ELITE PLANS ECONOMY BASIC SILVER GOLD PLATINUM DIAMOND DIAMOND PLUS
Policy Maximum $25,000 per Incident Max $50,000 per Incident Max $75,000 per Incident Max $100,000 per Incident Max $175,000 per Incident Max $50,000 Annual Max $100,000 Annual Max
Physician’s Visits/ Urgent Care Limited to $55 per visit, one visit per day and 30 visits per Policy Period Limited to $75 per visit, one visit per day and 30 visits per Policy Period Limited to $75 per visit, one visit per day and 30 visits per Policy Period Limited to $100 per visit, one visit per day and 30 visits per Policy Period Limited to $130 per visit, one visit per day and 30 visits per Policy Period Limited to $75 per visit, one visit per day and 30 visits per Policy Period Limited to $75 per visit, one visit per day and 30 visits per Policy Period
Prescription drugs and medications $250 per Incident $350 per Incident $350 per Incident $350 per Incident $350 per Incident $250 per Incident $250 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 $2,000 per day to a maximum of 30 days $3,000 per day to a maximum of 30 days $1,500 per day to a maximum of 15 days $1,500 per day to a maximum of 15 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 $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 $2,300 per day to a maximum of 8 days $2,300 per day to a maximum of 8 days
Physician's Surgical Treatment $3,500 per Incident $5,000 per Incident $5,000 per Incident $6,000 per Incident $7,500 per Incident $3,500 per Incident $3,500 per Incident
Diagnostic X-rays and Lab Services $450 per Incident $750 per Incident $750 per Incident $750 per Incident $1,000 per Incident $750 per Incident $750 per Incident
Assistant Physician’s Surgical $850 per Incident $850 per Incident $1,200 per Incident $1,400 per Incident $1,800 per Incident $850 per Incident $850 per Incident
Ambulance Service $500 per Incident $650 per Incident $650 per Incident $650 per Incident $750 per Incident $650 per Incident $650 per Incident
Get Quote
Brochure
Certificate

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
  • Deductibles $0- Ages 0-69 and $100 or $200 Ages 70-89
  • COVID-19, SARS-CoV-2 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 plan details for a complete list of limits 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
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
Medically Necessary Treatment for COVID-19, SARS-CoV-2, and any mutation or variation of SARS-CoV-2 up to the medical maximum per Period of Insurance
Dental Treatment for Pain to Sound Natural Teeth
$600- $750 Per Incident
Well Doctor Visit
Up to $125 - One Visit per Period of Insurance restrictions apply
Telemedicine
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 - For details visit https://trawickinternational.com/telemedicine
Additional Benefits
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
Accidental Death and Dismemberment
$25,000 - $35,000 Principal Sum
Extendable
Up to 364 days total coverage, provided you meet eligibility requirements
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.
24/7 Non-Insurance Benefits
Non Insurance Assistance Services
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

  • 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 Coverage, 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.

  • ACUTE ONSET OF PRE-EXISTING CONDITION

    ACUTE ONSET OF A PRE-EXISTING CONDITION EXPENSES: 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:

    1. Treatment must be obtained within twenty-four (24) hours of the sudden and Unexpected outbreak or reoccurrence.
    2. the Covered Person must be under seventy (70) years of age.
    3. 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.
    4. the Covered Person must not be traveling with the intent or purpose to seek or obtain Treatment for the Pre-existing
    5. 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.
    6. the Pre-existing Condition must have been stabilized for at least thirty (30) days prior to the Effective Date without change in Treatment.

    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.

  • OPTIONAL EXTENSION PROCEDURES

    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 5 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. Once the coverage has lapsed, reapplication may be allowed provided you meet the ELIGIBILITY requirements. Please note, upon application for a new coverage, the Pre-Existing Condition exclusion, deductible and coinsurance start over.

This is a brief description of the important features of the plan. It is not a contract of insurance. This plan includes both insurance and non-insurance benefits. The terms and conditions of coverage are set forth in the Plan issued to with ITA Global Trust, LTD. For a detailed plan description, exclusions, and limitations please view the plan on file with ITA Global Trust, LTD. The Policy contains a complete description of all of the terms, conditions, and exclusions of the insurance plan as underwritten by Crum & Forster SPC. The Policy will prevail in the event of any discrepancy between this information and the Policy as a brief description of the important features of the plan. The Policy contains a complete description of all of the terms, conditions, and exclusions of the insurance plan as underwritten by Crum & Forster SPC. The Policy will prevail in the event of any discrepancy between this website and the Policy.