Stand alone
single trip health insurance for
international travel
- Choice of varying medical limits and
deductibles
- For trips up to 6 months for ages 74 or
younger
- Covers pre-existing conditions for medical
evacuation, repatriation of remains and bedside visit benefit
This plan does not require that
you have a
primary health plan
|
Supplemental single trip health insurance for international travel
- Choice of varying medical limits and
deductibles
- For trips up to 6 months for ages
84 or younger
- Covers pre-existing
conditions for medical services,
medical evacuation, repatriation of remains and bedside visit benefit
This plan requires that you have a
primary health plan or MEDICARE
|
|
TravelGap
Voyager Benefits
|
|
Medical Benefits |
|
Maximum Benefit per Insured Person per policy
period |
Options include $50,000; $100,000; $500,000;
$1,000,000 |
|
Deductible per Insured Person per policy
period |
Options include $0; $100; $250; $500
|
|
After the Deductible is
satisfied, benefits are paid for Covered Expenses as follows up to the
Medical Limit: |
| |
I Deductible is Paid:
|
|
Professional Services: |
|
a. Surgery, anesthesia, radiation therapy,
in-hospital doctor visits, diagnostic X-ray and lab |
100% |
|
b. Office Visits: including X-rays and lab
work billed by the attending physician. |
100% |
|
Inpatient Hospital Services: |
|
a. Surgery, X-rays, In-hospital doctor visits
|
100% |
|
b. In-patient medical emergency |
100% |
| |
|
Ambulatory Surgical Center |
100% |
|
Ambulance Service (non Medical Evacuation)
|
100% up to $1000 |
|
Benefits for claims resulting from downhill
(alpine) skiing and scuba diving, PADI or NAUI required or diving under
the supervision of a certified instructor |
Maximum Benefit up to $10,000 |
|
Outside the U.S. Outpatient prescription drugs
|
50% of Covered Expenses |
|
Dental Care required due to an Injury
|
100% of Covered Expenses up to $200 maximum
per Trip Period and $200 per tooth |
|
Dental Care for Relief of Pain |
100% of Covered Expenses up to $100 maximum
per Trip Period and $100 per tooth |
| |
I |
|
Accidental Death and Dismemberment
|
Maximum Benefit Principal Sum up to $25,000
|
|
Repatriation Of Remains |
Maximum Benefit up to $25,000 |
|
Medical Evacuation |
Maximum Benefit per Trip Period for all
Evacuations up to $500,000 |
|
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 |
|
|
TravelGap
Excursion
Benefits |
|
Medical Benefits |
|
Maximum Benefit per Insured Person per policy
period |
Options include $50,000; $100,000; $500,000;
$1,000,000 |
|
Deductible per Insured Person per policy
period |
Options include $0; $100; $250; $500
|
|
After the Deductible is
satisfied, benefits are paid for Covered Expenses as follows up to the
Medical Limit: |
| |
s Paid: |
|
Professional Services: |
|
a. Surgery, anesthesia, radiation therapy,
in-hospital doctor visits, diagnostic X-ray and lab |
100% |
|
b. Office Visits: including X-rays and lab
work billed by the attending physician. |
100% |
|
Inpatient Hospital Services: |
|
a. Surgery, X-rays, In-hospital doctor visits
|
100% |
|
b. In-patient medical emergency |
100% |
| |
|
Ambulatory Surgical Center |
100% |
|
Ambulance Service (non Medical Evacuation)
|
100% up to $1000 |
|
Benefits for claims resulting from downhill
(alpine) skiing and scuba diving, PADI or NAUI required or diving under
the supervision of a certified instructor |
Maximum Benefit up to $10,000 |
|
Outside the U.S. Outpatient prescription drugs
|
100% of Covered Expenses |
|
Dental Care required due to an Injury
|
100% of Covered Expenses up to $500 maximum
per Trip Period and $250 per tooth |
|
Dental Care for Relief of Pain |
100% of Covered Expenses up to $500 maximum
per Trip Period and $250 per tooth |
|
O |
I |
|
Accidental Death and Dismemberment
|
Maximum Benefit Principal Sum up to $50,000
|
|
Repatriation Of Remains |
Maximum Benefit up to $25,000 |
|
Medical Evacuation |
Maximum Benefit per Trip Period for all
Evacuations up to $500,000 |
|
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 |
|
