Online Major Medical Plan from Petersen International Underwriters
Need for coverage
Domestic Major Medical policies provide a very limited amount of coverage while you are travelling outside the USA. Most Domestic policies define the international coverage as “emergency only” or “life threatening” coverage for conditions while you are outside the USA. This means that many conditions are not covered under your base plan while you are outside the USA. For instance if you were to have a broken bone, influenza, food poisoning, urinary tract infection, or other common accidents or sicknesses chances are that your domestic policy will not cover you. If you were to purchase an Online Major Medical the conditions listed above will be covered unless they are determined to be a pre-existing condition.
Description of Available Benefits
The insurance being described is a temporary major medical insurance plan. Eligible expenses caused by an illness or injury and incurred from any doctor or any hospital within a specified geographical area will be reimbursed to you. Benefits may be assignable directly to the providers once a claim has been reviewed and completed.
|Choice of Deductible||Coinsurance||Maximum Benefit|
||After Deductibles are paid, Underwriters will reimburse 80% of the next $5,000 in eligible expenses and then 100% of eligible expenses up to the Maximum Benefit||Age 0-69: $50,000 to $5,000,000
Age 70-74: $50,000 to $250,000
Age 75-79: $50,000 to $100,000
Age 80-84: $50,000
|(Deductibles listed are per person, per policy period)||(Benefits listed are per person, per policy period)|
- Hospital Expenses: All medically necessary expenses while hospitalized.
- Physician Services: All medically necessary expenses for treatment.
- Skilled Nursing Facilities: All medically necessary expenses if confinement begins following a medically necessary hospital confinement of 3 days or longer.
- Home Health Care: All medically necessary expenses if hospitalization would have been required if Home Health Care was not provided and the care is provided in accordance with a written plan established, approved and followed by a physician.
- Ambulance Services Expenses: To and from a hospital within 100 miles in the same geographic area.
- Prescription Drugs: Covered during and following a period of hospitalization.
- $100,000 Repatriation of Remains: In the event of death, Underwriters will reimburse the cost of delivery of your remains to a mortuary nearest your home up to $100,000.
- $100,000 Global Medical Transportation: All medically necessary expenses for stabilization and transportation to the facility nearest your home, which can provide the appropriate care up to $100,000.
- $25,000 Accidental Death: Double indemnity ($50,000 total) if accidental death occurs while riding as a passenger of a common carrier.
- $5,000 Emergency Return Home: If, after you have departed, you learn of the death of an Immediate Family Member, or you learn of the substantial destruction of your home by fire, wind, flood, or earthquake, Underwriters shall reimburse you the cost of an economy one way air or ground transportation ticket for you to your home, up to a maximum of $5,000.
- $1,000 Trip Cancellation Benefit: If within two weeks prior to your pre-paid ticketed or vouchered initial trip departure your entire trip must be cancelled due to 1) your death, illness or injury causing hospitalization or outpatient surgery, or 2) the death of an Immediate Family member, or 3) the substantial destruction of your home due to fire, wind, flood, or earthquake, any unused and nonrefundable portion of expenses shall be reimbursed up to a maximum of $1,000, excess of $100 each and every loss and excess of all other valid Insurances.
- $500 Lost Luggage: In the event that your checked on luggage is completely and totally lost, Underwriters shall reimburse you to a maximum of $500, excess of any and all other valid and collectible coverages.
- Common Accident Provision: In the event that you and any additional insured family members suff er injuries from the same accident, only one deductible and coinsurance shall be applied.
War & Terrorism Coverage
If you elect this option Underwriters will reimburse You for Eligible Expenses which are incurred as a result of Injuries or Illnesses sustained due to war/terrorism or act of war/terrorism. Injuries or Illnesses due to war/terrorism or act of war/terrorism involving the use or release of any nuclear weapon or device or chemical or biological agent, regardless of any contributory cause(s) are not covered with this optional benefit.
Sports or Activity Coverage
If you elect this option, underwriters will reimburse you up to $250,000 for eligible expenses which are incurred due to an injury resulting from the participation in a sport or activity that is specifically named on the Schedule of Coverage. (See exclusions for a list of commonly excluded sports and activities.)
This is not intended to be a complete outline of coverage. Actual wording may change without notice.
Underwriters reserve the right to modify terms and benefi ts at time of underwriting.
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.