Liaison Majestic Travel Medical Insurance

Schedule of Benefits and Limits
Medical Maximum: $60,000; $125,000; $600,000; $1,000,000 (ages 80+, maximum limited to $20,000)
Deductible: $0; $100; $250; $500; $1000; $2500    Deductible is per person per policy period, maximum of 3 Policy Period deductibles per family. The selected Deductible and Coinsurance amount must be met for each 12-month period (see Continuing Coverage)
Coinsurance:
  • Inside the United States and Canada: After the Insured pays the deductible, the program pays 80% of the next $5,000 of eligible expenses, then 100% to the selected Maximum.
  • Outside the United States and Canada: After the Insured pays the deductible, the program pays 100% to the selected Maximum.
Hospital Indemnity: $150 / night (traveling outside the US and Canada) In addition to any other Covered Expense.
Dental (Emergency): $100 or ($500 for accidents) Only available to programs purchased for 1 month or more.
Emergency Medical Evacuation / Repatriation: $300,000 (in addition to the Medical Maximum)
Home Country Coverage: Incidental trips to the home country: $50,000
Follow me home coverage: $5,000
Political Evacuation & Repatriation: $50,000
Return of Mortal Remains: $50,000
Emergency Reunion: $50,000
Return of Minor Child(ren): $50,000
Interruption of Trip: $5,000
Loss of Checked Luggage: $250
Local Ambulance Expense: $5,000
Accidental Death & Dismemberment: $25,000 Principal Sum for Insured or Insured Spouse, $5,000 for Dependent Child(ren)
Note: In the event of a Common Carrier Accidental Death this benefit will not be paid.
Common Carrier AD&D: $50,000 per adult, $12,500 per child(ren) under age of 19; $250,000 Maximum per family
Coma Benefit : $50,000
Felonius Assault Benefit : $10,000
Hospital Room & Board: Usual, reasonable and customary to the selected Policy Maximum.
Intensive Care: Usual, reasonable and customary to the selected Policy Maximum.
Outpatient Medical Expense: Usual, reasonable and customary to the selected Policy Maximum.
Terrorism: Usual, reasonable and customary up to $50,000
Waiver of Pre-Existing Conditions:
  • Up to chosen Medical Maximum for U.S. citizens traveling outside the United States & Canada with a Primary Health Plan, otherwise up to $20,000 (refer to exclusion #1 for details)
  • For foreign nationals visiting the United States, up to $200 per day for each night spent in the hospital after being admitted for either a heart attack or stroke. Max. Benefit of $3,000 (refer to exclusion #1 for details)
Benefit Period: 180 days
Restricted Countries: Afghanistan, Chechnya, Cuba, Iran, Iraq, Israel (West Bank and Gaza Strip), Pakistan, Somalia

Emergency Medical Evacuation/Repatriation

The program will pay Covered Expenses incurred if any covered Injury or Illness commences during the Period of Coverage that results in a Medically Necessary Emergency Medical Evacuation or Repatriation (your medical condition warrants immediate transportation from the medical facility where you are located to the nearest adequate medical facility where medical treatment can be obtained). This benefit must be arranged by the Assistance Company in consultation with the local attending Physician.*

Political Evacuation and Repatriation

If due to political or military events in a host country, a formal recommendation from the appropriate authorities is issued for you to leave the host country, or you are expelled or declared persona non-grata by the host country, all reasonable expenses incurred for transportation to the nearest place of safety or for repatriation to your Home Country is covered up to a maximum of $50,000. Evacuation must occur within ten (10) days of any such event. Coverage will apply to the most appropriate and economical means consistent, under the circumstances, with your health and safety. Evacuation costs will be paid once per insured per occurrence.*

The Political Evacuation and Repatriation of Remains Benefit will not pay, should the Insured not heed Travel Warnings issued by the State Department or the appropriate authorities recommending that travelers avoid a certain country.

Return of Mortal Remains

The Program will pay the reasonable Covered Expenses incurred up to a maximum of $50,000 to return your remains to your Home Country, if you should die.* political evacuation and repatriation   If due to political or military events in a host country, a formal recommendation from the appropriate authorities is issued for you to leave the host country, or you are expelled or declared persona non-grata by the host country, all reasonable expenses incurred for transportation to the nearest place of safety or for repatriation to your Home Country is covered up to a maximum of $50,000. Evacuation must occur within 10 days of any such event. Coverage will apply to the most appropriate and economical means consistent, under the circumstances, with your health and safety. Evacuation costs will be paid once per insured per occurrence.*

Emergency Medical Reunion

When Emergency Medical Evacuation or Repatriation is arranged and the attending Physician recommends that a family member travel with you, the program will arrange and pay, up to $50,000, for round-trip economy-class transportation for one individual of your choice, from your Home Country, to be at your side while you are hospitalized and then accompany you during your return to your Home Country.

