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IMG Visitors Care Travel
Medical Insurance Plan Information
Information on Visitors Care plan for people
in need of travel insurance
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| The Visitors Care
plan provides travel medical insurance coverage for
individuals traveling outside their country of citizenship for
a minimum of one month up to 24 months. If the initial
purchase is for a period of three (3) months or longer, the
plan is renewable for a minimum of 3 months at a time for a
total of 24 continuous months. This plan offers
Lifetime benefit maximums of US$25,000, US$50,000 and US$100,000. You
have your choice of deductibles of US$75 or US$150 per period
of insurance. When you incur eligible medical expenses , the
plan will provide benefits for Usual, Reasonable and Customary
charges as outlined in the Schedule of Benefits below. |
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Plan A - US$25,000 maximum benefit per life of
plan |
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Option 1
US$75 deductible
per period of coverage |
Option 2
US$150 deductible
per period of coverage |
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Age |
One Month |
One Month |
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2 weeks - 49 |
$28 |
$25 |
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50-69 |
$42 |
$39 |
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70-79 |
$61 |
$58 |
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80+* |
$122 |
$116 |
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Dependent child |
$23 |
$20 |
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Option 1
US$75 deductible
per period of coverage |
Option 2
US$150 deductible
per period of coverage |
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Age |
Daily |
Daily |
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2 weeks - 49 |
$0.95 |
$0.85 |
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50-69 |
$1.40 |
$1.30 |
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70-79 |
$2.05 |
$1.95 |
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80+* |
$4.10 |
$3.90 |
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Dependent child |
$0.80 |
$0.70 |
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*
US$10,000 Benefit |
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Plan B - US$50,000 maximum benefit per life of
plan |
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Option 3
US$75 deductible
per period of coverage |
Option 4
US$150 deductible
per period of coverage |
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Age |
One Month |
One Month |
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2 weeks - 49 |
$42 |
$38 |
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50-69 |
$63 |
$59 |
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70-79 |
$91 |
$86 |
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Dependent child |
$34 |
$30 |
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Option 3
US$75 deductible
per period of coverage |
Option 4
US$150 deductible
per period of coverage |
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Age |
Daily |
Daily |
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2 weeks - 49 |
$1.40 |
$1.30 |
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50-69 |
$2.10 |
$2.00 |
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70-79 |
$3.05 |
$2.90 |
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Dependent child |
$1.15 |
$1.00 |
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Plan C - US$100,000 maximum benefit per life of
plan |
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Option 5
US$75 deductible
per period of coverage |
Option 6
US$150 deductible
per period of coverage |
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Age |
One Month |
One Month |
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2 weeks - 49 |
$62 |
$58 |
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50-69 |
$94 |
$91 |
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70-79 |
$136 |
$132 |
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Dependent child |
$52 |
$48 |
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Option 5
US$75 deductible
per period of coverage |
Option 6
US$150 deductible
per period of coverage |
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Age |
Daily |
Daily |
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2 weeks - 49 |
$2.10 |
$1.95 |
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50-69 |
$3.15 |
$3.05 |
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70-79 |
$4.55 |
$4.40 |
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Dependent child |
$1.75 |
$1.60 |
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| All
premium rates are in US dollars and are effective through
3/31/2006. Rates include 2.5% surplus lines tax where
applicable. A dependent child is your child shown on the
Application Form over 14 days and under 18 years of age,
traveling with you, and for whom premium has been paid.
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| The plan
offers benefit maximums of US$25,000, US$50,000 or US$100,000
for the life of the plan, and a choice of deductibles of US$75
or US$150 applied per period of coverage. When you incur
eligible medical expenses, the plan will provide benefits for
Usual, Reasonable and Customary charges up to the limits
outlined in the Schedule of Benefits below, with no
coinsurance. The four benefits below apply to all three plans.
