Deductible $0, $100, $250, $500 per Insured Person, as indicated on the Declaration
Coinsurance for Eligible Medical Expenses
Coinsurance
  • In addition to Deductible
 Plan pays 100%
Insured pays 0%
Out of Pocket Maximum
  • Copayments do not apply toward the Out of Pocket Maximum
 $0
Pre-certification
  • Interfacility Ambulance Transfer: No coverage if Pre-certification requirements are not met.
  • Emergency Medical Evacuation: No coverage if not approved by the Company. Refer to the EMERGENCY MEDICAL EVACUATION provision for complete requirements and coverage.
  • All other Treatments & supplies: 50% reduction of Eligible Medical Expenses if Pre-certification requirements are not met.
  • Deductible is taken after reduction.
  • Coinsurance is applied to remainder of the reduced amount.
  • Refer to the PRE-CERTIFICATION REQUIREMENTS provision for a complete list of services that require Pre-certification.
Pre-existing Conditions
Charges resulting directly or indirectly from or relating to any Pre-existing Condition are excluded from coverage under this insurance.
  • The Pre-existing Condition exclusion is not applicable to the EMERGENCY MEDICAL EVACUATION and RETURN OF MORTAL REMAINS provisions
Acute Onset of Pre-existing Conditions
Subject to Deductible and Coinsurance unless otherwise noted
Eligible Medical Expenses are limited to Usual, Reasonable and Customary
Limits per Period of Coverage
Acute Onset of Pre-existing Conditions
  • Insured Person must be under 70 years of age
  • Not applicable to the EMERGENCY MEDICAL EVACUATION OR RETURN OF MORTAL REMAINS provisions
  • Refer to the ACUTE ONSET OF PRE-EXISTING CONDITIONS provision for further details and requirements
United States citizens:
  • Age 64 and under without a Primary Health Plan:
    • Maximum Limit: $20,000
  • Age 64 and under with a Primary Health Plan:
    • Up to the Period of Coverage limit
  • Age 65 through age 69:
    • Maximum Limit: $2,500
Acute Onset of Pre-existing Conditions
  • Insured Person must be under 70 years of age
  • Refer to the ACUTE ONSET OF PRE-EXISTING CONDITIONS provision for further details and requirements
Non-United States citizens:
  • Age 69 and under:
    • Up to the Period of Coverage limit or $1,000,000 (whichever is lower)
Emergency Medical Evacuation
  • Arises or results directly from a covered Acute Onset of a Pre-existing Condition
  • Insured Person must be under 70 years of age
  • Maximum Limit: $25,000
Inpatient or Outpatient Services
Subject to Deductible and Coinsurance unless otherwise noted
Eligible Medical Expenses are limited to Usual, Reasonable and Customary
Limits per Period of Coverage
Benefit Coinsurance
Eligible Medical Expenses 100%
Physician Visits / Services 100%
Urgent Care Clinic
  • Not subject to Deductible
  • Copayment: $25
  • Copayment is not applicable if the Declaration states a $0 Deductible
100%
Walk-in Clinic
  • Not subject to Deductible
  • Copayment: $15
  • Copayment is not applicable if the Declaration states a $0 Deductible
100%
Hospital Emergency Room 100%
Hospitalization / Room & Board
  • Average semi-private room rate
  • Includes nursing services, miscellaneous and Ancillary services
100%
Intensive Care
Bedside Visit
  • Not subject to Deductible
  • Maximum Limit: $1,500
  • Hospitalized in an Intensive Care Unit
  • Refer to the BEDSIDE VISIT provision for further details
100%
Outpatient Surgical / Hospital Facility 100%
Laboratory 100%
Radiology / X-ray 100%
Chemotherapy / Radiation Therapy 100%
Pre-admission Testing 100%
Surgery 100%
Reconstructive Surgery
  • Surgery is incidental to and follows Surgery that was covered under the plan
 100%
Assistant Surgeon
  • 20% of the primary surgeon’s eligible fee
 100%
Anesthesia 100%
Durable Medical Equipment 100%
Chiropractic Care
  • Medical order or Treatment plan required
 100%
Physical Therapy
  • Medical order or Treatment plan required
 100%
Extended Care Facility
  • Upon direct transfer from an acute care Facility
 100%
Home Nursing Care
  • Provided by a Home Health Care Agency
  • Upon direct transfer from an acute care Facility
100%
Prescription Drugs and Medication
Subject to Deductible and Coinsurance unless otherwise noted
Eligible Medical Expenses are limited to Usual, Reasonable and Customary
Limits per Period of Coverage
The following Prescription Drugs and Medication Maximum Limit accumulates toward the plan Maximum Limit per Injury or Illness
Prescription Drugs and Medication
  • Obtained through Retail Pharmacy, Inpatient and Outpatient Surgery, Emergency Room and Outpatient Office Visits
  • Dispensing maximum for Retail Pharmacy: 90 days per prescription
100%

