Provides Stabe Pre-Existing Condition coverage to non-US citizens who reside outside the USA and are traveling outside of their Home Country to visit the United States. You must purchase the coverage before leaving on your trip and arrive in the USA before traveling to other countries. Coverage in countries outside the USA is available for up to 30 days during your Period of Insurance. A 90-day Minimum Premium is required. This plan is not available to any individual who is considered a Permanent or Habitual Resident of the country or jurisdiction in which care is received.

STABLE PRE-EXISTING CONDITION BENEFIT

Notwithstanding any other provision of this plan, benefits are payable for covered Medical Expenses resulting from a sudden and unplanned recurrence or acute exacerbation of a Stable Pre‑Existing Condition, provided such condition meets the requirements outlined in this section. Coverage applies only when immediate medical treatment is required to prevent serious deterioration of health. Except as specifically modified by this section, all other terms, conditions, exclusions, and limitations apply.

STABILITY REQUIREMENT

A Pre‑Existing Condition shall be considered Stable only if it meets the definition of Stable Pre‑Existing Condition contained in the Definitions section of this Certificate of Coverage.

Covered Stable Pre‑Existing Condition Maximum Limit

Benefits for all eligible expenses related to Pre‑Existing Conditions are subject to separate Deductible and Maximum Limits per Period of Insurance, as stated in the Schedule of Benefits. Once the Pre‑Existing Condition Maximum Limit is reached then 1) no further benefits will be payable for Pre‑Existing Conditions; 2) coverage will remain in effect for all other eligible expenses unrelated to Pre‑Existing Conditions.

Stable Pre-Existing Condition Events

Expenses for a Pre‑Existing Condition will be considered only when 1) the episode is sudden, unplanned, and first occurs after the effective date of coverage; 2) symptoms represent a sudden and unplanned recurrence or acute exacerbation of a Pre‑Existing Condition, or the sudden onset of a complication directly resulting from that condition, beyond routine maintenance care or expected disease progression; and 3) treatment is Medically Necessary and cannot be reasonably delayed. Multiple episodes of a Pre‑Existing Condition may be covered during the Period of Insurance, provided each episode results from a separate acute exacerbation; occurs after the Covered Person has been medically stabilized from the previous episode; is not a continuation of the same illness or course of treatment; is supported by appropriate medical records demonstrating a separate occurrence.

Excluded Pre‑Existing Condition Treatment

The following are not covered: 1) Routine or maintenance care, including scheduled physician visits, Elective or planned procedures, long-term disease management, medication refills not associated with a sudden and unplanned recurrence or acute exacerbation. 2) Treatment that was recommended prior to the Effective Date, or reasonably foreseeable at the time of travel. 3) Ongoing or continuous treatment without evidence of sudden and unplanned recurrence or acute exacerbation. 4) Dialysis, long‑term rehabilitation, or custodial care. 5) Where travel was undertaken primarily for the purpose of receiving medical Treatment for a Pre‑Existing Condition.

Medical Necessity and Documentation

All Pre‑Existing Condition Expenses must 1) be supported by Physician documentation describing the acute change in condition, and 2) demonstrate the Treatment was Medically Necessary and emergent or urgent in nature and are required to stabilize the condition. Expenses will be evaluated based on clinical presentation and medical records, and not solely on diagnostic coding.

Relationship to Other Plan Provisions Payments under this section shall not extend or increase the overall Policy Maximum. Expenses must meet the definitions of both Medical Expense and Medically Necessary. This section does not provide coverage for services otherwise excluded herein.

Termination of Pre‑Existing Condition Benefits

Pre-Existing Condition Benefits terminate upon the earliest of 1) exhaustion of the Pre‑Existing Condition Maximum Limit; or 2) the Termination of the Period of Insurance.