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INTERNATIONAL
EMERGENCY CARE
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Emergency Evacuation |
To
US$50,000 when coordinated through IMG
(not
to exceed plan maximum) |
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The plan includes coverage for Emergency Medical
Evacuations to the nearest qualified medical facility in
life-threatening situations, and expenses for reasonable
travel and accommodations resulting from the evacuation,
which must be approved and coordinated in advance. |
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Repatriation |
To
US$7,500 when coordinated through IMG |
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If a covered illness/injury results in death, expenses for
repatriation of bodily remains or ashes to the country of
residence or citizenship will be covered, up to a maximum
of US$7,500. |
SPECIAL COVERAGES
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Home Country Coverage |
As
described below |
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Incidental Home Country Coverage - During
the period of coverage, an insured person may return to
his/her home country for incidental visits up to a
cumulative two weeks total, and retain continuing coverage
during such visit(s), so long as: a. The
insured person must have previously left his/her home
country for some portion of the period of coverage, and
b. The return to the home country must
not be undertaken for the purpose of receiving treatment
for an illness or injury incurred while traveling or
residing outside the home country. |
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Common Carrier Accidental Death |
US$25,000 to Beneficiary |
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If accidental death should occur while traveling on a
commercial common carrier during the period of coverage,
US$25,000 will be paid to the designated beneficiary. |
MEDICAL BENEFITS -
usual,
reasonable and customary charges, subject to deductible and
coinsurance
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Plan A - US$25,000 maximum benefit per life of
plan |
Plan B - US$50,000 maximum benefit per life of
plan |
Plan C - US$100,000 maximum benefit per life of
plan |
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Inpatient Treatment |
| Hospital
room & board |
Up to US US$825 per day, 30 day maximum per period of
coverage |
Up to US
US$1,275 per day, 30 day maximum per period of coverage |
Up to US US$1,750 per day, 30 day maximum per period of
coverage |
| Intensive
Care |
Additional US$400 per day, 8 day maximum per period of
coverage |
Additional
US$575 per day, 8 day maximum per period of coverage |
Additional US$750 per day, 8 day maximum per period of
coverage |
| Surgical
Treatment |
US$2,000 per surgical session |
US$3,000
per surgical session |
US$5,000 per surgical session |
| Consult
physician |
US$350 per period of coverage |
US$400 per
period of coverage |
US$450 per period of coverage |
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Pre-admission tests |
US$750 per period of coverage |
US$1,000
per period of coverage |
US$1,000 per period of coverage |
| Private
duty nurse |
US$400 per period of coverage |
US$500 per
period of coverage |
US$500 per period of coverage |
| Physician
visits |
US$40 allowable charge per visit, 30 visits per period of
coverage |
US$50
allowable charge per visit, 30 visits per period of
coverage |
US$50 allowable charge per visit, 30 visits per period of
coverage |
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Outpatient Treatment |
| Surgical
treatment |
US$2,000 per surgical session |
US$3,000
per surgical session |
US$5,000 per surgical session |
| Diagnostic
x-ray & lab |
US$650 per period of coverage, (US$325 allowable charge
per procedure) |
US$800 per
period of coverage, (US$400 allowable charge per
procedure) |
US$950 per period of coverage, (US$450 allowable charge
per procedure) |
| Hospital
emergency room |
US$200 allowable charge per visit |
US$300
allowable charge per visit |
US$500 allowable charge per visit |
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Prescription drugs |
US$150 per period of coverage |
US$250 per
period of coverage |
US$250 per period of coverage |
| Physician
visits |
US$50 allowable charge per visit, 10 visits per period of
coverage |
US$50
allowable charge per visit, 10 visits per period of
coverage |
US$50 allowable charge per visit, 10 visits per period of
coverage |
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Miscellaneous Inpatient & Outpatient Services |
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Anesthetist |
US$450 per surgical session |
US$750 per
surgical session |
US$1,250 per surgical session |
| Assistant
surgeon |
US$450 per surgical session |
US$750 per
surgical session |
US$1,250 per surgical session |
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Other Coverages |
| Ambulance |
US$250 per period of coverage |
US$400 per
period of coverage |
US$400 per period of coverage |
| Dental for
accident to sound natural teeth |
US$350 per period of coverage |
US$500 per
period of coverage |
US$500 per period of coverage |
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Physiotherapy |
US$25 per visit per day, 12 visits per period of coverage |
US$35 per
visit per day, 12 visits per period of coverage |
US$35 per visit per day, 12 visits per period of coverage |
The period of coverage is the period of time for which
premium has been timely paid. At each renewal, a new period of
coverage will begin.
PLEASE
NOTE: This web page contains only a consolidated and summary
description of all current Visitors Care benefits, conditions,
limitations and exclusions. A certificate of insurance
containing the complete Policy Wording with all terms,
conditions, limits and exclusions will be included with the
fulfillment kit. Please review the Policy Wording carefully
upon receipt and contact IMG if you have any questions
concerning available coverages and benefits. The plan
underwriter reserves the right to amend or modify the Policy
Wording, and issue the most current Policy Wording for the
Visitors Care plan, in the event an Application Form and/or
this brochure has expired, is modified, or is replaced with a
newer version. Current Policy Wordings are available upon
request. |
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1. Coverage and
benefits are subject to the applicable deductible and Scheduled
limits, and the other terms of the plan as contained in the
complete Policy Wording.