If the plan Maximum Limit per Illness or Injury is $50,000, $100,000 or $250,000, the Prescription Drugs and Medications limit is up to the plan Maximum Limit per Illness or Injury

If the plan Maximum Limit per Illness or Injury is $500,000 or $1,000,000, the Prescription Drugs and Medications Maximum Limit is up to $250,000 per Period of Coverage
Mental or Nervous / Substance Abuse
Subject to Deductible and Coinsurance unless otherwise noted
Eligible Medical Expenses are limited to Usual, Reasonable and Customary
Limits per Period of Coverage
Inpatient Mental or Nervous / Substance Abuse
  • Maximum Limit: $10,000
  • Not covered if incurred at the Student Health Center
100%
Outpatient Mental or Nervous / Substance Abuse
  • Maximum Limit per day: $50
  • Maximum Limit: $500
  • Not covered if incurred at the Student Health Center
 100%
Emergency Services
NOT Subject to Deductible and Coinsurance unless otherwise noted
Eligible Medical Expenses are limited to Usual, Reasonable and Customary
Limits per Period of Coverage
Emergency Local Ambulance
  • Subject to Deductible and Coinsurance
  • Injury
  • Illness resulting in an Inpatient Hospital admission
100%
Emergency Medical Evacuation
  • Maximum Limit: $1,000,000
  • Approved in advance and coordinated by the Company
100%
Emergency Reunion
  • Maximum Limit: $100,000
  • Maximum days: 15
  • Meal maximum per day: $25
  • Reasonable and necessary travel costs and accommodations
  • Approved in advance by the Company
100%
Interfacility Ambulance Transfer
  • Transfer must be a result of an Inpatient Hospital admission
 100%
Natural Disaster Evacuation
  • Maximum Limit: $25,000
  • Approved in advance by the Company
100%
Political Evacuation and Repatriation
  • Maximum Limit: $100,000
  • Approved in advance by the Company
100%
Return of Minor Children
  • Maximum Limit: $100,000
  • Approved in advance by the Company
100%
Return of Mortal Remains
  • Up to the Period of Coverage limit
  • Local Burial / Cremation Maximum Limit: $5,000
  • Return of Insured Person’s Mortal Remains to Country of Residence
  • Approved in advance by the Company
100%
Other Services
NOT Subject to Deductible and Coinsurance unless otherwise noted
Eligible Medical Expenses are limited to Usual, Reasonable and Customary
Limits per Period of Coverage
Accidental Death & Dismemberment
  • Principal Sum Maximum Limit: $50,000
  • Death must occur within 90 days of the Accident
Accidental Death: 100% of Principal Sum
Dismemberment:  
Accidental Loss Percent of Principal Sum
Sight of one eye 50%
One hand or one foot 50%
One hand and the loss of sight of one eye 100%
One foot and the loss of sight of one eye 100%
One hand and one foot 100%
Both hands or both feet 100%
Sight of both eyes 100%
Common Carrier Accidental Death
  • Maximum Limit per adult: $100,000
  • Maximum Limit per Child: $25,000
