|
International Medical & Travel Insurance Call 888.708.0812 or +1.503.642.4646 FAX - +1.503.212.5599 |
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Details: Index / Benefits / Exclusions / Provider
Directory / Application Download / Quote
& Apply
Rates: Worldwide Including US & Canada / Worldwide Excluding US & Canada |
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Missionary Medical Insurance > IMG > Schedule of Benefits
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| MEDICAL INSURANCE | BENEFIT Subject to deductible and coinsurance |
| Coverage Area |
Worldwide |
| Policy Maximum Per Individual | US$5,000,000 lifetime |
|
Hospitalization Semi-private room and board |
URC |
| Intensive Care Unit
|
URC |
| Surgery Surgical care Second surgical opinion Anesthetics Physician charges for surgery Treatment, services and supplies routinely provided |
URC |
| Transplants
Covered only within IMG's PPO Transplant Facilities |
US$1,000,000 lifetime |
| Outpatient Emergency treatment of illness or injury Surgery Rehabilitative treatment Treatment, services or supplies routinely provided Prescription medication |
URC |
| Emergency Surgery or dental treatment following an accident Emergency room following an accident |
URC |
| Emergency Transportation
by Ground Ambulance |
URC |
| Emergency
Medical Evacuation Included with Emergency Medical Evacuation is an Emergency Reunion benefit of US$10,000 lifetime |
up to policy maximum |
| Repatriation | US$25,000 |
| Supplemental Accident The first $300 will be covered for each accidental injury |
US$300 per occurrence(not subject to the deductible or coinsurance) |
| Maternity After 12 months of continuous coverage Pre and Post-natal care Normal delivery or C-section Well baby care and treatment of newborn coverage for first 31 days |
US$50,000 lifetime maximum of US$5,000 for normal delivery for each pregnancy lmaximum of US$7,500 for C-Section delivery for each pregnancy |
| Newborns Eligible newborn children may be added without evidence of insurability. An application must be submitted within 31 days of child's birth |
URC |
| Child Wellness Available for eligible children from 14 days to 18 years of age after 12 months of continuous coverage |
US$50 maximum per visit; US$200 per policy period (not subject to deductible or coinsurance) |
|
Pre-existing Conditions |
US$50,000 lifetime (maximum of US$5,000 per policy period) |
| Mental/Nervous Care
After 12 months of continuous coverage Inpatient and outpatient care by a licensed psychiatrist |
US$10,000 per period, US$20,000 lifetime |
| Wellness
Females age 30 and over after 12 months on the plan. Routine physicals Mammogram, ob/gyn visit, etc. (exams must be separtated by 12 months) Males age 30 and over, after 12 months on the plan Routine physicals (exams must be separated by 12 months) |
US$250 per period (not subject to deductible or coinsurance) |
| Dental Emergency Necessary treatment of sudden, unexpected pain to sound natural teeth |
US$100 per period of coverage |
| Complimentary Medicine | |
| Acupuncture | US$150 |
| Aroma Therapy | US$50 |
| Herbal Therapy | US$50 |
| Magnetic Therapy | US$75 |
| Massage Therapy | US$150 |
| Vitamin therapy | US$100 |
| Recreational SCUBA Coverage Illness or injury while using safe diving practices as laid down by an Authoritative Diving Body |
URC |
| Other Chiropractor when referred by a physician Radiation treatment Home nursing care Hospice care Physical therapy (maximum US$50 per visit) Prosthetic devices |
URC |