Global Medical Insurance - International Long-Term Insurance Plan
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*Best for all Nationalities - Expatriates, Recent Green Card Holders, H1-H4-B1-B2-J1-F1 visa holders and US Citizens!
*Worldwide including US/Canada option
*Annually Renewable
*Prescription Discount Card included
*Worldwide excluding US/Canada option
*Nationwide PPO Network - Comprehensive Benefit!
*4 Levels of Coverage - Silver, Gold, Gold Plus & Platinum!
 
Global Medical Insurance
  1. Quote-Buy On-line

  2. View Brochure
  3. View Application
  4. View Rates
  5. Rates
  6. Benefits
  7. Exclusions
  8. Nationwide PPO Network
  9. Prescription Discount Card


Global Medical Insurance offers worldwide coverage to a wide variety of international clientele, including expatriates, international executives, diplomats, students, entertainers and other international travelers.. Traveling abroad can be an exciting experience. But what would happen if you or one of your family members became ill or injured while away from home? International travel can quickly turn frightening if you're not prepared for a medical emergency.

Most travelers assume they will be covered by their standard medical plan. The truth is, while traditional plans may offer adequate domestic coverage, they may not be designed for international travel. Without even realizing it, you may be putting your health - & that of your family - at risk.

What if you are injured or become ill during your trip? Could you get quality treatment at an unfamiliar hospital? How would you deal with the language and currency barriers? What if the treatment you need isn't available nearby? Who do you call? Imagine trying to call your insurance company at 3:00 a.m. from a foreign country during a medical emergency! Will they be there when you need them the most?

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.


The Experienced Plan Administrator:
Since 1990, International Medical Group has provided a unique, full-service approach to insurance coverage. Dedicated exclusively to international insurance market, IMG provides coverage services to individuals and families in more than 150 countries. Medical treatment while traveling is often an unfortunate fact of life. Our goal is to make the medical process a smooth and efficient one. IMG's multilingual claims administrators, on-site medical staff and customer service professionals work together to ensure that you medical needs are met. We process as many as 100,000 claims each year from countries throughout the world, and can confidently handle virtually any language or currency.

To give you true Global Peace of Mind, IMG representatives are available 24 hours a day, seven days a week, 365 days a year for medical emergencies, evacuations and precertifications. Our customer service is routinely rated among the highest in the industry. You can rest assured that IMG will be there for you, whether it be for routine treatment or during a medical emergency.

IMG gives you worldwide coverage experience, impeccable service and international expertise. Don't leave your medical care to chance. Let IMG reduce the uncertainties of international travel for you & your family.


Overview:

Long-Term comprehensive medical plan for individuals and families

Flexible, long-term, annually renewable, worldwide medical insurance program for U.S. citizens living or working abroad and for non-U.S. nationals worldwide.

Highlights:

  • Comprehensive, long-term medical coverage
  • Coverage for individuals and families
  • Four unique plan designs - Silver, Gold, Gold Plus and Platinum
  • Optional riders: Global Term Life Insurance, Global Daily Indemnity, Maternity, Terrorism, Sports
  • Choose your area of coverage (worldwide or worldwide excluding the U.S. and Canada)
  • Select from multiple deductible options
  • Family premium covers first two children between 14 days and 9 years at no additional cost
  • Choose from several payment modes
  • Multiple underwriting options to fit your needs
  • Freedom to choose your provider
  • Access to two extensive provider networks
  • Emergency Medical Evacuation and other evacuation benefits
  • Medical Concierge Program
  • Medical professionals to coordinate your care
  • 24 hour access to information

Who the plan is designed for:

  • Coverage for individuals or families living or working abroad
  • Contract employees living and working abroad
  • Seniors with dual residencies six months or longer outside the U.S.

Being a citizen of the global community can be an exciting experience, yet one that can pose potential complications. Your health care while abroad should not be one of those concerns. Global Medical Insurance is a revolutionary program from IMG that offers the flexible worldwide coverage you need, backed by the world-class services you expect. Unlike other health care programs on the market, Global Medical Insurance allows you to custom build a plan that is specifically tailored for you. With this booklet, you can easily create the blueprint for your own benefits package. You can conveniently compare the benefits of several plan options, and learn about the unique services and the dynamic company that provides them. Choosing and applying for the best coverage available is easy.

Global Medical Insurance is designed to meet your total needs. The program offers you the flexibility to select from an assortment of unique benefit options - each with specialized coverages. To accommodate your financial means, you can customize your length and area of coverage with the flexibility to select from multiple deductibles and modes of payment. With your medical history in mind, the program also provides flexible underwriting methods to extend coverage to you that may be declined by other companies.

Additionally, the program provides world-class services. To maximize the outcome of your medical care, our on-site clinical staff is ready to assist you at a moment’s notice, and our extensive global provider networks are quickly and easily accessible. You also have direct access to our Medical Concierge, an unequalled service that provides you with personalized assistance in locating the best provider for your specific needs, while saving you on out-of-pocket and medical expenses. You can also efficiently save time managing routine areas of your account by utilizing our secure, online service tools. In addition, IMG is available for service at your convenience - either through phone, email or Live Chat.

