Plan Advantage 25K Advantage 50K Advantage 100K Advantage 150K
Policy Maximum $25,000 per Incident Max $50,000 per Incident Max $100,000 per Incident Max $175,000 per Incident Max
Physician’s Visits/ Urgent Care Limited to $55 per visit, one visit per day and 30 visits per Period of Insurance Limited to $75 per visit, one visit per day and 30 visits per Period of Insurance Limited to $100 per visit, one visit per day and 30 visits per Period of Insurance Limited to $130 per visit, one visit per day and 30 visits per Period of Insurance
Prescription drugs and medications $250 per Incident $350 per Incident $350 per Incident $350 per Incident
Hospital Room and Board $1,400 per day to a maximum of 30 days $2,000 per day to a maximum of 30 days $2,000 per day to a maximum of 30 days $3,000 per day to a maximum of 30 days
Hospital Intensive Care Unit $2,100 per day to a maximum of 10 days $2,500 per day to a maximum of 8 days $3,000 per day to a maximum of 8 days $4,500 per day to a maximum of 8 days
Physician's Surgical Treatment $3,500 per Incident $5,000 per Incident $6,000 per Incident $7,500 per Incident
Diagnostic X-rays and Lab Services $450 per Incident $750 per Incident $750 per Incident $1,000 per Incident
Assistant Physician’s Surgical $850 per Incident $850 per Incident $1,400 per Incident $1,800 per Incident
Ambulance Service $500 per Incident $650 per Incident $650 per Incident $750 per Incident
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Plan Highlights

  • This is a LIMITED BENEFIT PLAN where the maximum amount paid to the provider is listed on the plan
  • Accident and Sickness Medical Policy Maximum Choices $25,000, $50,000, $75,000, $100,000, $175,000
  • Deductible $0
  • Coinsurance per Period of Insurance - 80%
  • Out of Pocket Maximum per Period of Insurance -$5,000 (Ineligible Charges do not count towards the Out-of-Pocket Maximum)
  • Pre-Certification Required
  • COVID-19 EXPENSES are covered and treated as any other sickness
  • ACUTE ONSET OF A PRE-EXISTING CONDITION up to the policy maximum for ages 0-69, up to $25,000 for ages 70-79 and up to $15,000 Ages 80-89
  • Cardiac Conditions or Stroke are limited to $25,000 for Ages 0-69 and $15,000 Ages 70-89
  • Wellness Visit - covered up to $125 (restrictions apply)
  • Emergency Medical Evacuation/Medically Necessary Repatriation/Repatriation of Remains /Local Burial/Cremation
  • Return to Country Incidental Trip Coverage-Included
  • EXAMPLES OF PER INCIDENT LIMITED BENEFITS (varies by plan)
  • Hospital Room and Board Expenses $1,400 -$3,000 per day to a maximum of 30 days
  • Physician's Surgical Treatment $3,500 - $7,500 per Incident
  • Physician’s Non-Surgical Visits/Urgent Care $55 - $130 per visit/1 per day /30 visits per Policy Period
  • Outpatient Surgical Facility $1,000 - $1,400 per Incident
  • Diagnostic X-rays and Lab Services $450 - $1,000 per Incident
  • Ambulance Service Benefits $500 - $750 per Incident
  • Please view brochure for a complete list of limits compared by plan
  • SureGo Online Claims Administration

