Why Consider Patriot America Visitors Insurance?                               

Why Patriot America®

CONDITIONS OF COVERAGE   

     

1. Coverage and benefits are subject to the deductible and coinsurance, and all terms of the Certificate of Insurance and Master Policy.  

2. Coverage under a Patriot plan is secondary to any other coverage.

3. Coverage and benefits are for medically necessary, usual, reasonableand customary charges only.                

4. Charges must be administered or ordered by a physician.           

5. Charges must be incurred during the Period of Coverage or the Benefit Period.  

6. Claims must be presented to IMG for payment within ninety (90) days from the date the claim was incurred.

 

ELIGIBILITY

 

The following conditions apply to all persons applying for and/or enrolling in Patriot Travel Medical Insurance.

 

 Patriot Travel Medical Insurance is travel insurance for U.S. citizens traveling outside the United States with coverage for brief returns to the U.S., and for non-U.S. citizens traveling outside their home country. „ For those under 65 years of age and visiting the U.S., your initial Period of Coverage must begin within six months of arrival in the U.S.  For those 65 years of age and older, it must beginwithin 30 days of arrival.  These requirements will be waived with proof of previous valid international travel insurance. Prior U.S. domestic health care coverage does not meet this eligibility requirement.  Please provide the name of your international insurance carrier on the Application Form.  If you are not in the U.S. at the time of application, please indicate your expected date of arrival on your Application Form.

 

RENEWAL OF COVERAGE

 

If your Patriot plan is purchased for a  minimum of one month, coverage may be renewed (unless there is a break in coverage) for a total of up to two years.  Renewals are available in whole month or daily increments and may be completed online or by using a paper application, however, renewals of less than one month are available only online. For each renewal of less than one month completed online, you will be charged an additional $5 processing fee. Each insured person must only satisfy one deductible and coinsurance within each 12 month coverage period. Please note: Renewal rates may differ from initial rates. Eligibility to purchase, extend or renew this product, or its terms and conditions, may be modified or amended based upon changes to applicable law, including the Patient Protection and Affordable Care Act (PPACA).

 

QUALITY GUARANTEE

 

Your satisfaction is very important to IMG. If you are not pleased with this product for any reason, you may submit a written request, prior to your effective date, for cancellation and refund of your premium. If you do not have any claims filed with IMG, you may cancel your plan after your effective date, however, the following conditions will apply: 

1. You will be required to pay a $50 cancellation fee and 

2. only full month premiums will be considered for refunds (e.g., if you choose to cancel your coverage two months and two weeks  prior to the date your coverage ends, IMG will only consider the two full months for a refund). If you have filed claims, your premium is non-refundable.

*EVERY INSURANCE POLICY COMES WITH OUR EXCLUSIVE MAESTRO TRAVEL COMPANION

 

 

 

 

ENROLLMENT PROCESS & APPLICATION FORM 

 

You should read the following important information prior to completing the Application Form.

HOW TO ENROLL

Before you begin your travel, simply fill out the Application Form and calculate the premium for the time period you and/or your family will be traveling. Once you have completed the Application Form, return it to your insurance agent or broker, and/or mail it to GMI.

 

You, your spouse and unmarried dependent children (over 14 days and under 18 years of age) listed on the Application Form and for whom premiums have been paid will be covered from the latest of the following dates: 

1. The date IMG receives your completed Application Form and the appropriate premium; 

2. the date you depart from your home country; or 

3. the date requested on your Application Form.   

 

Patriot Travel Medical Insurance coverage ends on the earliest of the following dates: 

1. The end of the period for which premium has been paid;

2. the date requested on your Application Form; or  

3. the date you return to your home country (however, see End of Trip Home Country Coverage on page 13).

ONLINE FULFILLMENT KIT

 

For convenience, approved applicants may choose to commu-nicate electronically and download their fulfillment kit from the IMG website for immediate access. To do this, you must check the appropriate box listed in Section 2 of the application form. We must have your correct email address to complete this process. If IMG has processed and approved your application form, you will receive an email from IMG that contains all the hyperlinks to easily obtain the fulfillment information through the Internet.

 

CLAIMS PROCEDURE

 

PRECERTIFICATION

Each proposed hospital admission, in-patient or out-patient surgery,and other procedures as noted in the Certificate of Insurance must be Precertified for medical necessity, which means the insured person or their attending physician must communicate with an IMG representative at the number listed on the IMG identification card prior to admission 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 eligible for reimbursement must be medically necessary and will be paid or reimbursed at usual, reasonable, and customary rates. Please refer to the Certificate of Insurance for full details of the Precertification requirements. For Precertification, emergency evacuation, and return of mortal remains, 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: An insured person may begin the Precertification process through MyIMG or the Client Resources section of our website, www.imglobal.com. 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 two 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.  

 

CLAIM PAYMENT

All benefits payable under Patriot Travel Medical Insurance are subject to the terms and conditions in the Certificate of Insurance. To make claim processing efficient, claims may be paid in two ways:

1. Eligible expenses that have been paid by or on behalf of the insured person may be reimbursed by check directly to the insured person.  

2. Eligible expenses that have not yet been paid by the insured person may, at the option of IMG, be paid either to the insured  person or directly to the provider. Claim forms can be accessed at www.imglobal.com and mailed to International Medical Group, P.O. Box 88500, Indianapolis, IN 462080500 USA.  All IMG contact numbers, claim forms and the Certificate of Insurance are included in the fulfillment kit. IMG may also be contacted by fax:  1.317.655.4505 or email: insurance@imglobal.com. 

*EVERY INSURANCE POLICY COMES WITH OUR EXCLUSIVE MAESTRO TRAVEL COMPANION

 

 

SUMMARY OF BENEFITS

The following is a summary of benefits and terms that are available to eligible insureds on the Patriot plans.

 

DEDUCTIBLE:

 

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.

EMERGENCY ROOM:

Charges incurred for the use of the Emergency Room due to an accident or illness are covered up to the Maximum Limit. 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 an accident - Each Patriot Travel Medical Insurance plan covers the cost of emergency dental treatment and dental surgical procedures necessary to restore or replace sound natural teeth lost or damaged in an accident up to the Maximum Limit.  Sudden dental emergency - Each plan will pay up to $100 for the necessary treatment of sudden, unexpected pain to sound natural teeth.

SUDDEN AND UNEXPECTED RECURRENCE OF A

PRE-EXISTING CONDITION:

 

(Non-U.S. citizens only) For those under age 65, Patriot America wil pay up to a $50,000 lifetime maximum for eligible medical expenses. For those age 65 and older, Patriot America will pay up to $2,500 lifetime maximum. In addition, up to $25,000 will be paid to U.S. and non-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.

 

HOSPITAL DAILY INDEMNITY:

 

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.

BENEFIT PERIOD:

 

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.

 

INTERNATIONAL EMERGENCY CARE

 

POLITICAL EVACUATION:

 

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 pays 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 politica evacuatio 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. 

*EVERY INSURANCE POLICY COMES WITH OUR EXCLUSIVE MAESTRO TRAVEL COMPANION

 

*EVERY INSURANCE POLICY COMES WITH OUR EXCLUSIVE MAESTRO TRAVEL COMPANION

 

For More info:

Global Visitors Insurance

3410 Midcourt Rd
Carrollton
75006877-856-1411

info@globalmedins.com