You need to know that you have the proper worldwide coverage. When you select Global Medical Insurance, you receive IMG’s commitment to deliver exceptional health benefits, medical assistance and service - all designed to give you Global Peace of Mind®.


Rates:
Global Medical Insurance - Annual Premiums Listed Below:
Global Medical Insurance is a surplus lines product underwritten by Sirius International Insurance Corporation (publ) (the "Company"). It is distributed, managed and administered, as agent for and on behalf of the Company, by International Medical Group®, Inc. ("IMG®").

Global Medical Insurance® New Business Rates

  • WORLDWIDE COVERAGE
  • WORLDWIDE COVERAGE EXCLUDING U.S./CANADA
  • ALL PRODUCTS

Premiums

  1. SILVER - ANNUAL PREMIUMS
  2. GOLD - ANNUAL PREMIUMS
  3. GOLD PLUS - ANNUAL PREMIUMS
  4. PLATINUM - ANNUAL PREMIUMS
New Business Rates through 30-Jun-2011 (Rates include surplus lines tax where applicable)

SILVER WORLDWIDE COVERAGE - ANNUAL PREMIUMS
  $250.00
deductible 		$500.00
deductible 		$1,000.00
deductible 		$2,500.00
deductible 		$5,000.00
deductible 		$10,000.00
deductible
 
Age M F M F M F M F M F M F
 
14 Days-9** First 2 Free*, Then 310 First 2 Free*, Then 270 First 2 Free*, Then 210 First 2 Free*, Then 184 First 2 Free*, Then 169 First 2 Free*, Then 150
 
10-18** 317 282 233 217 204 180
* The first two Dependent Children between the ages of 14 days to 9 years are free only when both parents or guardians are insured under the plan. **Dependent child rates are only available when at least one parent or guardian is insured under the plan. Children applying with no parent or guardian insured by must use the Male 19-24 rates.
 
19-24 718 895 622 881 484 675 422 588 331 473 294 407
 
25-29 758 1,020 662 991 515 764 449 663 352 551 313 433
 
30-34 848 1,128 730 1,063 566 823 496 718 389 576 345 490
 
35-39 950 1,333 770 1,182 596 918 522 793 408 661 364 516
 
40-44 1,202 1,463 976 1,273 647 997 567 873 542 676 482 602
 
45-49 1,339 1,614 1,098 1,373 850 1,062 741 925 605 730 538 650
 
50-54 1,635 1,796 1,386 1,548 1,071 1,201 935 1,068 794 886 706 789
 
55-59 1,976 1,976 1,718 1,718 1,330 1,328 1,159 1,159 976 984 868 876
 
60-64 2,909 2,738 2,651 2,480 2,235 1,973 2,024 1,816 1,691 1,502 1,505 1,337
 
65-69 6,075 5,271 5,814 5,041 5,439 4,591 4,181 3,412 3,656 3,274 3,254 2,914
 
70 - 74 Please contact IMG or your agent for premium information concerning this age bracket
New Business Rates through 30-Jun-2011
Optional Maternity Rider $2,500 annual premium
New Business Rates through 30-Jun-2011 (Rates include surplus lines tax where applicable)

SILVER WORLDWIDE COVERAGE EXCLUDING U.S/CANADA - ANNUAL PREMIUMS
  $250.00
deductible 		$500.00
deductible 		$1,000.00
deductible 		$2,500.00
deductible 		$5,000.00
deductible 		$10,000.00
deductible
 
Age M F M F M F M F M F M F
 
14 Days-9** First 2 Free*, Then 232 First 2 Free*, Then 203 First 2 Free*, Then 158 First 2 Free*, Then 138 First 2 Free*, Then 127 First 2 Free*, Then 112
 
10-18** 238 212 175 163 153 134
* The first two Dependent Children between the ages of 14 days to 9 years are free only when both parents or guardians are insured under the plan. **Dependent child rates are only available when at least one parent or guardian is insured under the plan. Children applying with no parent or guardian insured by must use the Male 19-24 rates.
 
19-24 539 671 466 660 363 506 317 441 248 355 221 306
 
25-29 569 766 497 744 385 572 336 498 264 413 234 326
 
30-34 636 846 548 798 424 618 372 538 291 432 259 369
 
35-39 714 1,000 578 888 447 689 392 595 307 496 273 387
 
40-44 901 1,098 731 955 486 748 425 655 407 510 362 451
 
45-49 1,004 1,211 823 1,030 638 797 556 694 453 548 404 487
 
50-54 1,226 1,347 1,040 1,161 803 901 702 801 595 665 530 592
 
55-59 1,482 1,482 1,288 1,288 997 996 869 869 731 738 651 657
 
60-64 2,182 2,054 1,988 1,860 1,676 1,480 1,518 1,363 1,268 1,127 1,129 1,003
 
65-69 4,556 3,953 4,361 3,781 4,080 3,443 3,136 2,559 2,742 2,456 2,441 2,185
 
70 - 74 Please contact IMG or your agent for premium information concerning this age bracket
New Business Rates through 30-Jun-2011
Optional Maternity Rider $2,500 annual premium

