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Travel Gap Multi Trip Benefits
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Gap Multi-Trip Brochure |
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Medical Benefits |
Silver |
Gold |
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Maximum International Benefits per Insured
Person per policy period |
$50,000 |
$250,000* |
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*For
Individuals aged 70 - 84, the Maximum International Medical Benefit for
TravelGap Gold is $100,000. |
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Maximum Domestic Benefits per Insured Person
per policy period |
$2,500 |
$25,000 |
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Deductible per Insured Person per policy
period* |
$50 |
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*Deductible
waived for physician and hospital services delivered by HTH
International Healthcare Community Providers. |
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After the Deductible is satisfied, benefits are paid for Covered
Expenses as follows up to the Medical Limit: |
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Benefits |
Insurer Pays After
Medical Benefit Deductible is Paid |
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Professional Services: |
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a. Surgery, anesthesia, radiation therapy,
in-hospital doctor visits, diagnostic X-ray and lab |
100% |
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b. Office Visits: including X-rays and lab
work billed by the attending physician. |
100% |
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Inpatient Hospital Services: |
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a. Surgery, X-rays, In-hospital doctor
visits |
100% |
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b. In-patient medical emergency |
100% |
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Ambulatory Surgical Center |
100% |
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Ambulance Service (non Medical Evacuation) |
100% up to $1000 |
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Benefits for claims resulting from downhill
(alpine) skiing and scuba diving (certification by the Professional
Association of Diving Instructors (PADI) or the National Association of
Underwater Instructors (NAUI) required or diving under the supervision
of a certified instructor) |
Maximum Benefit up to $10,000 |
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Outside the U.S. Outpatient prescription
drugs |
100% of Covered Expenses |
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Dental Care required due to an Injury |
100% of Covered Expenses up to $200 maximum
per Trip Period and $200 per tooth |
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Dental Care for Relief of Pain |
100% of Covered Expenses up to $100 maximum
per Trip Period and $100 per tooth |
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Other Benefits
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Insurer Pays Without a
Deductible Being Applicable |
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Silver
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Gold |
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Accidental Death And Dismemberment
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$0 |
$25,000 |
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Repatriation Of Remains |
$15,000 |
$25,000 |
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Medical Evacuation |
$250,000 |
$500,000 |
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Bedside Visit |
Maximum Benefit per Trip Period up to $1,500
for the cost of one economy round trip air fare ticket to the place of
the Hospital Confinement for one (1) person |
