Atlas MultiTrip

From Tokio Marine HCC

Available for all trips of 30 or 45 days duration or less per year, Atlas MultiTrip is a comprehensive multi-trip travel medical plan that provides coverage for any new illness & injury that might occur while traveling outside of your home country.

**Note: Not available to individuals who 76 or older, or are physically located in New York, Maryland, or Washington or in the country of Canada or Australia at time of purchase.

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Atlas MultiTrip Benefit Schedule

Benefit

Description

Maximum Per Injury / Illness
$1,000,000
Overall Maximum Limit per Certificate Period
$1,000,000
Deductible
$250 per covered trip.
Coinsurance
Claims incurred in US or Canada
For the certificate period, underwriters will pay 80% of the next $5,000 of eligible expenses after the deductible, then 100% to the overall maximum limit. Coinsurance will be waived if expenses are incurred within the PPO and expenses are submitted to underwriters for review and payment directly to the provider
Coinsurance
Claims incurred outside US or Canada
For the certificate period, underwriters will pay 100% of eligible expenses after the deductible up to the overall maximum limit
Hospital Room and Board
Average semi-private room rate, including nursing services
Local Ambulance
Usual, reasonable and customary charges, when covered illness or injury results in hospitalization as inpatient
Intensive Care Unit
Usual, reasonable and customary charges
Emergency Room Co-payment
In addition to coinsurance, the member shall be responsible for a $200 copayment for each use of emergency room for an Illness unless the member is admitted to the hospital. There will be no copayment for emergency room treatment of an injury
Urgent Care Center
For each visit, the member shall be responsible for a $50 co-payment, after which coinsurance will apply. Not subject to Deductible
Hospital Indemnity
addition to medical expenses
$100 per day of inpatient hospitalization for member’s use to off set miscellaneous expenses (not subject to deductible or coinsurance)
Physical Therapy
$50 maximum per day
All Other Eligible Medical Expenses
Usual, reasonable and customary charges
Acute Onset of Pre-existing Condition
only available to members under age 70
Limited benefit up to the medical coverage maximum (excludes chronic and congenital conditions). $25,000 lifetime maximum for emergency medical evacuation.
Emergency Dental
acute onset of pain
$250 limit per certificate period (not subject to deductible or coinsurance)
Emergency Medical Evacuation
$1,000,000 lifetime maximum, except as provided under acute onset of pre-existing condition (not subject to deductible or coinsurance)
Return of Minor Children
$50,000 per certificate period (not subject to deductible or coinsurance)
Pet Return
Up to $1,000 to return a traveling pet home if member is hospitalized
Repatriation of Remains
Overall maximum limit (not subject to deductible or coinsurance)
Emergency Reunion
$50,000 limit per certificate period, subject to a maximum of 15 days (not subject to deductible or coinsurance)
Natural Disaster Benefit
Maximum $100 a day for 5 days (not subject to deductible or coinsurance)
Trip Interruption
$5,000 limit per certificate period (not subject to deductible or coinsurance)
Trip Delay
$100 for a 12-hour delay requiring an unplanned overnight stay (2 days maximum)
Lost Checked Luggage
$500 limit per certificate period (not subject to deductible or coinsurance)
Accidental Death and Dismemberment
Not subject to deductible or coinsurance (excludes loss due to common carrier accident; $250,000 maximum benefit per any one family or group)
Members up to age 18
Lifetime max. - $5,000; Death - $5,000; Loss of 2 limbs - $5,000; Loss of 1 limb - $2,500
Members age 18 through 69
Lifetime max. - $50,000; Death - $50,000; Loss of 2 limbs - $50,000; Loss of 1 limb - $25,000
Members age 70 through 74
Lifetime max. - $12,500; Death - $12,500; Loss of 2 limbs - $12,500; Loss of 1 limb - $6,250
Members age 75 and older
Lifetime max. - $6,250; Death - $6,250; Loss of 2 limbs - $6,250; Loss of 1 limb - $3,125
Common Carrier Accidental Death
$250,000 maximum benefit per any one family or group

Not subject to deductible or coinsurance

  • Up to age 18 - $25,000 per member
  • Age 18 to 69 - $50,000 per member
  • Age 70 to 74 - $12,500 per member
  • Age 75 and older - $6,250 per member
Hospital Pre-certification Penalty
50% of eligible medical expenses
Crisis Response
$10,000 limit per certificate period; Includes access to Unity Crisis Group services
Personal Liability
$10,000 lifetime maximum
Bedside Visit
$1,500 (economy ticket for family member to visit if member admitted to ICU)

Benefit Period Medical Coverage

While the certificate is in effect, the benefit period does not apply. Upon termination of the certificate, underwriters will pay eligible medical expenses, as defi ned herein, for up to 90 days beginning on the fi rst day of diagnosis or treatment of a covered injury or illness while the member is outside his or her home country and while the certificate was in effect. The benefit period applies only to eligible medical expenses related to the injury or illness that began while the certificate was in effect.

Home Country Defined

If you are a U.S. citizen, your Home Country is the United States, regardless of the location of your Principal Residence. If you are not a U.S. citizen, your Home Country is the country where you principally reside and receive regular mail.

Patient Protection and Affordable Care Act

(“PPACA”): This insurance is not subject to, and does not provide certain of the insurance benefits required by, the United States PPACA. PPACA requires certain U.S. residents and citizens to obtain PPACA compliant insurance coverage. In certain circumstances penalties may be imposed on U.S. residents and citizens who do not maintain PPACA compliant insurance coverage. You should consult your attorney or tax professional to determine if PPACA’s requirements are applicable to you. The policy contains the plan benefits, including a lifetime maximum that you have selected. Please review your choices to ensure that you have sufficient coverage to meet your medical needs.

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