New Business Rates through 30-Jun-2011 (Rates include surplus lines tax where applicable)

GOLD WORLDWIDE COVERAGE - ANNUAL PREMIUMS
  $250.00
deductible 		$500.00
deductible 		$1,000.00
deductible 		$2,500.00
deductible 		$5,000.00
deductible 		$10,000.00
deductible
 
Age M F M F M F M F M F M F
 
14 Days-9** First 2 Free*, Then 430 First 2 Free*, Then 368 First 2 Free*, Then 275 First 2 Free*, Then 250 First 2 Free*, Then 221 First 2 Free*, Then 200
 
10-18** 476 388 304 275 246 221
* The first two Dependent Children between the ages of 14 days to 9 years are free only when both parents or guardians are insured under the plan. **Dependent child rates are only available when at least one parent or guardian is insured under the plan. Children applying with no parent or guardian insured by must use the Male 19-24 rates.
 
19-24 995 1,310 856 1,241 685 917 592 793 462 640 365 483
 
25-29 1,018 1,445 875 1,348 700 995 606 860 473 671 373 495
 
30-34 1,080 1,555 929 1,430 743 1,085 646 944 507 766 401 573
 
35-39 1,100 1,691 946 1,485 757 1,105 658 961 517 780 408 584
 
40-44 1,445 1,888 1,322 1,719 1,058 1,269 910 1,201 710 915 561 717
 
45-49 1,673 2,024 1,522 1,856 1,172 1,407 1,055 1,266 860 989 679 781
 
50-54 1,989 2,144 1,790 1,951 1,432 1,561 1,325 1,444 1,060 1,155 837 913
 
55-59 2,590 2,517 2,305 2,236 1,879 1,822 1,587 1,540 1,333 1,293 1,053 1,022
 
60-64 3,637 3,430 3,401 3,186 2,720 2,516 2,557 2,365 2,148 1,901 1,761 1,568
 
65-69 7,275 6,541 7,057 6,118 6,563 5,611 5,086 4,679 4,476 4,118 3,670 3,377
 
70 - 74 Please contact IMG or your agent for premium information concerning this age bracket
New Business Rates through 30-Jun-2011
Optional Maternity Rider $2,500 annual premium
New Business Rates through 30-Jun-2011 (Rates include surplus lines tax where applicable)

GOLD WORLDWIDE COVERAGE EXCLUDING U.S/CANADA - ANNUAL PREMIUMS
  $250.00
deductible 		$500.00
deductible 		$1,000.00
deductible 		$2,500.00
deductible 		$5,000.00
deductible 		$10,000.00
deductible
 
Age M F M F M F M F M F M F
 
14 Days-9** First 2 Free*, Then 318 First 2 Free*, Then 272 First 2 Free*, Then 203 First 2 Free*, Then 185 First 2 Free*, Then 164 First 2 Free*, Then 148
 
10-18** 352 287 225 204 182 164
* The first two Dependent Children between the ages of 14 days to 9 years are free only when both parents or guardians are insured under the plan. **Dependent child rates are only available when at least one parent or guardian is insured under the plan. Children applying with no parent or guardian insured by must use the Male 19-24 rates.
 
19-24 736 969 633 918 507 679 438 587 342 473 270 358
 
25-29 753 1,069 648 998 518 736 448 637 350 497 276 366
 
30-34 799 1,151 687 1,058 550 803 478 698 376 567 297 424
 
35-39 814 1,251 700 1,099 560 818 487 711 382 578 302 432
 
40-44 1,069 1,397 978 1,272 783 939 673 889 525 677 415 531
 
45-49 1,238 1,498 1,127 1,373 867 1,041 781 937 636 732 503 578
 
50-54 1,472 1,587 1,325 1,444 1,060 1,155 980 1,068 784 855 620 675
 
55-59 1,917 1,863 1,706 1,655 1,390 1,348 1,175 1,139 987 957 780 756
 
60-64 2,691 2,538 2,516 2,358 2,013 1,862 1,892 1,750 1,590 1,407 1,303 1,161
 
65-69 5,384 4,840 5,222 4,527 4,856 4,152 3,764 3,463 3,312 3,047 2,716 2,499
 
70 - 74 Please contact IMG or your agent for premium information concerning this age bracket
New Business Rates through 30-Jun-2011
Optional Maternity Rider $2,500 annual premium

New Business Rates through 30-Jun-2011 (Rates include surplus lines tax where applicable)

GOLD PLUS WORLDWIDE COVERAGE - ANNUAL PREMIUMS
  $250.00
deductible 		$500.00
deductible 		$1,000.00
deductible 		$2,500.00
deductible 		$5,000.00
deductible 		$10,000.00
deductible
 
Age M F M F M F M F M F M F
 
14 Days-9** First 2 Free*, Then 576 First 2 Free*, Then 485 First 2 Free*, Then 370 First 2 Free*, Then 335 First 2 Free*, Then 300 First 2 Free*, Then 270
 
10-18** 625 510 395 360 320 290
* The first two Dependent Children between the ages of 14 days to 9 years are free only when both parents or guardians are insured under the plan. **Dependent child rates are only available when at least one parent or guardian is insured under the plan. Children applying with no parent or guardian insured by must use the Male 19-24 rates.
 
