Global Medical Insurance - Platinum

Two options: worldwide or worldwide excluding the U.S. and Canada

Ranges from $100 to $10,000 per period of coverage
50% reduction within PPO, Carry forward deductible - last 30 days of certificate year

2x the single

90% of the next $5,000 of eligible expenses after the deductible, then 100% to the overall maximum per period of coverage

100%

Private room rate

Usual, Reasonable and Customary (URC)

URC

URC

$2,000,000
lifetime maximum

URC

URC

URC  
subject to an additional $250 deductible if not admitted

URC

URC

Limited to policy maximum
not subject to deductible or coinsurance

$10,000
lifetime maximum

$50,000
lifetime maximum per insured -not subject to deductible or coinsurance

Same As Any Illness (SAAI)
$1,000 additional deductible, $50,000 lifetime maximum, $200 child wellness benefit for first 12 months. Available after 10 months of coverage

$500 per occurrence
not subject to deductible or coinsurance

SAAI
$50,000 lifetime maximum. Available after 12 months of continuous coverage

$500 per period of coverage - not subject to deductible or coinsurance
Available for those 18 years of age and over after 12 months of continuous coverage

$400 maximum per period of coverage - not subject to deductible or coinsurance
Available for children under 18 years of age after 12 months of continuous coverage

URC

Maximum $50 per visit

Up to $5,000 maximum

URC

Limited to $5,000 per certificate period up to a $20,000 lifetime maximum

Limited to $10,000 lifetime maximum

Acupuncture $150
Aroma Therapy $50
Herbal Therapy $50
Magnetic Therapy $75
Massage Therapy $150
Vitamin Therapy $100
Each per period of coverage

Calendar year maximum - $750
Individual deductible - $50
Schedule of benefits -
Class I: 90% Class II: 70%
Class III: 50% Ortho 0%
(6 month waiting period)

URC

See non-emergency dental benefits

Exams - up to $100 per 24 months
Materials - up to $150 per 24 months

Included

SAAI