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Patriot Go Travel Group Insurance Plan Group of 5 or more US/ Non-US Citizens traveling together

Patriot Go Travel Group Plan


Low-Cost Group Travel Insurance designed for a group of 5 or more US citizens or Non US citizens traveling outside their home country. Patriot GoTravel Group Medical Insurance products available to meet your needs, providing from $50,000 to US $2,000,000 of medical coverage with deductible options starting from $0 to $2500. This plan provides the same benefits as the individual Patriot GoTravel Medical Insurance but with a 10% discount for applying as a group. This plan offers 100% coverage after deductible if the treatment is received outside US & Canada. In USA the plan pays (After deductible) 90% In PPO up to US $5,000 and then 100% up to policy maximum. Coverage excludes Emergency evacuation & repatriation.

International travel can quickly turn into a frightening situation if you’re not prepared for a medical emergency. Most travelers assume they will be covered by their standard medical plan, but that isn’t the case. While traditional plans may offer adequate domestic coverage, they are not designed for international travel. Without even realizing it, you may be putting your health at risk. Don’t let your medical coverage be an uncertainty. Travel with one of IMG’s Travel Medical Insurance® plans so you can spend more time enjoying your international experience and less time worrying about medical coverage.

For one group of travelers, you would need to fill out one form rather than filling them out individually. One master policy is provided with individual ID cards for each traveler. The group health insurance plans are good for families with more than five members...

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PLAN INFORMATION
Deductible Your choice of $0, $100, $250, $500, $1,000 or $2,500

Your premium rate is dependent on the deductible you choose.

Coinsurance As described below

For treatment received outside the U.S. & Canada : No coinsurance

For treatment received within the U.S. & Canada:
In the PPO Network: The plan pays 90% of eligible expenses up to $5,000, then 100% up to the Policy Maximum
Outside the PPO Network: The plan pays 80% of eligible expenses up to $5,000, then 100% up to the Policy Maximum

Renewal of Coverage One months

If your Patriot plan is purchased for a minimum of one month, coverage may be renewed (unless there is a break in coverage) for a total of up to two years. Renewals are available in whole month or daily increments and may be com? pleated online or by using a paper apply?cation, however, renewals of less than one month are available only online. For each renewal of less than one month completed online, you will be charged an additional $5 processing fee. Each insured person must only satisfy one deductible and coinsurance within each 12 month coverage period.

Please note: Renewal rates may differ from initial rates.

Eligibility to purchase, extend or renew this product, or its terms and conditions, may be modified or amended based upon changes to applicable law, including the Patient Protection and Affordable Care Act (PPACA).

Benefit Period Six months

If a covered injury or illness requires continuing treatment after the Period of Coverage expires, the six-month Benefit Period may provide continued coverage. When the certificate expires, the Company will review the date of initial treatment for the covered injury or illness. If treatment began less than six months before the Period of Coverage expired, benefits for the covered injury or illness will continue subject to the Policy Limits and the other terms of the plan until there have been six months of continuous coverage for the covered injury or illness.

Sudden and Unexpected Recurrence of a Pre-existing Condition

(Non U.S. citizens only) For those under age 65, the Plan will pay up to a $50,000 lifetime maximum for eligible medical expenses. For those ages 65 and older, Patriot America Group will pay up to $2,500 lifetime maximum.

(U.S. citizens only) For those up to age 65 with a primary health the plan will pay the Usual, Reasonable and Customary charges of a sudden and unexpected recurrence of a Pre-existing Condition (defined on page 16) up to the plan maximum. For those without a primary health plan, the plan will pay up to a $20,000 lifetime maximum. For those ages 65 and older, with or without a primary health plan, Plan will pay up to a $2,500 lifetime maximum. The primary health plan must have existed prior to the effective date and during coverage of the Plan, and the Pre-existing Condition must be covered under the primary health plan.

In addition, up to $25,000 will be paid for the eligible costs and expenses of an Emergency Medical Evacuation arising or resulting from a sudden and unexpected recurrence of a Pre-existing Condition.

Additional Benefits for U.S. Citizens
Indemnity

(U.S. citizens only) Patriot GoTravel Group International will pay directly to the insured person $100 for each night of a required overnight stay in a hospital. However, the hospital stay must be covered under this plan in order to receive this benefit.

