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Overseas Travel Medical Plan
 
Short Term Medical Protection Benefits
for Individuals
Traveling Outside
of Their Home Country
- U.S.
citizens traveling abroad
- Non U.S.
citizens traveling to the U.S.
- Hospital
& Medical Expenses
-
Emergency Dental
- 24-Hour
Medical Emergency Services
-
Emergency Evacuation
- Return
of Minor Children
- Trip
Interruption
- Lost
Luggage
-
Accidental Death & Dismemberment
Benefits provided by:
American Consumer Insurance Trust
Administered By:
HPA, Inc., Rockford IL
Overseas Travel Medical Plan
Today, more and more people are traveling outside of their
home country, either for business, recreation or personal
reasons. Frequently, domestic health insurance does not
provide coverage for overseas medical emergencies, and
international travelers are unable to obtain this type of
protection after they are outside of their home country.
Furthermore, most traditional health insurance does not
provide coverage for expenses for an emergency medical
evacuation, medical reunion, return of mortal remains, trip
interruption or loss of checked luggage.
Anyone traveling outside of their home country needs the
type of comprehensive protection the
Overseas Travel Medical Plan provides.
If You are a citizen or
resident of the United States (U.S.), You
can purchase the Overseas Travel
Medical Plan to travel anywhere
outside of the U.S.
At this time, this program is not available to residents of:
NY, OR and KS. If You are a U.S. citizen residing outside of
the U.S., You can purchase this protection as long as You
hold a current and valid U.S. passport.
If You are a foreign visitor
traveling to the United States (U.S.), You
can purchase the
Overseas Travel Medical Plan as long as You
provide us with your current and valid passport I.D.
number.
The Overseas Travel Medical Plan
includes a unique added benefit for You and Your family,
24 Hour Medical Emergency
Protection. Our emergency assistance
services are superior and include:
- Medical
referrals and medical care location
-
Communication arrangements between family and doctors
-
International hospital bill translation / interpretation
services
- Medical
case management and catastrophic case notification
-
Coordinating emergency medical evacuation or
repatriations
-
Arrangements for medical transportation
-
Assisting in the replacement of lost passports
- Locating
legal assistance and local interpreters
Eligible Persons:
A person who has applied for benefits, is named on the
application and for whom HPA has received the appropriate
plan cost, is considered eligible for benefits under this
Plan.
Eligible Dependents:
Are considered a spouse who is legally married to You or
Your unmarried Child from 14 days old until his / her 19th
birthday.
Accident & Sickness Medical Benefits Maximum Choices:*
$50,000,
$100,000, $250,000 or $1,000,000
Deductible
Choices:
$125, $250, $500, $1,000, $2,500
The Coinsurance (after satisfaction of the
Deductible) for U.S. citizens or residents
outside of the U.S. is
100%
of Eligible Expenses;
and for non U.S. citizens
inside of the U.S. it is
80%
of the first $5,000 of Eligible Expenses, and then
100%
of the remaining Eligible Expenses.
*The Maximum for Accident & Sickness Medical Benefits is
limited to
$10,000
for Eligible Persons ages
80 and above.
*The Maximum for Accident & Sickness Medical Benefits is
limited to
$10,000
for the Hazardous Sports Rider.
Additional
Benefits:
-
Emergency Medical Evacuation:
$100,000
- Return
of Mortal Remains: $20,000
-
Emergency Medical Reunion:
$10,000
- Return
of Minor Children: $5,000
-
Interruption of Trip: $5,000
- Loss of
Checked Luggage: $250
-
Emergency Dental for Accidents: $500
-
Accidental Death and Dismemberment:
$25,000
for Eligible Person; and
$5,000 for each
Eligible Dependent(s)
The minimum Term
of Protection
is 15 days; the maximum is
12 months. Benefits can be purchased
in a combination of monthly
and 15-day periods by paying the appropriate
Plan Cost.
Convenient Plan Cost payment options include:
(1) Payment in
Full by, Visa, MasterCard or Discover credit
cards; (2)
Monthly Pay as you go, allows you to pay
monthly by, Visa, MasterCard or Discover credit cards.
Effective Date
of the Term of Protection begins on the latest of the
following:
- The Date
HPA receives a completed Application and the appropriate
Plan Cost for the Period of Protection; or
- The
Effective Date requested on the Application; or
- The
moment You arrive in the country noted on the
Application; or
- The Date
HPA approves the Application.
Expiration Date
of the Term of
Protection terminates on the earlier of the following:
- The moment
You return to Your Home Country; or
- The
expiration of twelve months from the Effective Date; or
- The date
shown on the Schedule provided by HPA; or
- The end of
the period for which the Plan Cost has been paid; or
- The date You
are no longer considered an Eligible Person; or
- For foreign
visitors, the Date You become a permanent resident of the
United States.
Medical Benefits:
Benefits will be paid for Reasonable and Customary Eligible
Expenses incurred by You due to an accidental Injury or
Illness up to the earlier of the maximum amount You chose
after the Deductible and Coinsurance is satisfied, or the
Expiration Date of Your Term of Protection. All bodily
disorders, or bodily Injuries sustained in any one Accident,
existing simultaneously which are due to the same or related
causes shall be considered one Disablement. If a
Disablement is due to causes which are the same or related
to the cause of a prior Disablement (including complications
arising there from), the Disablement shall be considered a
continuation of the prior Disablement and not a separate
Disablement.