  • Maximum Limit per Family: $250,000
100%
Dental Treatment
  • Subject to Deductible and Coinsurance
  • Limit: $300
    (Unexpected pain or Treatment due to an Accident)
100%
Traumatic Dental Injury
  • Subject to Deductible and Coinsurance
  • Treatment at a Hospital due to an Accident
  • Additional Treatment for the same Injury rendered by a Dental Provider will be paid at 100%
100%
Emergency Eye Examination
  • Deductible per occurrence: $50
    (plan Deductible waived)
  • Limit: $150
  • Loss or damage to prescription corrective lenses due to an Accident
100%
Hospital Indemnity
  • Overnight limit: $250
  • Maximum nights: 10
  • Outside Insured Person’s Country of Residence and the United States
  • Inpatient Hospitalization only
100%
Identity Theft
  • Limit: $500
 100%
Lost Luggage
  • Limit: $500
  • Limit: $50 per item
100%
Natural Disaster
  • Limit per day: $250
  • Maximum days: 5
100%
Personal Liability
  • Secondary to any other insurance
  • No coverage for Injury to a related third party or damage to related third person’s property
  • Refer to the PERSONAL LIABILITY provision for further details and requirements
Combined Maximum Limit: $25,000
Injury to third person:
  • Per Injury Deductible: $100
Damage to third person’s property:
  • Per damage Deductible: $100
Pet Return
  • Limit: $1,000
  • For a pet cat or dog travelling with the Insured Person
100%
Small Pet Common Air Carrier Accidental Death Benefit
  • Maximum Limit per pet: $500
  • For a pet cat or dog up to 30 pounds travelling with the Insured Person
100%
Terrorism
  • Maximum Limit: $50,000
 100%
Trip Interruption
  • Limit: $10,000
 100%
Incidental Services
NOT Subject to Deductible and Coinsurance unless otherwise noted
Eligible Medical Expenses are limited to Usual, Reasonable and Customary
Limits per Period of Coverage
Combined Maximum Limit: $50,000
Emergency Treatment While Traveling Through the United States
  • Maximum consecutive days: 14
    (in addition to the combined Maximum Limit)
  • Must be Pre-certified and coordinated by the Company
  • Refer to the EMERGENCY TREATMENT WHILE TRAVELING THROUGH THE UNITED STATES provision for further details and requirements
100%
Emergency Medical Evacuation to the United States and Associated Treatment
  • Maximum consecutive days: 14
    (in addition to the combined Maximum Limit)
  • Must be Pre-certified and coordinated by the Company
  • Refer to the EMERGENCY MEDICAL EVACUATION TO THE UNITED STATES AND ASSOCIATED TREATMENT provision for further details and requirements
100%
Emergency Treatment During Incidental Trip to Country of Residence
  • Maximum consecutive days: 14
    (in addition to the combined Maximum Limit)
  • Must be Pre-certified and coordinated by the Company
  • Refer to the EMERGENCY TREATMENT DURING INCIDENTAL TRIP TO COUNTRY OF RESIDENCE provision for further details and requirements
100%