SCHEDULE OF BENEFITS  (all amounts listed are in U.S. dollars)
MEDICAL BENEFITS Usual, reasonable and customary charges, subject to deductible and coinsurance
Hospital Room and Board Up to Policy Maximum for average semi-private room rate
Intensive Care Up to Policy Maximum
Medical Expenses Up to Policy Maximum
Outpatient Medical Up to Policy Maximum
Local Ambulance Up to Policy Maximum
Prescription Drugs Up to Policy Maximum
Emergency Room Accident Up to Policy Maximum
Emergency Room Illness with
In-patient Admission
Up to Policy Maximum
Emergency Room Illness without
In-patient Admission
Up to the Maximum Limit with
additional $250 deductible
Hospital Daily Indemnity Up to $100 per night up to a
maximum of 10 days

Charges incurred for the use of the Emergency Room due to an accident are covered up to the Policy Maximum.

Charges incurred for the use of the Emergency Room for treatment of an illness are subject to an additional (extra) $250 deductible if treatment does not require admittance to the hospital.

ADDITIONAL BENEFITS
Home Country Coverage As described below
Incidental Home Country Coverage -

During the Period of Coverage an insured person may return to their home country for incidental visits up to a cumulative two weeks total, subject to:

  1. The insured person must have left their home country,
  2. The total Period of Coverage must be for a minimum of 30 days, and
  3. The return to the home country may not be taken to receive treatment for an illness or injury incurred while traveling.

End of Trip Home Country Coverage -For every five months of continuous coverage you purchase, you can purchase one additional month of home country coverage as an accommodation and supplemental travel benefit, up to a maximum of two months. To purchase this special home country extension coverage, please check the appropriate box on the Application Form, and calculate your premium to include the additional month(s).

Natural Disaster $100 per day for five days

This benefit is available in the event an insured person is required to depart his/her destination due to an evacuation order issued by prevailing authorities in connection with a Natural Disaster. Natural Disaster is defined as widespread disruption of human lives by disasters such as flood, drought, tidal wave, fire, hurricane, earthquake, windstorm, or other storm, landslide, or other natural catastrophe or event resulting in migration of the population for its safety.

Trip Interruption

If, during a covered trip, there is an unexpected death of an immediate family member (spouse, child, parent or sibling), a break-in at the insured's principle residence, or the substantial destruction of the insured's principal residence due to a fire or natural disaster, each Patriot plan pays to return the insured to the area of principal residence. The plan pays for a one way air or ground transportation ticket of the same class as the unused travel ticket, less the value of the unused return ticket.

Common Carrier Accidental Death $50,000 to Beneficiary; maximum of $250,000 per family

If accidental death should occur while traveling on a commercial Common Carrier, $50,000 is payable to the designated beneficiary, to a maximum of $250,000 per family.

Sports & Activities Coverage

Each Patriot plan covers injuries incurred during athletic activities which are non-organized, non-contact and engaged in by the insured person solely for leisure, recreation, entertainment or fitness purposes. Some of these sports and activities include, but are not limited to, motor cycle/motor scooter riding, recreational downhill and/or cross country snow skiing, horseback riding, sub-aquatic activities (to 10m), wakeboarding, and water skiing. However, activities not covered include amateur or professional sports or other athletic activity which is organized and/or sanctioned by the National Collegiate Athletic Association (and/or any other collegiate sanctioning or government body), or the International Olympic Committee, and or Adventure Sports. Please note this is only a summary of sports and activities and exclusions. For additional information, please refer to the Certificate of Insurance.

Accidental Death & Dismemberment $25,000 principal sum

Each Patriot GoTravel Group plan includes $25,000 principal sum benefit for Accidental Death and Dismemberment occurring during the Period of Coverage: a) Accidental Loss of life - principal sum; b) Accidental Loss of two Members - principal sum; c) Accidental Loss of one Member - 50% of principal sum. "Member" means hand,, foot or eye.

Terrorism Coverage Up to $50,000 lifetime maximum

Each Patriot plan provides coverage for injuries and illness incurred as a result of an act of Terrorism, limited in amount and by circumstances. If an insured person is injured as a result of an act of Terrorism, and the insured person has no direct or indirect participation in the act, the plan reimburses eligible medical claims subject to a $50,000 lifetime maximum. Terrorism includes criminal acts, including against civilians, committed with the intent to cause death or serious bodily injury, or taking of hostages, with the pur?pose to provide a state of terror in the general public or in a group of persons or particular persons, intimidate a population, or compel a government or international organization to do or to abstain from doing an act. However, this benefit does not cover an act of Terrorism in any country or location where the United States government has issued a travel advisory that has been in effect within the six months prior to the insured person's date of arrival. In addition, claims incurred as a result of radiological, nuclear, chemical or biological weapons or events are not covered.