19-24 1,230 1,620 1,058 1,541 823 1,153 726 1,021 595 825 469 623
 
25-29 1,273 1,894 1,111 1,789 861 1,284 757 1,129 623 983 487 675
 
30-34 1,406 2,120 1,235 1,988 961 1,477 852 1,307 697 1,102 549 824
 
35-39 1,527 2,349 1,357 2,135 1,049 1,641 930 1,439 760 1,229 597 847
 
40-44 1,970 2,574 1,741 2,300 1,349 1,784 1,198 1,585 976 1,260 772 989
 
45-49 2,217 2,677 1,980 2,416 1,535 1,879 1,361 1,662 1,111 1,283 876 1,008
 
50-54 2,694 2,906 2,424 2,643 1,887 2,063 1,718 1,871 1,408 1,531 1,104 1,203
 
55-59 3,411 3,315 3,127 3,038 2,441 2,373 2,153 2,092 1,813 1,761 1,415 1,374
 
60-64 4,795 4,520 4,434 4,159 3,713 3,438 3,388 3,135 2,812 2,488 2,308 2,055
 
65-69 11,385 8,634 9,539 8,273 8,820 7,549 6,859 6,196 5,950 5,356 4,903 4,415
 
70 - 74 Please contact IMG or your agent for premium information concerning this age bracket
New Business Rates through 30-Jun-2011
Optional Maternity Rider $2,500 annual premium
New Business Rates through 30-Jun-2011 (Rates include surplus lines tax where applicable)

GOLD PLUS WORLDWIDE COVERAGE EXCLUDING U.S/CANADA - ANNUAL PREMIUMS
  $250.00
deductible 		$500.00
deductible 		$1,000.00
deductible 		$2,500.00
deductible 		$5,000.00
deductible 		$10,000.00
deductible
 
Age M F M F M F M F M F M F
 
14 Days-9** First 2 Free*, Then 430 First 2 Free*, Then 365 First 2 Free*, Then 280 First 2 Free*, Then 250 First 2 Free*, Then 225 First 2 Free*, Then 200
 
10-18** 469 384 298 269 242 217
* The first two Dependent Children between the ages of 14 days to 9 years are free only when both parents or guardians are insured under the plan. **Dependent child rates are only available when at least one parent or guardian is insured under the plan. Children applying with no parent or guardian insured by must use the Male 19-24 rates.
 
19-24 922 1,215 794 1,156 617 825 545 731 446 620 353 467
 
25-29 954 1,420 834 1,342 646 963 568 847 467 738 366 507
 
30-34 1,054 1,591 926 1,491 755 1,109 638 981 523 827 413 618
 
35-39 1,146 1,761 1,018 1,602 788 1,231 697 1,079 571 922 448 636
 
40-44 1,477 1,931 1,306 1,726 1,012 1,338 898 1,189 733 945 579 743
 
45-49 1,663 2,009 1,484 1,812 1,151 1,409 1,021 1,247 835 963 657 756
 
50-54 2,021 2,180 1,819 1,983 1,415 1,547 1,289 1,404 1,056 1,148 828 903
 
55-59 2,559 2,487 2,345 2,279 1,830 1,780 1,614 1,570 1,360 1,321 1,062 1,031
 
60-64 3,596 3,391 3,326 3,120 2,784 2,578 2,542 2,351 2,109 1,866 1,731 1,542
 
65-69 7,426 6,476 7,154 6,205 6,615 5,662 5,144 4,648 4,463 4,017 3,677 3,312
 
70 - 74 Please contact IMG or your agent for premium information concerning this age bracket
New Business Rates through 30-Jun-2011
Optional Maternity Rider $2,500 annual premium

New Business Rates through 30-Jun-2011 (Rates include surplus lines tax where applicable)

PLATINUM WORLDWIDE COVERAGE - ANNUAL PREMIUMS
  $100.00
deductible 		$250.00
deductible 		$500.00
deductible 		$1,000.00
deductible 		$2,500.00
deductible 		$5,000.00
deductible 		$10,000.00
deductible
 
Age M F M F M F M F M F M F M F
 
14 Days-9** First 2 Free*, Then 1,910 First 2 Free*, Then 1,738 First 2 Free*, Then 1,558 First 2 Free*, Then 1,328 First 2 Free*, Then 1,256 First 2 Free*, Then 1,188 First 2 Free*, Then 1,130
 
10-18** 2,020 1,836 1,608 1,381 1,305 1,232 1,168
* The first two Dependent Children between the ages of 14 days to 9 years are free only when both parents or guardians are insured under the plan. **Dependent child rates are only available when at least one parent or guardian is insured under the plan. Children applying with no parent or guardian insured by must use the Male 19-24 rates.
 