Click here to view the benefits for U.S. residents traveling outside of the U.S.

Benefits for Non-U.S. Citizens

Coverage Limit / Maximum Amount for Eligible Medical Expenses
Period of Coverage 5 days up to 12 months
Per Injury/Illness Maximum Limit
  • Through age 64: $50,000, $100,000, $250,000, $500,000 $1,000,000 per insured Person, as indicated on the Declaration
  • Ages 65 to 69: $100,000
  • Ages 70 to 79: $50,000
Area of Coverage Worldwide excluding the Insured Person’s Country of Residence
Benefit Plan Features
Benefit Levels United States United States International
In-Network Out-of-Network International
Deductible for Eligible Medical Expenses
Deductible $0, $100, $250, $500 per Insured Person, as indicated on the Declaration
Coinsurance for Eligible Medical Expenses
Coinsurance
  • In addition to Deductible
 Plan pays 100%
Insured pays 0% 		Plan pays 80%
Insured pays 20% 		Plan pays 100%
Insured pays 0%
Out of Pocket Maximum $0 $1,000 $0
Pre-certification
  • Interfacility Ambulance Transfer: No coverage if Pre-certification requirements are not met.
  • Emergency Medical Evacuation: No coverage if not approved by the Company. Refer to the EMERGENCY MEDICAL EVACUATION provision for complete requirements and coverage.
  • All other Treatments & supplies: 50% reduction of Eligible Medical Expenses if Pre-certification requirements are not met.
  • Deductible is taken after reduction.
  • Coinsurance is applied to remainder of the reduced amount.
  • Refer to the PRE-CERTIFICATION REQUIREMENTS provision for a complete list of services that require Pre-certification.
Pre-existing Conditions
Charges resulting directly or indirectly from or relating to any Pre-existing Condition are excluded from coverage under this insurance.
  • The Pre-existing Condition exclusion is not applicable to the EMERGENCY MEDICAL EVACUATION and RETURN OF MORTAL REMAINS provisions
Inpatient or Outpatient Services
Subject to Deductible and Coinsurance unless otherwise noted
Eligible Medical Expenses are limited to Usual, Reasonable and Customary
Limits per Period of Coverage
Benefit In-Network Out-of-Network International
Eligible Medical Expenses 100% 80% 100%
Physician Visits / Services 100% 80% 100%
Urgent Care Clinic
  • Not subject to Deductible
  • Copayment: $25
  • Copayment is not applicable if the Declaration states a $0 Deductible
100% 80% 100%
Walk-in Clinic
  • Not subject to Deductible
  • Copayment: $15
  • Copayment is not applicable if the Declaration states a $0 Deductible
100% 80% 100%
Teladoc Consultation
  • Not subject to Deductible and Coinsurance
  • Services rendered in the United States only
  • Coverage for a Teladoc Consultation is not a determination that any specific condition discussed, raised or identified during such consultation is covered under this insurance. The Company reserves the right to decline future claims relating to or arising from any condition discussed, raised or identified during a Teladoc Consultation where the Illness or Injury is directly or indirectly related to any Pre-existing Condition or is otherwise excluded under this Certificate of Insurance
100% Not Applicable Not Applicable
Hospital Emergency Room: United States
  • 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 a direct Hospital admission
100% 80% Not Applicable
Hospital Emergency Room: International Not Applicable Not Applicable 100%
Hospitalization / Room & Board
  • Average semi-private room rate
  • Includes nursing services, miscellaneous and Ancillary services
100% 80% 100%
Intensive Care 100% 80% 100%
Bedside Visit
  • Not subject to Deductible
  • Maximum Limit: $1,500
  • Hospitalized in an Intensive Care Unit
  • Refer to the BEDSIDE VISIT provision for further details
100% 80% 100%
Outpatient Surgical / Hospital Facility 100% 80% 100%
Laboratory 100% 80% 100%
Radiology / X-ray 100% 80% 100%
Chemotherapy / Radiation Therapy 100% 80% 100%
Pre-admission Testing 100% 80% 100%
Surgery 100% 80% 100%
Reconstructive Surgery
  • Surgery is incidental to and follows Surgery that was covered under the plan
 100% 80% 100%
Assistant Surgeon
  • 20% of the primary surgeon’s eligible fee
 100% 80% 100%
Anesthesia 100% 80% 100%
Durable Medical Equipment 100% 80% 100%
Chiropractic Care
  • Medical order or Treatment plan required
 100% 80% 100%
Physical Therapy
  • Medical order or Treatment plan required
 100% 80% 100%
Extended Care Facility
  • Upon direct transfer from an acute care Facility
 100% 80% 100%
Home Nursing Care
  • Provided by a Home Health Care Agency
  • Upon direct transfer from an acute care Facility
100% 80% 100%
Prescription Drugs and Medication
Subject to Deductible and Coinsurance unless otherwise noted
Eligible Medical Expenses are limited to Usual, Reasonable and Customary
Limits per Period of Coverage
The following Prescription Drugs and Medication Maximum Limit accumulates toward the plan Maximum Limit per Injury or Illness
Prescription Drugs and Medication
  • Obtained through Retail Pharmacy, Inpatient and Outpatient Surgery, Emergency Room and Outpatient Office Visits
  • Dispensing maximum for Retail Pharmacy: 90 days per prescription
Not Applicable 80% 100%

If the plan Maximum Limit per Illness or Injury is $50,000, $100,000 or $250,000, the Prescription Drugs and Medications limit is up to the plan Maximum Limit per Illness or Injury