This benefit also does not cover an act of Terrorism in the event that an advisory to leave a certain country or location is issued by the United States government after the insured person's arrival date, and the insured person unreasonably fails or refuses to heed such warning or depart the country or location.

Identity Theft Assistance Up to $500 per Period of Coverage

If an imposter obtains key personal information such as a Social Security or Driver's License number, or other method of identifying an insured person in order to impersonate or obtain credit, merchandise or services in the insured person's name, the Patriot plans provide coverage up to $500 for the reasonable, customary and necessary costs incurred by the insured for: re-filing a loan or other credit application that is rejected solely as a result of the stolen identity event; notarization of legal documents, long distance telephone calls, and postage that has resulted solely as a result of reporting, amending and/or rectifying records as a result of the stolen identity event; up to three credit reports obtained within one year of the insured person's knowledge of the stolen identity event; and stop payment orders placed on missing or unauthorized checks as a result of the stolen identity event.

The identity theft event must occur during the Period of Coverage.

Hospital Daily Indemnity

Each plan pays $100 directly to the insured person for each night of a required overnight stay in a hospital up to a maximum of 10 days. The hospital stay must be covered under this plan in order to receive this benefit. This benefit is not available for Patriot America (non-U.S. citizens) if the hospitalization is due to the Sudden Recurrence of a Pre-existing Condition.

Description of Optional Riders:
ADVENTURE SPORTS RIDER:

The Adventure Sports Rider is available on both Patriot plans for those up to the age of 65. The following activities are covered to the lifetime maximum amounts listed on page four as long as they are engaged solely for leisure, recreation, or entertainment purposes: abseiling, BMX, bobsledding, bungee jumping, canyoning, caving, hang gliding, heli-skiing, high diving, hot air ballooning, inline skating, jet skiing, jungle zip lining, kayaking, mountain biking, parachuting, paragliding, parascending, piloting a non-commercial aircraft, rappelling, rock climbing or mountaineering (ropes and guides to 4500m from ground level), scuba diving (to 50m), skydiving, snorkeling, snowboarding, snowmobiling, snow skiing, spelunking, surfing, trekking, whitewater rafting (to Class V), wildlife safaris, and windsurfing. All such activities must be carried out in strict accordance with the rules, regulations and guidelines of the applicable Governing Body or Authority of each such activity. Certain sports activities are never covered, regardless of whether or not you purchase the Adventure Sports Rider. Please see page 16, exclusion 8. Please note this is only a summary of Adventure Sports and exclusions. For additional information, please refer to the Certificate of Insurance.

Riders EXTREME SPORTS RIDER

The Extreme Sports Rider is available on both Patriot plans for those up to the age of 65. The following activities are covered to the lifetime maximum amounts: abseiling, aviation, BMX, bobsleigh, bungee jumping, canyoning, caving, flying (private plane), hang gliding, heli-skiing, high diving, hot air ballooning, inline skating, jet skiing, kayaking, mountain biking, paragliding, parascending, rappelling, rock climbing (ropes and guides to 4500m from ground level), skydiving, snow boarding, snowmobiling, snow skiing, spelunking, surfing, trekking, whitewater rafting (to Class V), wind-surfing. These extreme activities must be engaged in solely for leisure, recreation, or entertainment purposes.

Age Lifetime Maximum
0 - 49 $50,000
50 - 59 $30,000
60 - 64 $15,000
PATRIOT GoTravel Group RETURN RIDER  

(Non-U.S. citizens only) When purchased at the time of application, the Patriot GoTravel Group Return Rider provides temporary medical coverage for non-U.S. citizens returning to their home country.

Up to Policy Maximum

ENHANCED AD&D RIDER  

This optional coverage is available for the primary insured person only. This coverage is in addition to the Accidental Death and Dismemberment already included in the Patriot GoTravel Group plans. Coverage must be purchased for a minimum of one month.

Up to an Additional $400,000