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What is covered in the IMG Global Medical Insurance policy?
Global Medical Insurance is a long-term, annually renewable, U.S.-style major medical insurance plan. There are three plan options available: Silver, Gold and Platinum. The Silver and Gold plans provide US$5,000,000 of lifetime coverage, while the Platinum plan provides US$8,000,000 of lifetime coverage.
Jump to Plan Feature Descriptions:
:: Silver | Gold | Platinum Plan Features
:: Gold | Platinum Additional Plan Features
:: Platinum Plan Additional Features
:: Platinum Global Concierge & Asisstance Services
:: Pre-Existing Conditions
:: Exclusions and Limitations
Silver | Gold | Platinum Plan Features
The following is a partial list of benefits and terms that are offered on all three plan options (Silver, Gold, and Platinum). Please see the Summary Schedule of Benefits for further comparison of specific benefit levels. Please refer to the Certificate Wording for specific terms, conditions and other details regarding the benefits.
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Hospitalization
Offers benefits for the following:
- room and board
- nursing services
- prescription medication
- physician charges
- diagnostic and laboratory testing
- X-rays, chemotherapy and radiation
- durable medical equipment
- treatment, services and supplies routinely provided
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Surgery
Offers benefits for the following:
- surgical care
- second surgical opinion
- physician charges for surgery
- treatment, inpatient and outpatient services and supplies routinely provided
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Outpatient
An insured who receives medically necessary treatment by a physician or other health care provider that does not require an overnight stay.
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Rx Coverage
Medication prescribed by a physician for treatment of a covered illness or injury. These plan options also include a discount drug card administered by Universal Rx.
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Emergency Room
Accident
Charges incurred for the use of the emergency room are covered up to the policy maximum.
Illness
Services received in the emergency room are covered up to the policy maximum. Emergency room charges that do not require admittance to the hospital will be subject to an additional $250 deductible.
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Emergency Medical Evacuation
This coverage is available when there is not a qualified facility in the immediate are to treat your life-threatening illness or injury.
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Return of Mortal Remains
Covers expenses for repatriation of bodily remains or asses to the insured person's home country for death resulting from a covered injury or illness.
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Transplants
The plan options will reimburse an insured person with respect to a covered transplant insured up to the benefit limit for each plan option. These are limited to certain transplants and covered only within designated transplant facilities that are members of the independently contracted PPO Network.
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Child Wellness
Routine physical exams, inoculations, vaccinations, and other related well child care for eligible children.
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Other Services
Provides the following services:
chiropractor when referred by a physician, radiation treatment, home nursing care, hospice care, physical therapy and prosthetic devices.
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Mental / Nervous
Charges for the diagnosis, treatment, and prescribed medication by a licensed physician for a mental or nervous state of health; physical, emotional, or behavioral illness. This benefit is part of the Sliver plan option as inpatient only.
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Maternity
Coverage for pre- and post-natal care, normal delivery or C-section for each pregnancy, well baby care and treatment of newborn for the first 31 days. Coverage may be purchased as a rider at the time of initial application under the Silver and Gold plan options. Under the Platinum plan option, Maternity is covered the same as any illness. See Summary Schedule of Benefits for additional information.
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Gold | Platinum Additional Plan Features
In additional to the benefits listed above, the following are included on the Gold and Platinum plan options.
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Emergency Reunion
Expenses incurred for the travel of a relative or friend of the insured person during an emergency medical evacuation.
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Recreational SCUBA
Covers usual, reasonable and customary charges for illness or injury incurred while SCUBA diving if the insured person is using safe diving practices as laid down by an authoritative diving body.
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Adult Wellness
Includes routine physicals, mammograms and ob/gyn visits. Visits must be separated by at least 12 months.
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Complementary Medicine
Alternative treatments deemed medically necessary and prescribed by a licensed physician for a covered illness.
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Platinum Plan Additional Features
The Platinum plan option is the complete international protection program. It offers enhanced and additional benefits, access to a dedicated service team ready to assist you, and access to our exclusive Global Concierge and Assistance ServicesSM.
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Remote Transportation
In addition to Emergency Medical Evacuation, the Platinum plan option provides Remote Transportation. In the event of a diagnosis of a critical medical condition which is not necessarily immediately life-threatening, but severe enough to result in death or a permanent disability if not treated right away, Remote Transportation will provide for eligible charges arising out of the transportation of an insured person to a qualified facility for further treatment (if the current facility is unable to provide such treatment).
To be eligible, Remote Transportation must be recommended by the attending physician in critical medical situations, and approved in advance and coordinated by IMG.
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Political Evaculation
If the United States Department of State, Bureau of Consular Affairs issues a mandatory evacuation order of the host country that becomes effective on or after the insured person's date of arrival in the host country, the Company will pay up to $10,000 lifetime maximum for transportation to the nearest place of safety or for repatriation to the insured person's home country or country of residence provided that 1) the evacuation order must apply specifically to the insured person, 2) the insured person contacts the Company within 10 days of the United States Department of State, Bureau of Consular Affairs issuance of the evacuation order 3) there is not a travel advisory in effect on or within six (6) months prior to the insured person's date of arrival or return in the host country and 4) Political Evacuation and repatriation is approved and coordinated by IMG.
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Vision / Dental
The Platinum plan option provides coverage for the cost of vision exams and materials (includes frames, lenses and contacts).
The plan provides for Dental Services as follows: Class I (Diagnostic and Preventive Services), Class II (Basic Services) and Class III (major Services) as defined by the Certificate. These benefits are available after a six (6) month waiting period and exclude orthodontia care.
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High School Spotrs Injury
Covers up to a maximum of $5,000 for injuries incurred during sanctioned, organized sports at the high school level and below.
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Platinum Global Concierge & Asisstance Services
The Platinum plan option provides clients more than insurance protection. IMG's Global Concierge and Assistance Services offers the knowledge and information they need to keep them healthy and safe. Below is a list of services handled by a dedicated service team that is available 24 hours per day, seven days per week, exclusively for our Platinum members. (Global Concierge and Assistance Services are additional services offered under the Platinum plan option. They are not insurance benefits.)
- 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 Referral - 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 medications.
- 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.
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Pre-Existing Conditions
After coverage has been in effect for 24 continuous months, Global Medical Insurance provides 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. This is important since few pre-existing conditions remain free from ongoing consultation or treatment, and often do not qualify for coverage in standard plans.
Global Medical Insurance does 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.*
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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 under the plan, and are subject to the waiting period and other limitations of coverage described above: tonsillectomy, disc disease, 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.
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Exclusions and Limitations
OTHER EXCLUSIONS AND LIMITATIONS
- Routine physical examinations-first 12 months
- Maternity and newborn-first 12 months
- Mental and nervous-first 12 months
- Organized amateur or professional sports
- 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
- Devices to correct sight or hearing
- 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
- Services and treatment eligible for payment by any government or other insurance
* See certificate wording for a definition of pre-existing conditions and a complete list of exclusions and limitations, and for all other specific terms and conditions of the plan. Certificate wording is available upon request.
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Last updated on: 07/21/2008
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