If the plan Maximum Limit per Illness or Injury is $500,000 or $1,000,000, the Prescription Drugs and Medications Maximum Limit is up to $250,000 per Period of Coverage
Mental or Nervous / Substance Abuse
Subject to Deductible and Coinsurance unless otherwise noted
Eligible Medical Expenses are limited to Usual, Reasonable and Customary
Limits per Period of Coverage
Inpatient Mental or Nervous / Substance Abuse
  • Maximum Limit: $10,000
  • Not covered if incurred at the Student Health Center
100% 80% 100%
Outpatient Mental or Nervous / Substance Abuse
  • Maximum Limit per day: $50
  • Maximum Limit: $500
  • Not covered if incurred at the Student Health Center
 100% 80% 100%
Emergency Services
NOT Subject to Deductible and Coinsurance unless otherwise noted
Eligible Medical Expenses are limited to Usual, Reasonable and Customary
Limits per Period of Coverage
Emergency Local Ambulance
  • Subject to Deductible and Coinsurance
  • Injury
  • Illness resulting in an Inpatient Hospital admission
Not Applicable 80% 100%
Emergency Medical Evacuation
  • Maximum Limit: $50,000
  • Approved in advance and coordinated by the Company
 100% 100% 100%
Emergency Reunion
  • Maximum Limit: $100,000
  • Maximum days: 15
  • Meal maximum per day: $25
  • Reasonable and necessary travel costs and accommodations
  • Approved in advance by the Company
 100% 100% 100%
Interfacility Ambulance Transfer
  • Transfer must be a result of an Inpatient Hospital admission
 100% 100% 100%
Natural Disaster Evacuation
  • Maximum Limit: $25,000
  • Approved in advance by the Company
 100% 100% 100%
Political Evacuation and Repatriation
  • Maximum Limit: $100,000
  • Approved in advance by the Company
 100% 100% 100%
Return of Minor Children
  • Maximum Limit: $100,000
  • Approved in advance by the Company
 100% 100% 100%
Return of Mortal Remains
  • Up to the Period of Coverage limit
  • Local Burial / Cremation Maximum Limit: $5,000
  • Return of Insured Person’s Mortal Remains to Country of Residence
  • Approved in advance by the Company
 100% 100% 100%
Other Services
NOT Subject to Deductible and Coinsurance unless otherwise noted
Eligible Medical Expenses are limited to Usual, Reasonable and Customary
Limits per Period of Coverage
Accidental Death & Dismemberment
  • Principal Sum Maximum Limit: $50,000
  • Death must occur within 90 days of the Accident
Accidental Death: 100% of Principal Sum
Dismemberment:  
Accidental Loss Percent of Principal Sum
Sight of one eye 50%
One hand or one foot 50%
One hand and the loss of sight of one eye 100%
One foot and the loss of sight of one eye 100%
One hand and one foot 100%
Both hands or both feet 100%
Sight of both eyes 100%
Common Carrier Accidental Death
  • Maximum Limit per adult: $100,000
  • Maximum Limit per Child: $25,000
  • Maximum Limit per Family: $250,000
100% 100% 100%
Dental Treatment
  • Subject to Deductible and Coinsurance
  • Limit: $300 (Unexpected pain or Treatment due to an Accident)
Not Applicable 80% 100%
Traumatic Dental Injury
  • Subject to Deductible and Coinsurance
  • Treatment at a Hospital due to an Accident
  • Additional Treatment for the same Injury rendered by a Dental Provider will be paid at 100%
100% 80% 100%
Emergency Eye Examination
  • Subject to Coinsurance
  • Deductible per occurrence: $50 (plan Deductible waived)
  • Limit: $150
  • Loss or damage to prescription corrective lenses due to an Accident
Not Applicable 80% 100%
Hospital Indemnity
  • Overnight limit: $250
  • Maximum nights: 10
  • Outside Insured Person’s Country of Residence and the United States
  • Inpatient Hospitalization only
Not Applicable Not Applicable 100%
Identity Theft
  • Limit: $500
 100% 100% 100%
Incidental Trip
  • Maximum days: 14
  • Insured Person’s Country of Residence is not the United States
100% 100% 100%
Lost Luggage
  • Limit: $500
  • Limit: $50 per item
100% 100% 100%
Natural Disaster
  • Limit per day: $250
  • Maximum days: 5
100% 100% 100%
Personal Liability
  • Secondary to any other insurance
  • No coverage for Injury to a related third party or damage to related third person’s property
  • Refer to the PERSONAL LIABILITY provision for further details and requirements
Combined Maximum Limit: $25,000
Injury to third person:
  • Per Injury Deductible: $100
Damage to third person’s property:
  • Per damage Deductible: $100
Pet Return
  • Limit: $1,000
  • For a pet cat or dog travelling with the Insured Person
100% 100% 100%
Small Pet Common Air Carrier Accidental Death Benefit
  • Maximum Limit per pet: $500
  • For a pet cat or dog up to 30 pounds travelling with the Insured Person
100% 100% 100%
Terrorism
  • Maximum Limit: $50,000
 100% 100% 100%
Trip Interruption
  • Limit: $10,000
 100% 100% 100%

* 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.

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