Global Medical Insurance Benefits

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Worldwide Rates: Silver | Gold | Platinum
Rates Excluding US & Canada: Silver | Gold | Platinum

Global Medical Insurance offers you the choice of three plan options: Silver, Gold and Platinum. You also have the opportunity to select a coverage area: worldwide or worldwide excluding the U.S. and Canada. Simply choose the plan option and coverage area that best fits your needs. Each one offers a full range of benefits suited for individuals and families, provides coverage 24 hours a day, and you have the freedom to choose any doctor or hospital for treatment.

When you select Global Medical Insurance, you receive IMG’s commitment to deliver world class health benefits, medical assistance and Global Peace of Mind®.

Benefit Description Subject to deductible and coinsurance unless otherwise noted	Silver	Gold	Platinum
Coverage Area	Two options: worldwide or worldwide excluding the U.S. and Canada	Two options: worldwide or worldwide excluding the U.S. and Canada	Two options: worldwide or worldwide excluding the U.S. and Canada
Policy Maximum	$5,000,000 lifetime per individual	$5,000,000 lifetime per individual	$8,000,000 lifetime per individual
Deductible	Ranges from $250 to $10,000 per period of coverage, 50% reduction within PPO	Ranges from $250 to $10,000 per period of coverage, 50% reduction within PPO, Carry forward deductible - last 30 days of certificate year	Ranges from $100 to $10,000 per period of coverage, 50% reduction within PPO, Carry forward deductible - last 30 days of certificate year
Family Deductible	3x the single	3x the single	2x the single
Coinsurance within the U.S. and Canada	80% of the next $5,000 of eligible expenses after the deductible, then 100% to the overall maximum per period of coverage	80% of the next $5,000 of eligible expenses after the deductible, then 100% to the overall maximum per period of coverage	90% of the next $5,000 of eligible expenses after the deductible, then 100% to the overall maximum per period of coverage
Coinsurance within the PPO network and outside the U.S. and Canada	100%	100%	100%
Hospitalization / Room & Board	$600 per day (maximum of 240 consecutive days per covered event)	Average semi-private room rate	Private room rate
Intensive Care Unit	$1,500 per day (maximum of 180 consecutive days per covered event)	Usual, Reasonable and Customary (URC)	Usual, Reasonable and Customary (URC)
Surgery	URC	URC	URC
Anesthetist's Charges Associated with Surgery	20% of surgery benefit	URC	URC
Transplants	$250,000 per transplant	$1,000,000 lifetime maximum	$2,000,000 lifetime maximum
Outpatient	Visits/Exams - 25 visits per insured person per period of coverage to the maximum limit as outlined: physician $70; specialist $70; psychiatrist $60; chiropractor $50; surgical intervention consultation $500; X-rays - $250 per exam maximum limit; Lab Tests - $300 per exam maximum limit	URC	URC
Rx Coverage	URC	URC	URC
Emergency Room Illness	URC subject to an additional $250 deductible if not admitted	URC subject to an additional $250 deductible if not admitted	URC subject to an additional $250 deductible if not admitted
Emergency Room Accident	URC	URC	URC
Local Ambulance	$1,500 per covered event not subject to deductible or coinsurance	URC	URC
Emergency Evacuation	$50,000 per period of coverage not subject to deductible or coinsurance	Limited to policy maximum not subject to deductible or coinsurance	Limited to policy maximum not subject to deductible or coinsurance
Emergency Reunion	NA (Not Applicable)	$10,000 lifetime maximum	$10,000 lifetime maximum
Return of Mortal Remains	$25,000 lifetime maximum per insured not subject to deductible or coinsurance	$25,000 lifetime maximum per insured not subject to deductible or coinsurance	$50,000 lifetime maximum per insured not subject to deductible or coinsurance
Maternity	Optional Rider - $50,000 lifetime maximum, maximum of $5,000 for normal delivery, $7,500 for C-section, $200 child wellness benefit for first 12 months - not subject to deductible or coinsurance. Available after 10 months of coverage benefits reduced by 50% for births that occur in11th or 12th month of continuous coverage	Optional Rider - $50,000 lifetime maximum, maximum of $5,000 for normal delivery, $7,500 for C-section, $200 child wellness benefit for first 12 months - not subject to deductible or coinsurance. Available after 10 months of coverage benefits reduced by 50% for births that occur in11th or 12th month of continuous coverage	Same As Any Illness (SAAI) $1,000 additional deductible, $50,000 lifetime maximum, $200 child wellness benefit for first 12 months. Available after 10 months of coverage
Supplemental Accident	NA	$300 per occurrence not subject to deductible or coinsurance	$500 per occurrence not subject to deductible or coinsurance
Mental/Nervous	Outpatient only - (see Outpatient) Available after 12 months of continuous coverage	$10,000 per period of coverage up to a $50,000 lifetime maximum. Available after 12 months of continuous coverage	SAAI $50,000 lifetime maximum. Available after 12 months of continuous coverage
Adult Wellness	NA	$250 per period of coverage not subject to deductible or coinsurance Available for those 30 years of age and over after 12 months of continuous coverage	$500 per period of coverage not subject to deductible or coinsurance Available for those 18 years of age and over after 12 months of continuous coverage
Child Wellness	Three visits per period of coverage maximum $70 per visit. Available for children under 18 years of age after 12 months of continuous coverage	$200 maximum per period of coverage not subject to deductible or coinsurance Available for children under 18 years of age after 12 months of continuous coverage	$400 maximum per period of coverage not subject to deductible or coinsurance Available for children under 18 years of age after 12 months of continuous coverage
Other Services	Extended Care - limited to first 30 days of confinement Radiation Treatment - URC Home Nursing Care - limited 30 days per covered event Hospice Care - limited 30 days per covered event Prosthetic Devices - all URC	URC	URC
Physical Therapy	Maximum $40 per visit 30 visit maximum per period of coverage	Maximum $50 per visit	Maximum $50 per visit
High School Sports Injury	NA	NA	Up to $5,000 maximum
Recreational SCUBA	NA	URC	URC
Remote Transportation	NA	NA	Limited to $5,000 per certificate period up to a $20,000 lifetime maximum
Political Evacuation and Repatriation	NA	NA	Limited to $10,000 lifetime maximum
Complementary Medicine	NA	Acupuncture $150 Aroma Therapy $50 Herbal Therapy $50 Magnetic Therapy $75 Massage Therapy $150 Vitamin Therapy $100 Each per period of coverage	Acupuncture $150 Aroma Therapy $50 Herbal Therapy $50 Magnetic Therapy $75 Massage Therapy $150 Vitamin Therapy $100 Each per period of coverage
Non-emergency Dental	NA	NA	Calendar year maximum - $750 Individual deductible - $50 Schedule of benefits - Class I: 90% Class II: 70% Class III: 50% Ortho 0% (6 month waiting period)
Emergency Dental due to Accident	$1,000 per period of coverage	URC	URC
Emergency Dental due to Sudden Unexpected Pain	NA	$100 per period of coverage	See non-emergency dental benefits
Vision	NA	NA	Exams - up to $100 per 24 months Materials - up to $150 per 24 months
Global Concierge & Assistance Services	NA	NA	Included
Pre-existing Conditions	$5,000 per period of coverage up to a $50,000 lifetime maximum. Available after 24 months of continuous coverage	$5,000 per period of coverage up to a $50,000 lifetime maximum. Available after 24 months of continuous coverage	SAAI
NA (Not Applicable) / URC (Usual, Reasonable and Customary) / SAAI (Same As Any Illness)