Return of Minor Child(ren)

If you are traveling alone with a Minor Child(ren) and are hospitalized because of a covered Illness or Injury and the Minor Child(ren), under age 19, is left unattended, the program will arrange and pay up to $50,000 for one-way economy fare to their Home Country (including the cost of an attendant/escort, if necessary to ensure the safety and welfare of a Minor Child(ren)).*

Hospital Indemnity

If you are hospitalized while traveling outside of the United States or Canada, and the hospitalization is considered a Covered Expense, the program will indemnify you $150 for each night spent in the hospital (this benefit is in addition to any other covered expenses of the program).

Interruption of Trip

If you are unable to continue the Trip due to the death of an Immediate Family member (parent, spouse, sibling or child) or due to serious damage to your principal residence from fire, flood or similar natural disaster (tornado, earthquake, hurricane, etc.), the program will reimburse you (up to $5,000) for the cost of economy travel, less the value of applied credit from an unused return travel ticket, to return you home to your area of principal residence*

Loss of Checked Luggage

If your checked luggage is permanently lost by the airline, the program will reimburse you for the replacement of clothing and personal hygiene items lost to a maximum per bag limit of $50 (up to $250). This benefit is secondary to any other (including airline) coverage available. You must furnish proof to the Company that full reimbursement has been obtained from the airline.

Felonious Assault Benefit

If you are Injured as a result of a Felonious Assault while traveling outside of your Home Country, the program will pay $10,000. This benefit is in addition to any other benefit available under this program. Refer to the Program summary for full description and conditions.

Terrorism Benefit

Coverage for Injuries and Illnesses up to $50,000 resulting from an Act of Terrorism, as defined in the program summary, provided all of the following conditions are met:

  1. You have no direct or indirect involvement in the Act of Terrorism.
  2. The Act of Terrorism is not in a country or location where the United States government has issued a travel warning that has been in effect within the six (6) months prior to your date of arrival.
  3. You have not unreasonably failed or refused to depart a country or location following the date a warning to leave that country or location is issued by the United States government.

Coma Benefit

If a covered Injury renders you Comatose within 90 days of the date of the accident that caused the Injury, and if the Coma continues for a period of 30 consecutive days, the program will pay a monthly benefit equal to 1% of $50,000. No benefit is provided for the first 30 days of the Coma. The benefit is payable monthly as long as you remain Comatose due to that Injury, but ceases on the earliest of: (1) the date you cease to be Comatose due to that Injury; (2) the date the Insured dies; or (3) the date the total amount of monthly Coma benefits paid for all Injuries caused by the same accident equals the maximum amount. This benefit is in addition to any other benefit available under this program. See Program Summary for full description and conditions.

Hazardous Sport Coverage

To cover motorcycle/motor scooter riding, hang gliding, parachuting, bungee jumping, water skiing, snow skiing, snowmobiling, and snow boarding.

Parachuting shall mean an activity involving the breaking of a free fall from an airplane using a parachute.

Home CountryCoverage

Incidental Trips to Your Home Country: This benefit covers you for incidental trips to your Home Country (Sixty (60) days per twelve (12) months of purchased coverage or pro rata thereof- example: approximately five (5) days per month of purchased coverage). Maximum benefit is reduced to $50,000 for any Illness or Injury occurring while on an incidental trip to your Home Country. You must first depart your Home Country in order to utilize this benefit and it does not apply to the final trip home. In the event of a claim, you may be required to provide proof of your travel intentions. Earned Home Country Coverage days for the current Policy year do not extend or carry over after a completed 12 month Period of Coverage. If you choose to renew beyond a 12 month Period of Coverage, the earning of incidental days will start over again, i.e. 5 days for every month that you purchase, allowing up to a maximum amount of sixty (60) days per twelve (12) month Period of Coverage..

Follow Me Home Coverage: This plan shall pay for Covered Expenses incurred in your Home Country up to $5,000 for conditions that are first diagnosed and treated outside Your Home Country (Does not apply for Emergency Medical Evacuation or Repatriation).

*NOTE: In the event of Emergency Medical Evacuation, Repatriation, Return of Mortal Remains, Emergency Reunion, Return of Minor Child(ren) or Interruption of Trip benefit is needed or utilized, all arrangements must be made by the Assistance Service Provider. Complete details about the benefits and about the required notification of the Assistance Service Provider are contained in the Program Summary.

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.