Benefits of Coverage

Medical Benefits
Note
This plan pays a fixed amount for each service provided. Any charges over the eligible allowed amount, is your responsibility.
Medical Expenses
Policy Maximum Choices: Ages 0- 69 $25,000, Per Incident. Ages 70 - 89 $25,000 Annual coverage. Benefits terminate upon reaching age 90. See brochure for a comparison of plan limits.
  • Fixed Benefit Plan: This plan offers a set payment limit for all covered treatments. Any charges over the eligible allowed amount, is your responsibility.
Deductible
$0
Co-insurance
80% of the first $25,000 - per Period of Insurance
Out-of-Pocket-Maximum per Period of Insurance
$5,000 (Ineligible Charges do not count towards the Out-of-Pocket Maximum)
Acute Onset of a Pre-Existing Condition
Covered up to the policy maximum for ages 0-69 coverage related to Cardiac Conditions or Stroke are limited to $25,000/Covered up to $25,000 for ages 70-79 Cardiac Conditions or Stroke are limited to $25,000 and for ages 80 and above, up to $15,000 including Cardiac Conditions or Stroke.
  • To qualify for this benefit the pre-existing condition must: occur spontaneously and without advance warning either in the form of Physician recommendations or symptoms, is of short duration, is rapidly progressive, requires urgent and immediate medical care;
  • occur a minimum of 48 hours after your Effective Date;
  • Treatment must be obtained within twenty-four (24) hours of the sudden and Unexpected outbreak or reoccurrence;
  • the Covered Person must not be traveling against or in disregard of the recommendations, established Treatment programs, or medical advice of a Physician or other healthcare provider;
  • the Covered Person must not be traveling with the intent or purpose to seek or obtain Treatment for the Pre-existing Condition;
  • the Pre-existing Condition must have been stabilized for at least thirty (30) days prior to the Effective Date without change in Treatment.
  • Note: Any repeat/reoccurrence within the same Period of Insurance will no longer be considered Acute Onset of a Pre-Existing Condition and will not be eligible for additional coverage;
  • This benefit does not include coverage for known, scheduled, required, or expected medical care, drugs or treatments existent or necessary prior to the Effective Date of coverage;
  • This benefit covers only one (1) Acute Onset episode of a Pre-Existing Condition.
Cardiac Conditions or Stroke Limit
$25,000 per Period of Insurance for ages 0-69/$15,000 per Period of Insurance for Ages 70-89
Covid Coverage
Covered as any other Sickness
Dental treatment for Injury of Sound Natural Teeth due to Accident
$600- $750 Per Incident
Well Doctor Visit
Up to $125 - One Visit per Period of Insurance restrictions apply
Telemedicine
This is non insurance service - For details visit https://trawickinternational.com/telemedicine
Emergency Evacuation Benefits
Emergency Medical Evacuation
$100,000 or Unlimited
Political Evacuation
$500-$2,000 per Period of Insurance
Natural Disasters Evacuation
$500-$2,000 per Period of Insurance
Return of Minor Children or Grandchildren
$5,000 - $10,000 per Period of Insurance
Repatriation of Mortal Remains
$7,500 - $25,000 per Period of Insurance
Local Burial/Cremation
$5,000 per Period of Insurance
  • Does not cover funeral costs. Make sure to read the Description of Coverage/Policy for full details of coverage. Pre-existing conditions are not covered.
  • Must be approved in advance by the Assistance Provider.
Additional Benefits
Accidental Death and Dismemberment
$25,000 - $35,000 Principal Sum
24/7 Non-Insurance Benefits
Non Insurance Assistance Services
Included

Plan Definitions

  • ACUTE ONSET OF PRE-EXISTING CONDITION

    ACUTE ONSET OF A PRE-EXISTING CONDITION: Benefits are payable for an Acute Onset of a Pre-Existing Condition up to the maximum as stated in the Schedule of Benefits provided the Acute Onset Event: 1. occurs spontaneously and without advance warning either in the form of Physician recommendations or symptoms, is of short duration, is rapidly progressive, and requires urgent and immediate medical care; 2. occurs a minimum of 48 hours after the Effective Date of the Coverage; and 3. treatment is obtained within 24 hours of the sudden and Unexpected outbreak or recurrence.

    Any repeat/reoccurrence within the same Period of Insurance will no longer be considered Acute Onset of a Pre-Existing Condition and will not be eligible for additional coverage. This benefit covers only one (1) Acute Onset episode of a Pre-Existing Condition. Sudden and Acute Onset of a Pre-Existing Condition Coverage expires upon medical advice that the condition and onset is no longer acute, or the Covered Person is discharged from a medical facility.

    To be eligible for the foregoing limited coverage and benefits for an Acute Onset of a Pre-existing Condition, the Covered Person must be in compliance with all Terms of this insurance. The Company will provide such coverage and benefits only when all of the following conditions and restrictions have been met.

    At the time of the Acute Onset of a Pre-existing Condition:

    (a) Treatment must be obtained within twenty-four (24) hours of the sudden and Unexpected outbreak or reoccurrence.
    (b) the Covered Person must be under ninety (90) years of age.
    (c) the Covered Person must not be traveling against or in disregard of the recommendations. established Treatment programs, or medical advice of a Physician or other healthcare provider.
    (d) the Covered Person must not be traveling with the intent or purpose to seek or obtain Treatment for the Pre-existing Condition. (e) the Covered Person must not be traveling during a period of time when the Covered Person is preparing or waiting for, involved in, or undertaking a new, changed or modified Treatment program with respect to the Pre-existing Condition, and is not traveling subsequent to any such new, changed or modified Treatment program having been advised or recommended. (f) the Pre-existing Condition must have been stabilized for at least thirty (30) days prior to the Effective Date without change in Treatment.
    (g) the Covered Person must be traveling outside their Habitual Country.