2. Coverage under the plan is secondary to any other coverage.
3. Coverage and benefits are for medically necessary, usual,
reasonable and customary charges only.
4. Charges must be administered or ordered by a physician.
5. Charges must be incurred during the Period of Coverage.
6. Claims must be presented to IMG for payment within the Period
of Coverage or during the three months immediately following the
Period of Coverage. |
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Charges for the
following services, treatments and/or conditions are excluded from
coverage under the Visitors Care plan.
1. Pre-existing Conditions. Charges resulting directly or
indirectly from any Pre-existing Condition, defined as any Injury,
Illness, sickness, disease, or other physical or medical disorder
or ailment that existed at the time of Application or at any time
during the three years prior to the effective date of this
insurance, whether or not previously manifested or symptomatic,
diagnosed or treated, including any subsequent, chronic or
recurring complications or consequences related thereto or arising
therefrom.
2. Heart disease, cancer, and stroke - Charges resulting directly
or indirectly from heart and blood circulatory disorders including
without limitation arteriosclerosis and ischemic cardiovascular
disease; cancer, tumor, and stroke or central nervous system
hypoxia; and including any subsequent chronic or recurring
complications or consequences related thereto or arising therefrom.
3. Treatment or surgeries which are elective, investigational,
experimental or for research purposes.
4. War, political insurrection, protest, or any act thereof.
5. Immunizations and routine physical exams.
6. Treatment of Temporomandibular Joint or dental treatment,
except as provided for herein.
7. Venereal disease, AIDS virus, AIDS related illness, ARC
Syndrome, or AIDS, and the cost of testing for these conditions,
and charges for treatment or surgeries which are incurred by any
Insured who was HIV+ at time of enrollment into this insurance.
8. Pregnancy, childbirth, birth control, artificial insemination,
treatment for infertility or impotency, sterilization or reversal
thereof, or abortion.
9. Any Injury or Illness sustained while taking part in
mountaineering activities where specialized climbing equipment,
ropes or guide are normally or reasonably should have been used,
Amateur Athletics or professional athletics, aviation ( except
when traveling solely as a passenger in a commercial aircraft),
hang gliding and parachuting, snow skiing except for recreation
downhill and/or cross country snow skiing( no cover provided
whilst skiing in violation of applicable laws, rules or
regulations; away from prepared and marked in-bound territories;
and/or against the advice of the local authoritative body), racing
of any kind including by horse, motor vehicle ( of any type), or
motorcycle, spelunking, and sub aqua pursuits involving underwater
breathing apparatus.
10. Vision or ear tests and the provision of visual or hearing
aids.
11. Vocational, recreational, speech or music therapy.
12. Treatment while confined primarily to receive custodial care,
educational or rehabilitative care, or nursing services.
13. Charges, injuries and/or illnesses resulting or arising from
or occurring during the commission or continuing perpetration of a
violation of law by the insured, including without limitation, the
engaging in an illegal occupation or act, but excluding minor
traffic violations.
14. Treatment for, and injuries and/or illnesses resulting or
arising from, substance abuse or drug addiction.
15. Injury and/or illness resulting or arising from or sustained
while under the influence of or disablement of drugs or alcohol.
16. Willful self-inflicted injury or illness.
17. Treatment required as a result of or arising from
complications from a treatment or condition not covered hereunder.
18. Any services or supplies performed or provided by a relative
of the Insured or provided at no cost to Insured.
19. Treatment for mental and nervous disorders.
20. Organ or tissue transplants or related services.
21. Illness or injury where the trip to the host country is
undertaken for treatment or advice for such Illness or injury,
except as provided for herein.
22. Treatment incurred as a result of or arising from exposure to
nuclear radiation, and/or radioactive material(s). |
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| This web material
contains only a consolidated and summary description of all
current Visitors Care benefits, conditions, limitations and
exclusions. A certificate containing the complete Policy Wording
with all terms, conditions and exclusions will be included with
the fulfillment kit. IMG reserves the right to issue the most
current Policy Wording for this insurance plan in the event this
application and/or brochure has expired, is modified, or is
replaced with a newer version. Current Policy Wordings are
available upon request. |
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Medical Group and underwritten by
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International Plans
are NOT available to Canadian Residents |