19-24 3,585 6,105 3,259 5,510 2,890 5,272 2,380 3,934 2,169 3,552 1,886 3,099 1,613 2,484
 
25-29 3,690 6,685 3,354 6,080 3,004 5,775 2,463 4,313 2,237 3,863 1,945 3,443 1,652 2,551
 
30-34 4,008 7,410 3,644 6,736 3,273 6,352 2,679 4,873 2,441 4,380 2,107 3,787 1,785 2,981
 
35-39 4,130 8,135 3,754 7,395 3,405 6,779 2,767 5,348 2,519 4,762 2,169 4,154 1,831 3,048
 
40-44 5,140 8,855 4,672 8,049 4,200 7,257 3,387 5,762 3,075 5,186 2,615 4,243 2,194 3,459
 
45-49 5,700 6,750 5,181 6,136 4,694 5,184 3,771 4,484 3,411 4,036 2,895 3,250 2,407 2,681
 
50-54 6,290 7,270 5,718 6,608 5,614 6,068 4,501 4,865 4,152 4,469 3,509 3,765 2,882 3,086
 
55-59 8,420 8,205 7,654 7,458 7,069 6,885 5,649 5,507 5,052 4,927 4,348 4,241 3,523 3,440
 
60-64 11,575 10,945 10,522 9,949 9,775 9,205 8,281 7,711 7,609 7,089 6,416 5,747 5,373 4,849
 
65-69 23,205 20,315 21,093 18,466 20,344 17,724 18,855 16,225 14,795 13,424 12,913 11,683 10,745 9,736
 
70 - 74 Please contact IMG or your agent for premium information concerning this age bracket
New Business Rates through 30-Jun-2011
New Business Rates through 30-Jun-2011 (Rates include surplus lines tax where applicable)

PLATINUM WORLDWIDE COVERAGE EXCLUDING U.S/CANADA - ANNUAL PREMIUMS
  $100.00
deductible 		$250.00
deductible 		$500.00
deductible 		$1,000.00
deductible 		$2,500.00
deductible 		$5,000.00
deductible 		$10,000.00
deductible
 
Age M F M F M F M F M F M F M F
 
14 Days-9** First 2 Free*, Then 1,597 First 2 Free*, Then 1,451 First 2 Free*, Then 1,317 First 2 Free*, Then 1,146 First 2 Free*, Then 1,089 First 2 Free*, Then 1,038 First 2 Free*, Then 996
 
10-18** 1,676 1,523 1,356 1,185 1,128 1,073 1,025
* The first two Dependent Children between the ages of 14 days to 9 years are free only when both parents or guardians are insured under the plan. **Dependent child rates are only available when at least one parent or guardian is insured under the plan. Children applying with no parent or guardian insured by must use the Male 19-24 rates.
 
19-24 2,854 4,709 2,595 4,281 2,316 3,887 1,934 3,099 1,777 2,812 1,562 2,474 1,359 2,013
 
25-29 2,931 5,178 2,664 4,707 2,402 4,482 1,995 3,383 1,827 3,048 1,608 2,733 1,390 2,064
 
30-34 3,169 5,722 2,882 5,201 2,603 4,912 2,157 3,807 1,979 3,436 1,729 2,990 1,489 2,385
 
35-39 3,265 6,266 2,968 5,696 2,701 5,233 2,225 4,160 2,039 3,721 1,777 3,265 1,522 2,437
 
40-44 4,019 6,805 3,653 6,187 3,298 5,593 2,690 4,469 2,453 4,039 2,111 3,331 1,792 2,746
 
45-49 4,442 5,229 4,038 4,753 3,667 4,346 2,977 3,512 2,708 3,178 2,323 2,588 1,954 2,159
 
50-54 5,256 5,620 4,778 5,109 4,361 4,701 3,523 3,797 3,264 3,501 2,781 2,972 2,309 2,465
 
55-59 6,481 6,319 5,892 5,744 5,450 5,314 4,385 4,280 3,935 3,844 3,409 3,337 2,792 2,728
 
60-64 8,843 8,377 8,039 7,723 7,481 7,053 6,359 5,933 5,858 5,461 4,961 4,457 4,180 3,788
 
65-69 17,565 15,403 15,969 14,002 15,407 13,441 14,291 12,317 11,244 10,216 9,834 8,911 8,208 7,452
 
70 - 74 Please contact IMG or your agent for premium information concerning this age bracket
New Business Rates through 30-Jun-2011