  • Cancellation and Refund Procedure Provisions

    Full cancellation and refund will only be considered if We receive written request prior to or on the Effective Date of the coverage. If We receive a written request for cancellation and refund after the Effective Date of coverage, a partial cancellation and refund may be allowed. The following conditions apply a) If any claims have been filed with Us, the premium is fully earned and is non-refundable. If no claims have been filed with the Company, then (i) a cancellation fee of US $50 will be charged; and (ii) only unused days b) premiums will be considered as refundable; and c) If after a refund is made, it is determined that a claim was presented to Us on a Covered Person’s behalf, the Covered Person will be fully responsible for that claim in its entirety. Upon effectuation of such cancellation and refund, neither the Company nor the Covered Person shall have any further rights, liabilities, or obligations under this insurance.

  • Cardiac Conditions

    “Cardiac Conditions” means medical conditions related to coronary disease, hypertension, high cholesterol/hyperlipidemia, congestive heart failure, arrhythmias, cardiomyopathy, valvular heart disease, congenital heart disease, and rheumatic heart disease. For the purpose of this definition a heart attack and myocardial infarction fall under the definition of Cardiac Conditions.

  • Coinsurance

    “Coinsurance” means the amount split between Us (80%) and the Covered Person (20%) for payment of Medical Expenses at the percentage specified in the Schedule of Benefits and not including any applicable Deductible or Out-of-Pocket Maximum.

  • Effective Date

    “Effective Date, Effective Date of Coverage” means the later of (a) the date of coverage for the Covered Person as indicated on the Declaration or (b) the date that the Covered Person departs their Country of Residence.

  • Medically Necessary; Medical Necessity

    “Medically Necessary; Medical Necessity” means a Treatment, service, medicine, or supply which is necessary and appropriate for the diagnosis or Treatment of an Illness or Injury based on generally accepted standards of current medical practice as determined by the Company. By way of example but not limitation, a service, Treatment, medicine or supply will not be considered Medically Necessary or a Medical Necessity if it is provided or obtained only as a convenience to the Covered Person or their provider; and/or if it is not necessary or appropriate for the Covered Person's Treatment, diagnosis or symptoms; and/or if it exceeds (in scope, duration or intensity) that level of care which is needed to provide safe, adequate, and appropriate diagnosis or Treatment.

  • Pre-certification; Pre-certify

    “Pre-certification; Pre-certify” means a general determination of Medical Necessity only, made by the Company in reliance and based upon the completeness and accuracy of the information provided by the Covered Person and/or the Covered Person’s healthcare or medical service providers, guardians, Relatives and/or proxies at the time thereof. Pre-certification is not an assurance, authorization, pre-authorization or verification of coverage, a verification of benefits, or a guarantee of payment.

  • Pre-Existing Condition

    “Pre-Existing Condition” means any Injury, Illness, sickness, disease, or other physical, medical, Mental or Nervous Disorder, condition or ailment that, with reasonable medical certainty, existed at the time of Application or at any time during the three (3) years prior to the Effective Date of this insurance, whether or not previously manifested, symptomatic or known, diagnosed, Treated, or disclosed to the Company prior to the Effective Date, and including any and all subsequent, chronic or recurring complications or consequences related thereto or resulting or arising therefrom.

    Proof of Eligibility is required prior to any payment of Claim.

  • Termination Date

    "Termination Date" means the coverage provided with respect to the Covered Person shall terminate at 12:01 AM North American Central Time on the earliest of the following dates: 1. The date shown on the insurance confirmation card, for which the premium is paid; or 2. The date the Covered Person returns to Their Home Country; or 3. Three hundred and sixty-four (364) days after the Covered Person's original effective date, unless extended; or 4. The date the Covered Person becomes a United States citizen.

  • Terms

    “Terms” means all Terms, provisions, conditions, definitions, Deductibles, Coinsurance, limits, sub-limits, limitations, wordings, restrictions, requirements, qualifications and/or exclusions that bind the Covered Person as set forth in the Certificate of Coverage, Application, and any Riders.