Atlas Travel

From Tokio Marine HCC

Available for up to 364 days for US residents and visitors, Atlas Travel® is a comprehensive travel medical plan that provides coverage for any new illness & injury that might occur while traveling outside of your home country.

**Note: Not available to individuals who are physically located in New York, Maryland, or Washington or in the country of Canada or Australia at time of purchase.

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Atlas Travel® Benefit Schedule

Benefit

Description

Overall Maximum Limit per Certificate Period (Excludes Emergency Medical Evacuation, Accidental Death and Dismemberment, Common Carrier Accidental Death, Personal Liability, and Crisis Response)
  • Age 80 or older - $10,000;
  • Age 70 to 79 - $50,000, $100,000;
  • All others - $50,000, $100,000, $200,000, $500,000, $1,000,000, $2,000,000
Deductibles
$0, $100, $250, $500, $1,000 or $2,500 per Certificate Period.
Coinsurance - Claims incurred in US or Canada:
For the certificate period, underwriters will pay 80% of the next $5,000 of eligible expenses after the deductible, then 100% to the overall maximum limit. Coinsurance will be waived if expenses are incurred within the PPO
Coinsurance - Claims incurred outside US or Canada:
For the certificate period, underwriters will pay 100% of eligible expenses after the deductible up to the overall maximum limit
Medical Benefits

Subject To Deductible, Coinsurance, and per Certificate Period unless specifically indicated otherwise

Hospital Room and Board
Average semi-private room rate, including nursing services
Intensive Care Unit
Usual, reasonable and customary charges
Local Ambulance
Usual, reasonable and customary charges, when covered illness or injury results in hospitalization as inpatient
Emergency Room Co-payment - Claims incurred in U.S. or Canada
You shall be responsible for a $200 co-payment for each use of emergency room for an illness unless you are admitted to the hospital. There will be no co-payment for emergency room treatment of an injury.
Urgent Care Center - Claims incurred in U.S. or Canada
For each visit, you shall be responsible for a $50 co-payment, after which coinsurance will apply. Not subject to deductible. Co-payment waived if $0 deductible elected.
Acute Onset of Pre-existing Condition (excludes chronic and congenital conditions - only available to members under age 70)
  • Overall maximum limit
  • $25,000 lifetime maximum for Emergency Medical Evacuation
Terrorism
$50,000 maximum lifetime limit, eligible medical expenses only
Physical Therapy and Chiropractic Care
$50 maximum per day. (must be ordered in advance by a physician)
All Other Eligible Medical Expenses
Usual, reasonable and customary charges
Other Benefits

Usual reasonable and customary charges, not subject to deductible and coinsurance

Emergency Medical Evacuation
$1,000,000 lifetime maximum, except as provided under acute onset of pre-existing condition (not subject to deductible or coinsurance)
Repatriation of Remains
Overall maximum limit
Local Burial or Cremation
$5,000 lifetime maximum
Crisis Response - Ransom, Personal Belongings, and Crisis Response Fees and Expenses
$10,000
Optional Crisis Response Rider with Natural Disaster Evacuation
$90,000 per certificate period, with $10,000 maximum for Natural Disaster Evacuation
Emergency Reunion
$50,000 subject to a maximum of 15 days
Bedside Visit
$1,500
Return of Minor Children
$50,000
Pet Return
Up to $1,000 to return a traveling pet home if member is hospitalized
Political Evacuation
$10,000 lifetime maximum
Trip Interruption
$5,000 limit per certificate period
Accidental Death and Dismemberment
(excludes loss due to common carrier accident; $250,000 maximum benefit per any one family or group)
Members up to age 18
Lifetime max. - $5,000; Death - $5,000; Loss of 2 limbs - $5,000; Loss of 1 limb - $2,500
Members age 18 through 69
Lifetime max. - $50,000; Death - $50,000; Loss of 2 limbs - $50,000; Loss of 1 limb - $25,000
Members age 70 through 74
Lifetime max. - $12,500; Death - $12,500; Loss of 2 limbs - $12,500; Loss of 1 limb - $6,250
Members age 75 and older
Lifetime max. - $6,250; Death - $6,250; Loss of 2 limbs - $6,250; Loss of 1 limb - $3,125
Optional Accidental Death & Dismemberment Rider (only available to members age 18 through age 69)
  • Lifetime Maximum - $50,000
  • Death - $50,000
  • Loss of 2 Limbs - $50,000
  • Loss of 1 Limb - $25,000
Common Carrier Accidental Death
($250,000 maximum benefit per any one family or group)
Members up to age 18
$25,000
Members age 18 through 69
$50,000
Members age 70 through 74
$12,500
Members age 75 and older
$6,250
Lost Checked Luggage
$500 limit per certificate period (not subject to deductible or coinsurance)
Trip Delay
$100 for a 12-hour delay requiring an unplanned overnight stay (2 days maximum)
Emergency Dental (Acute Onset of Pain)
$250
Natural Disaster Benefit - Replacement Accommodations
Maximum $100 a day for 5 days
Hospital Indemnity
(addition to medical expenses)
$100 per day of inpatient hospitalization
Personal Liability
  • $10,000 lifetime maximum
  • $10,000 third person injury
  • $10,000 third person property
  • $2,500 related third person property
Optional Personal Liability Rider
$90,000 lifetime maximum

Benefit Period Medical Coverage

While the Certificate is in effect, the Benefit Period does not apply. Upon termination of the Certificate, Underwriters will pay Eligible Medical Expenses, as defined herein, for up to 90 days beginning on the first day of diagnosis or treatment of a covered Injury or Illness while the Member is outside his or her Home Country and while the Certificate was in effect. The Benefit Period applies only to Eligible Medical Expenses related to the Injury or Illness that began while the Certificate was in effect.

Incidental Home Country Coverage

For Citizens and legal residents of the U.S, for every three month period during which the Member is covered hereunder, Medical Expenses incurred in the U.S. are covered up to a maximum of 15 days for any three month period.. For Non-U.S. residents or Non-U.S Citizens, for every three month period during which the Member is covered hereunder, Medical Expenses incurred in the member’s home country are covered up to a maximum of 30 days for any three month period. Any benefit accrued under a single 3 month period does not accumulate to another period. Failure of the member to continue his or her international trip or the members return to their home country for the sole purpose of obtaining treatment for an illness or injury that began while traveling shall void any home country coverage provided under the terms of this agreement.

End of Trip Home Country Medical Coverage

If you are covered under the Atlas Travel® and outside of your Home Country continuously (except for covered Incidental Trips as described above) for six (6) months or more you may purchase an additional 30 days of End of Trip Home Country Medical Coverage.

Home Country Defined

If you are a US citizen, your Home Country is the United States, regardless of the location of your Principal Residence. If you are not a US citizen, your Home Country is the country where you principally reside and receive regular mail.

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.

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