Benefits:
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 Silver Gold
(1st 36 months of continuous coverage) 		Gold
(Beginning the 1st day of the 37th month) 		Gold Plus Platinum
Lifetime Maximum Limit $5,000,000
lifetime per individual		 $5,000,000
lifetime per individual		 $5,000,000
lifetime per individual		 $5,000,000
lifetime per individual		 $8,000,000
lifetime per individual
Deductible
(Per Period of Coverage) 		$250 to $10,000
50% waived within PPO network		 $250 to $10,000
50% waived within PPO network		 $250 to $10,000
50% waived within PPO network		 $250 to $10,000
50% waived within PPO network		 $100 to $10,000
50% waived within PPO network
Family Deductible Three times the individual deductible Three times the individual deductible Three times the individual deductible Three times the individual deductible Two times the individual deductible
Coinsurance within the PPO network No coinsurance No coinsurance No coinsurance No coinsurance No coinsurance
Coinsurance outside the U.S. and Canada No coinsurance No coinsurance No coinsurance No coinsurance No coinsurance
Coinsurance inside 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 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
Hospitalization / Room & Board $600 per day - 240 day maximum Average semi-private room rate Up to a limit of $2,250 per day Average semi-private room rate Private room rate
Intensive Care Unit $1,500 per day - 180 day per event URC Up to a limit of $4,500 per day URC URC
Surgery URC URC URC URC URC
Anesthetist's Charges Associated with Surgery 20% of surgery benefit URC 20% of surgery benefit URC URC
Transplants $250,000
per transplant		 $1,000,000
lifetime maximum		 $500,000
lifetime maximum		 $1,000,000
lifetime maximum		 $2,000,000
lifetime maximum
Out-patient 25 visits: $70 doctor/specialist; $60 psychiatrist; $50 chiropractor; $250 X-ray per exam maximum limit; $500 surgery intervention consultation; $300 lab tests per exam maximum limit URC Physician Charges - limit of $150 per visit; Hospital Charge - $100 co-pay unless admitted; Urgent Care Facility - $25 copay; Diagnostic Lab and X-Rays limited to $5,000 per certificate period; Physiotherapy - up to $75 per visit, $1,000 max per certificate period $10,000 lifetime maximum URC URC
Emergency Room Illness
(Additional $250 deductible if not admitted) 		URC URC URC URC URC
Emergency Room Accident URC URC URC URC URC
Supplemental Accident NA $300
per occurrence		 $300
per occurrence		 $300
per occurrence		 $500
per occurrence
Local Ambulance $1,500
per covered event - not subject to deductible or coinsurance		 URC $100 per event - not subject to deductible or coinsurance URC URC
Mental/Nervous Outpatient only after 12 months $10,000 per period - $50,000 maximum - Available after 12 months of continuous coverage $2,500 maximum per certificate period; In-patient limited to 25 days per certificate period; Out-patient limited to max of 20 visits per certificate period at 70% eligible expenses, up to $75 maximum per visit; Lifetime maximum of $30,000 $10,000 per period - $50,000 maximum - Available after 12 months of continuous coverage SAAI - $50,000 lifetime maximum - Available after 12 months of continuous coverage
Child Wellness 3 visits per period of coverage - $70 maximum per period - Available after 12 months of continuous coverage $200 maximum per period of coverage - Available after 12 months of continuous coverage $200 maximum per period of coverage - Available after 12 months of continuous coverage $200 maximum per period of coverage - Available after 12 months of continuous coverage $400 maximum per period of coverage - Available after 6 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 $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 $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 6 months of continuous coverage
Emergency Evacuation $50,000
per period of coverage - not subject to deductible or coinsurance		 Up to maximum limit - not subject to deductible or coinsurance $250,000 limit per person per certificate period Up to maximum limit - not subject to deductible or coinsurance Up to maximum limit - not subject to deductible or coinsurance
Emergency Reunion NA $10,000 lifetime maximum $10,000 lifetime maximum $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		 $15,000
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
Remote Transportation NA NA NA NA Limited to $5,000 per certificate period up to a $20,000 lifetime maximum
Political Evacuation and Repatriation NA NA NA NA Limited to $10,000 lifetime maximum
Rx Coverage URC URC $5,000 per certificate period for each insured person, out-patient only URC Outside U.S. - URC
Inside U.S. - Rx drug card co-pay: $20 for generic / $40 for brand name where generic is not available
Other Services Extended care: first 30 days; Radiation: URC; Home nursing: 30 days per covered event; Hospice: 30 days; Prosthetic Devices: all URC URC URC - Radiation & Chemotherapy treatments (in and out-patient) limited to $10,000 per year; $50,000 lifetime maximum URC URC
Physical Therapy Maximum $40 per visit - 30 visit maximum Maximum $50 per visit Maximum $50 per visit Maximum $50 per visit Maximum $50 per visit
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		 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
Recreational SCUBA NA URC URC URC URC
Non-emergency Dental NA NA 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 $500 per period URC URC
Emergency Dental due to Sudden Unexpected Pain NA $100 per period of coverage $100 per period of coverage $100 per period of coverage See non-emergency dental benefits
High School Sports Injury NA NA NA NA Up to $20,000 per certificate period
Vision NA NA NA NA Exams - up to $100 Materials - up to $150 per 24 months
Global Concierge & Assistance Services NA NA 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 $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
Maternity
Delivery, wellness, new born care & congenital disorders (not subject to deductible or coinsurance - available after 10 months of coverage 		Optional Rider - $50,000 lifetime maximum, maximum of $5,000 for normal delivery, $7,500 for C-section, $200 child wellness benefit for the first 12 months, new born care & congenital disorders maximum of $250,000 for the first 31 days (Benefits reduced by 50% for births in that occur in the 11th 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 the first 12 months, new born care & congenital disorders maximum of $250,000 for the first 31 days (Benefits reduced by 50% for births in that occur in the 11th 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 the first 12 months, new born care & congenital disorders maximum of $250,000 for the first 31 days (Benefits reduced by 50% for births in that occur in the 11th 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 the first 12 months, new born care & congenital disorders maximum of $250,000 for the first 31 days (Benefits reduced by 50% for births in that occur in the 11th or 12th month of continuous coverage) SAAI - $1,000 additional deductible, $50,000 lifetime maximum, $200 child wellness benefit for the first 12 months, new born care & congenital illness maximum of $250,000 for the first 31 days
NA (Not Applicable) / URC (Usual, Reasonable and Customary) / SAAI (Same As Any Illness)

