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Patriot GoTravel America Comprehensive Coverage Plan

Patriot GoTravel America


Patriot GoTravel America provides insurance plans for foreign nationals, temporary residents, missionaries, students, or green card holders traveling worldwide or US citizens traveling overseas. Life insurance policies are available and vision and dental insurance plans are also available. Non-US citizens traveling to foreign countries for over five days can receive coverage up to two years. Insurance plans purchased for periods over three months can be continued without any break in coverage for up to two years.

Most people are used to insurance in their lives. They have it for their home, their car, and for their health. However, many don't consider their health insurance when traveling abroad. A person could have the best insurance in America with the finest coverage, sadly this coverage of little use outside of the United States. This is where Patriot GoTravel America Insurance comes in. Patriot GoTravel America has over three decades of experience in the industry and allows travelers to use medical facilities and services abroad.

If a medical emergency, injury, or simply a need for medical care occurs while out of the United States a traveler is going to want travel insurance. Firstly, medical costs in other countries are often quite expensive and without travelers insurance an individual is likely to find themselves with a large bill if care is needed. Secondly, being far away from home a traveler is going to be unfamiliar with the local hospitals and there may also be a language barrier. Lastly, medical emergencies are stressful and unplanned events and help is always appreciated. With traveler's insurance help is always available twenty-four hours a day to assist. This can prove invaluable when a hospital is needed, getting past language barriers, or just converting cost of services from local currency to United States dollars.

PLAN INFORMATION
Plan Maximum

$50,000, $100,000, $500,000, $1,00,000, $2,000,000

Deductible

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

Coinsurance

As described below

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
For treatment received outside the U.S. & Canada: No coinsurance [100% coverage up to the Policy Maximum]

Renewal of Coverage

One month

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 completed online or by using a paper application, 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).

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.

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 offer continued coverage for that injury or illness. 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 continues. This is subject to the Maximum Limits and the other terms of the plan until there have been six months of continuous coverage for the covered injury or illness.

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 and 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/motorscooter 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 plan includes $25,000 principal sum benefit for Accidental Death and Dismemberment occurring during the Period of Coverage: • Accidental Loss of life – principal sum; • Accidental Loss of two Members – principal sum; • 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 purpose 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.

This rider is available with a minimum purchase of one month of medical and AD&D rider coverage.

CITIZENSHIP RETURN RIDER

When purchased at the time of application, the Citizenship Return Rider provides temporary medical coverage for non-U.S. citizens returning to their country of citizenship. For U.S. citizens, the rider provides up to 60 days of coverage for brief returns to the U.S. provided you have a current health plan in force and have resided outside the U.S. continuously for the past six months. Coverage for sudden recurrence of pre-existing conditions is excluded if the rider is selected. For premium information, please see the back of the Application Form.

EVACUATION PLUS RIDER

This optional rider is available to insureds up to age 65 and it provides coverage for medical evacuations for medical conditions that are non life-threatening and evacuations as a result of a natural disaster. This rider must be purchased for a minimum of one month regardless of the minimum number of days being traveled.