Global Medical Insurance Silver Benefit Schedule

International Medical & Travel Insurance
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Global Medical Insurance Silver Benefits

Benefit Description Subject to deductible and coinsurance unless otherwise noted	Global Medical Insurance - Silver
Coverage Area	Two options: worldwide or worldwide excluding the U.S. and Canada
Policy Maximum	$5,000,000 lifetime per individual
Deductible	Ranges from $250 to $10,000 per period of coverage, 50% reduction within PPO
Family Deductible	3x the single
Coinsurance within the U.S. and Canada	80% of the next $5,000 of eligible expenses after the deductible, then 100% to the overall maximum per period of coverage
Coinsurance within the PPO network and outside the U.S. and Canada	100%
Hospitalization / Room & Board	$600 per day (maximum of 240 consecutive days per covered event)
Intensive Care Unit	$1,500 per day (maximum of 180 consecutive days per covered event)
Surgery	URC
Anesthetist's Charges Associated with Surgery	20% of surgery benefit
Transplants	$250,000 per transplant
Outpatient	Visits/Exams - 25 visits per insured person per period of coverage to the maximum limit as outlined: physician $70; specialist $70; psychiatrist $60; chiropractor $50; surgical intervention consultation $500; X-rays - $250 per exam maximum limit; Lab Tests - $300 per exam maximum limit
Rx Coverage	URC
Emergency Room Illness	URC subject to an additional $250 deductible if not admitted
Emergency Room Accident	URC
Local Ambulance	$1,500 per covered event not subject to deductible or coinsurance
Emergency Evacuation	$50,000 per period of coverage not subject to deductible or coinsurance
Emergency Reunion	NA (Not Applicable)
Return of Mortal Remains	$25,000 lifetime maximum per insured not subject to deductible or coinsurance
Maternity	Optional Rider - $50,000 lifetime maximum, maximum of $5,000 for normal delivery, $7,500 for C-section, $200 child wellness benefit for first 12 months - not subject to deductible or coinsurance. Available after 10 months of coverage benefits reduced by 50% for births that occur in11th or 12th month of continuous coverage
Supplemental Accident	NA
Mental/Nervous	Outpatient only - (see Outpatient) Available after 12 months of continuous coverage
Adult Wellness	NA
Child Wellness	Three visits per period of coverage -maximum $70 per visit. Available for children under 18 years of age after 12 months of continuous coverage
Other Services	Extended Care - limited to first 30 days of confinement Radiation Treatment - URC Home Nursing Care - limited 30 days per covered event Hospice Care - limited 30 days per covered event Prosthetic Devices - all URC
Physical Therapy	Maximum $40 per visit 30 visit maximum per period of coverage
High School Sports Injury	NA
Recreational SCUBA	NA
Remote Transportation	NA
Political Evacuation and Repatriation	NA
Complementary Medicine	NA
Non-emergency Dental	NA
Emergency Dental due to Accident	$1,000 per period of coverage
Emergency Dental due to Sudden Unexpected Pain	NA
Vision	NA
Global Concierge & Assistance Services	NA
Pre-existing Conditions	$5,000 per period of coverage up to a $50,000 lifetime maximum. Available after 24 months of continuous coverage
NA (Not Applicable) / URC (Usual, Reasonable and Customary) / SAAI (Same As Any Illness)

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International Health Insurance > International Medical Group

Global Medical Insurance Silver Benefits

Global Medical Insurance - Silver