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Plan Highlights

  • MEDICAL MAXIMUM Choices $60,000, $250,000, $500,000, or $1,000,000 PER PERIOD OF INSURANCE
  • DEDUCTIBLE Choices $0, $50, $100, $250, $500, $1,000, $2,500 or $5,000 PER PERIOD OF INSURANCE
  • STABLE PRE-EXISTING CONDITION - sub-limits apply (*See Definition for details)
  • PRE-EXISTING CONDITION MEDICAL MAXIMUM Choices $1,500, $2,000, $2,500, $5,000, or $10,000
  • PRE-EXISTING CONDITION DEDUCTIBLE Choices $1,500, $2,000, $2,500, $5,000, or $10,000
  • After the deductibles, the plan pays 80% In Network / 60% Out of Network
  • COVID, SARS-CoV-2 are covered and treated as any other sickness
  • $50 per prescription up to a maximum of $500 per Period of Insurance (must be prescribed by a Physician)
  • Emergency Medical Evacuation $20,000/ Repatriation of Remains $10,000
  • Pre-certification is a general determination of Medical Necessity only. 50% reduction of Eligible Medical Expenses if Pre-certification requirements are not met.

Benefits of Coverage

Medical Benefits
Medical Expenses
Up to the Policy Maximum Selected $60,000, $250,000, $500,000, or $1,000,000 per Period of Insurance
Pre-existing Medical Maximum
Up to the Policy Maximum Selected $20,000, $25,000, $30,000, $40,000, or $50,000 per Period of Insurance
Deductible
$250, $500, $1,000, $2,500, or $5,000 per Period of Insurance
  • EMERGENCY ROOM SICKNESS WITH NO DIRECT HOSPITAL ADMISSION: $200 Additional deductible per visit – Only applies when receiving care in an Emergency Room for a Sickness that does not result in a Hospital admittance.
Pre-existing Conditions Deductible
$1,500, $2,000, $2,500, $5,000, or $10,000 per Period of Insurance
Stable Pre-existing Conditions
Covered subject to limits and exclusions
Co-insurance
After the applicable deductible, 80% In Network / 60% Out of Network
Pre-certification Requirements
Treatments & supplies: 50% reduction of Eligible Medical Expenses if Pre-certification requirements are not met/Deductible is taken after reduction/Coinsurance is applied to remainder/Refer to the PRE-CERTIFICATION REQUIREMENTS provision for a complete list of services that require Pre-certification
Cardiac Conditions or Stroke
Up to $25,000 per Period of Insurance for ages up to 69 or $15,000 per Period of Insurance for ages 70-89
Urgent Care Co-Pay
$25 In Network / $50 Out of Network Not Subject to Deductible
Dental Treatment for Injury of Sound Natural Teeth Due to Accident
Up to $250 per Period of Insurance for Injury or pain to Sound Natural Teeth
Prescription Medications
$50 per prescription up to a maximum of $500 per Period of Insurance (must be prescribed by a Physician)
Covid Coverage
Medically Necessary Treatment for COVID, SARS-CoV-2, and any mutation or variation of SARS-CoV-2 up to the medical maximum per Period of Insurance
Emergency Evacuation/Repatriation Benefits
Emergency Medical Evacuation
Up to $20,000 per Period of Insurance
  • Return of minor children or grandchildren or Travelling Companion - up to $5,000 per Period of Insurance
  • Limit of $25,000 Maximum per Period of Insurance for any condition covered under Acute Onset of a Pre-existing Condition Benefit
Emergency Reunion
Up to $15,000 per Period of Insurance
Repatriation of Mortal Remains
Up to $50,000 per Period of Insurance
Accidental Death Benefits
Accidental Death and Dismemberment
$25,000 Principal Sum
Additional Benefits
Return to Home Country Coverage
Optional Benefit
Up to $25,000 - provides coverage during the Period of Insurance, in your Home Country while on an Incidental Trip
  • For trips up to 60 days (total) per 12 months of Coverage Purchased. To be eligible your Period of Insurance must be greater than 30 days and are returning to the home country after the trip began.
  • Other Terms and Conditions apply- see Plan document for details
Extendable
Up to 364 days total coverage
24/7 Assistance Benefits
Non Insurance Assistance Services
Included - This is a non-insurance service included by Trawick International in the plan cost and is not a part of the insurance underwritten by Zurich Insurance Europe AG Belgian branch