This Web page contains only a consolidated and summary description of all current benefits, conditions, limitations and exclusions. A certificate containing the complete Certificate Wording with all terms, conditions and exclusions will be included in the fulfillment kit. IMG reserves the right to issue the most current Certificate Wording for this insurance plan in the event this Web page, application, and/or brochure has expired, is modified, or is replaced with a newer version. Current Certificate Wordings are available upon request.

Exclusions:

Pre-existing conditions and exclusions
Flexible Underwriting


Global Medical Insurance provides flexible underwriting methods to extend coverage to you. Your application may be underwritten by Standard Underwriting or the Flexible Underwriting Option.

Standard Underwriting - All disclosed medical conditions which have not been specifically excluded or restricted by a rider, will be covered after coverage has been in effect for 24 continuous months (subject to the foregoing limits and the other terms of the plan*).

The Silver, Gold and Gold Plus plan options provide a $50,000 lifetime benefit for eligible pre-existing conditions that existed at or prior to the effective date, subject to a maximum of $5,000 per period of coverage. This benefit is payable whether or not you have received consultation or treatment for the condition(s) during the 24-month period of continuous coverage.

The following illnesses which exist, manifest themselves or are treated or have treatment recommended prior to or during the first 180 days of coverage from the initial effective date are considered pre-existing conditions and are subject to the waiting period and other limitations of coverage described above: asthma, allergies, tonsillectomy, back conditions, adenoidectomy, hemorrhoids or hemorrhoidectomy, disorders of the reproductive system, hysterectomy, hernia, gall stones or kidney stones, any condition of the breast, and any condition of the prostate.

On the Platinum plan option, conditions that are fully disclosed on the application and have not been excluded or restricted by a rider will be covered the same as any illness. Conditions, including any complications therefrom, that are not fully disclosed on the application will not be covered.

Flexible Underwriting Option - Where you may have otherwise been declined for coverage, the Flexible Underwriting Option allows us to extend coverage to you. After 24 months of continuous coverage, a pre-existing condition which has not been specially excluded by a rider will be covered the same as any other pre-existing condition so long as in that 24 month period no treatment has been received for that condition. If treatment has been sought, then the 24 month period starts over from the treatment date. Treatment includes: 1) Consulted any physician for Medical Treatment or Advice (other than routine check-ups); or 2) Taken medication (including prescription drugs, special diets or injections).

Other Exclusions and Limitations*

  • Adult routine physical examinations are excluded under the Silver plan option and for the first 12 months for the Gold, Gold Plus and Platinum plan options
  • Out-patient mental and nervous for the first 12 months on all plan options
  • In-patient mental and nervous is excluded under the Silver plan option and for the first 12 months for the Gold, Gold Plus and Platinum plan options
  • Maternity, newborn and congenital disorders (unless the maternity rider or Platinum plan option is purchased)
  • Maternity expenses (including prenatal, delivery, postnatal, newborn and congenital care) when the pregnancy is a result of Invitro
  • Organ transplants not specifically listed
  • Devices to correct sight or hearing are excluded under the Silver, Gold and Gold Plus plan options
  • Treatment or supplies not medically necessary
  • Treatment not ordered or received by a physician
  • Treatment by a relative or family member
  • Treatment as a result of war or riot
  • Treatment resulting from illegal activities
  • Organized amateur or professional sports
  • Services and treatment eligible for payment by any government or other insurance
  • Investigational, experimental or research procedures
  • Routine foot care
  • Elective cosmetic or plastic surgery
  • Drug and alcohol abuse treatment
  • Speech therapy
  • Custodial care
  • Weight modification
  • Treatment of impotency
  • Contraceptive medication or treatment
  • Persons HIV+ at effective date


This website contains only a consolidated and summary description of some of the current Global Medical Insurance benefits,conditions, limitations and exclusions. A certificate containing the complete Certificate Wording with all terms, conditions and exclusions will be included in the fulfillment kit. IMG reserves the right to issue the most current Certificate Wording for this insurance plan in the event this application and/or brochure has expired, is modified, or is replaced with a newer version. Current Certificate Wordings are available upon request.

Global Concierge and Assistance ServicesSM

DEDICATED SERVICE LINE
An international toll-free number accessible worldwide 24/7.

DEDICATED CLAIMS TEAM
Provides members with expedited claims processing.

BAG TRACKING
Assistance in locating lost checked baggage and arranging the delivery of it to you anywhere in the world.

DRUG TRANSLATION SERVICES
24/7 online access that provides country specific brand names of common prescription and over-the-counter medications.