Plan Definitions

  • STABLE PRE-EXISTING CONDITION

    Stable Pre‑Existing Condition means a diagnosed illness, disease, or other medical condition that, during the ninety (90) days immediately preceding the Effective Date:

    1. Has not required hospitalization or emergency medical treatment;
    2. Has not experienced an acute deterioration requiring immediate medical intervention;
    3. Has not been the subject of a Physician's recommendation for surgery or other major medical intervention; and
    4. Has not required a material change in treatment due to deteriorating of the condition.

    Material change in treatment means initiation of a new prescription medication, a significant increase in medication dosage or frequency due to deteriorating of the condition, recommendation for surgery or other major medical intervention, or initiation of a new course of treatment because of deteriorating of the condition.

    Routine follow-up care, maintenance medications taken as prescribed, prescription refills, routine monitoring, preventative care, or treatment changes made solely to maintain, titrate, or optimize therapy without evidence of deteriorating shall not constitute a material change in treatment.

  • Pre-Existing Condition

    “Pre-Existing Condition”

    means any Injury, Illness, Sickness, disease, 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, known, diagnosed, Treated, or disclosed to the Company prior to the Effective Date, and including any subsequent Chronic or recurring complications or consequences thereof.

    For purposes of the PRE‑EXISTING CONDITION BENEFIT provision, the Company may require medical records, prescription history, physician statements, or other documentation reasonably necessary to establish that the condition met the requirements of a Stable Pre‑Existing Condition.

  • CANCELLATION AND REFUND PROCEDURE PROVISIONS

    A full cancellation and refund will be considered only if we receive a written cancellation request on or before the Coverage Effective Date. If we receive a written cancellation request after the coverage Effective Date, a partial cancellation and refund of Premium may be available, subject to the following conditions:

    Claims Filed: If any claim has been submitted to us, the premium is deemed fully earned and is non-refundable.

    No Claims Filed: If no claim has been submitted a cancellation fee of US$50 will apply and only the premium attributable to unused coverage days beyond the initial 90-day minimum Premium Period is eligible for refund.

    If a Premium refund is issued and it is later determined that a claim had been submitted on behalf of a Covered Person before the cancellation date, the Covered Person will be solely responsible for the full amount of that claim. Once the cancellation and any applicable refund of Premium have been processed, both the Company and the Covered Person will be released from all rights, obligations, and liabilities under this Certificate of Coverage.

  • OPTIONAL EXTENSION PROCEDURES

    If eligible, an extension notice will be sent to the Covered Person before the Period of Insurance ends and includes links to extend prior to the Termination Date. The Covered Person is subject to the following rules at extension: In order to extend, the Period of Insurance must be initially purchased for a minimum of 90 days. If available, an extension period can be purchased: 1. at the Premium rate in force at the time of the extension; 2. for a minimum of 5 days; 3. for up to a maximum of 364 days, provided the Covered Person’s Period of Insurance does not exceed 364 days in total. There are no grace periods for extension.

  • Home Country or Country of Residence

    means the country in which the Covered Person maintains their current primary residence or usual place of abode and any country to which the Covered Person pays income taxes based upon employment in that country. In the event there is more than one Country of Residence under the above-listed criteria, the Country of Residence is the country meeting the above-listed criteria and listed by the Covered Person as their Country of Residence on the Application.

In the event that you are dissatisfied and want to make a complaint, you can do so at: complaints@trawickinternational.com

Sanctions Limitations Clause

The Insurer will not provide any cover, pay any claim or provide any benefit under this Plan to the extent that the provision of such cover, the payment of such claim or the provision of such benefit would expose them to any sanction, prohibition or restriction under United Nations resolutions or the trade or economic sanctions, laws or regulations of the European Union, United Kingdom or United States of America.