EMBASSY & CONSULATE REFERRALS
Provides the location and contact information of the nearest U.S. Embassy or Consulate.

EMERGENCY CASH TRANSFERS
Assists in arranging and obtaining cash transfers anywhere in the world.

EMERGENCY MESSAGE RELAY
Relay messages to your family, friends and co-workers, helping you maintain contact during an emergency.

EMERGENCY TRAVEL ARRANGEMENTS
Assists in making the appropriate travel arrangements in the event you must interrupt your travel and return home.

LEGAL REFERRALS
Provides the contact information for an attorney located in your country of travel.

LOST PASSPORT/TRAVEL DOCUMENTS ASSISTANCE
Assists in reporting, retrieval or replacement of lost or stolen travel documents.

PRESCRIPTION DRUG REPLACEMENT ASSISTANCE
Assists in the replacement and shipment of lost or damaged medication.

PRE-TRIP HEALTH AND SAFETY ADVISORIES
24/7 online access to information concerning current passport and visa requirements; information regarding inoculations and vaccinations; and up-to-date travel safety advisories.

SECURITY UPDATES AND COUNTRY PROFILES
24/7 online access to the latest advisories and travel warnings.

Global Concierge and Assistance Services are additional services offered under the Platinum plan option. They are not insurance benefits.


Exclusions:

Pre-existing conditions and exclusions


Silver and Gold:
After coverage has been in effect for 24 continuous months, the Silver and Gold plan options provide a US$50,000 lifetime benefit for eligible pre-existing conditions that existed at or prior to the effective date, subject to a maximum of US$5,000 per period of coverage. This benefit is payable whether or not you have received consultation or treatment for the condition(s) during the 24-month period. The Silver and Gold plan options do not rider or charge additional premium for pre-existing conditions. If you properly disclose a pre-existing condition at the time of application and are accepted into the plan, you will be covered for eligible medical expenses after 24 months of continuous coverage, subject to the foregoing limits and the other terms of the plan.*

The following illnesses which exist, manifest themselves or are treated or have treatment recommended prior to or during the first 180 days of coverage from the initial effective date are considered pre-existing conditions and are subject to the waiting period and other limitations of coverage described above: asthma, allergies, tonsillectomy, back conditions,
adenoidectomy, hemorrhoids or hemorrhoidectomy, disorders of the reproductive system, hysterectomy, hernia, gall stones or kidney stones, any condition of the breast, and any condition of the prostate.

Platinum:
On the Platinum plan option, conditions that are fully disclosed on the application and have not been excluded or restricted by a rider will be covered the same as any illness. Conditions, including any complications therefrom, that are not fully disclosed on the application will not be covered.



OTHER EXCLUSIONS & LIMITATIONS*
  • Treatment not ordered or received by a physician
  • Treatment or supplies not medically necessary
  • Investigational, experimental or research procedures
  • Custodial care
  • Weight modification
  • Elective cosmetic or plastic surgery
  • Treatment of impotency
  • Contraceptive medication or treatment
  • Drug and alcohol abuse treatment
  • Organ transplants not specifically listed
  • Routine foot care
  • Treatment by a relative or family member
  • Treatment as a result of war or riot
  • Treatment resulting from illegal activities
  • Speech therapy
  • Persons HIV+ at effective date
  • Organized amateur or professional sports
  • Maternity and newborn care (unless the maternity rider or Platinum plan option is purchased - see Summary Schedule of Benefits)
  • Services and treatment eligible for payment by any government or other insurance
  • Adult routine physical examinations are excluded under the Silver plan option and for the first 12 months for the Gold and Platinum plan options
  • Devices to correct sight or hearing are excluded under the Silver and Gold plan options
  • Inpatient mental and nervous is excluded under the Silver plan option and for the first 12 months for the Gold and Platinum plan options
  • Outpatient mental and nervous for the first 12 months on all plan options


    • *This website contains only a consolidated and summary description of some of the current Global Medical Insurance benefits, conditions, limitations and exclusions. A certificate containing the complete Certificate Wording with all terms, conditions and exclusions will be included in the fulfillment kit. IMG reserves the right to issue the most current Certificate Wording for this insurance plan in the event this application and/or brochure has expired, is modified, or is replaced with a newer version. Current Certificate Wordings are available upon request.

    Nationwide PPO Network: Click here to ACCESS THE PPO DIRECTORY

    You may seek treatment under Global Medical Insurance with the hospital or doctor of your choice. If you choose the worldwide option and you
    need to seek treatment in the U.S., you may use the independent Preferred Provider Organization (PPO) contracted by IMG, a separately
    organized network of approximately 500,000 physicians and 4,700 privately owned and operated hospitals.* This PPO network includes
    a large number of hospitals including some of the most well-recognized university medical centers and transplant facilities

    Using this provider network could significantly reduce your out-of-pocket expenses. Your deductible will be reduced by 50%,
    and any coinsurance applicable to that charge is waived, when eligible treatment is received from a network provider.

    When a U.S. hospital outside the network is used, a co-payment of US $250 is required in addition to the regular deductible and coinsurance. This co-payment is waived, however,
    if there is not a network provider within 50 miles of the location of treatment.



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