The initial treatment of the Illness or Injury must occur
within 30 days of the Accident or onset of the Illness.
Only the following, which are specifically enumerated in the
following list of charges and which are not excluded, shall
be considered as Eligible Expenses:
- Charges
made by a Hospital for room and board, floor nursing and
other services inclusive of charges for professional
service and with the exception of personal services of a
non-medical nature; provided, however, that expenses do
not exceed the Hospital’s average charge for semiprivate
room and board accommodation.
- Charges
made for intensive care or coronary care charges and
nursing services.
- Charges
made for diagnosis, treatment and surgery by a
Physician.
- Charges
made for an operating room.
- Charges
made for outpatient treatment, same as any other
treatment covered on an inpatient basis. This includes
ambulatory Surgical centers, Physicians’ outpatient
visits and examinations, clinic care, and surgical
opinion consultations.
- Charges
made for the cost and administration of anesthetics.
- Charges
for medication, x-ray services, laboratory tests and
services, the use of radium and radioactive isotopes,
oxygen, blood, transfusions, iron lungs, and medical
treatment.
- Charges
for physiotherapy, if recommended by a Physician for the
treatment of a specific Disablement and administered by
a licensed physiotherapist.
-
Dressings, drugs, and medicines that can only be
obtained upon a written prescription of a Physician or
surgeon.
- Local
transportation to or from the nearest Hospital or to and
from the nearest Hospital with facilities for required
treatment. Such transportation shall be by licensed
ground ambulance only, within the metropolitan area in
which You are located at that time the service is used.
If You are in a rural area, then licensed ground
ambulance transportation to the nearest metropolitan
area shall be considered an Eligible Expense.
Optional
Hazardous Sports Rider:
Benefits will be paid if You are injured while
participating in one of the following: Motorcycle or motor
scooter riding, mountaineering (4500 meter limit), hang
gliding, parachuting, bungee jumping, water skiing, snow
skiing, snowmobiling, and snow boarding.
Emergency Dental
Treatment:
Benefits are paid for Reasonable and Customary expenses up
to the maximum shown on the Schedule of Benefits for repair
or replacement to sound, natural teeth damaged as a result
of an Accident.
Emergency Medical
Evacuation and Medically Necessary Repatriation:
Benefits are paid for Eligible Expenses incurred up
to the maximum shown in the Schedule of Benefits, if Injury
or Illness commences during the Term of Protection results
in Your Medically Necessary Emergency Medical Evacuation or
Repatriation. The decision for an Emergency Medical
Evacuation or Repatriation must be pre-approved and arranged
by the Assistance Company in consultation with Your local
attending Physician.
Emergency Medical Evacuation or Repatriation means: a) Your
medical condition warrants immediate transportation from the
place where You are located (due to inadequate medical
facilities) to the nearest adequate medical facility where
medical treatment can be obtained; or b) after being treated
at a local medical facility as a result of a Medical
Evacuation, Your medical condition warrants transportation
with a qualified medical attendant to Your Home Country to
obtain further medical treatment or to recover; or c) both
a) and b) above.
Eligible Expenses are expenses for transportation, medical
services and medical supplies necessarily incurred in
connection with Your Emergency Medical Evacuation or
Repatriation. All transportation arrangements must be by
the most direct and economical route. These Eligible
Expenses must be: a) pre-approved and ordered by the
Assistance Company and b) required by the standard
regulations of the conveyance transporting You.
Transportation means any land, water or air conveyance
required to transport You and includes, but is not limited
to, licensed ground and air ambulances, commercial airlines,
and private motor vehicles.
Return of Mortal
Remains:
Benefits will be paid for the reasonable Eligible Expenses
incurred up to the maximum as stated in the Schedule of
Benefits, to return Your remains to Your current Home
Country, if You die. Eligible Expenses include, but are not
limited to, expenses for embalming, or cremation, a
minimally necessary container appropriate for
transportation, shipping costs, and the necessary government
authorizations. All Eligible Expenses in connection with a
Return of Mortal Remains or cremation must be pre-approved
and arranged by the Assistance Company.
Emergency Medical
Reunion:
When You are eligible for an Emergency Medical Evacuation
under this Plan and the Assistance Company and the attending
Physician determine that it is necessary and prudent for one
individual selected by You from Your current Home Country to
be brought to where You are hospitalized and accompany You
during Your return to Your current Home Country, benefits
will be paid for the round trip economy-class transportation
arranged by the Assistance Company. The benefits payable
will include: All transportation in connection with an
Emergency Medical Reunion, which must be pre-approved and
arranged by the Assistance Company.
Return of Minor
Child(ren):
Should You be traveling alone and are hospitalized because
of an Illness or Injury and Your Minor Child(ren) is left
unattended, the Assistance Company will arrange and benefits
will be paid for one way economy fares to their current Home
Country. Meals and lodging are Your responsibility. If an
attendant/escort is necessary to insure the safety and
welfare of the Minor Child(ren), the Assistance Company
will arrange and benefits will be paid for these services up
to the maximum shown on the Schedule of Benefits. All
transportation in connection with a Return of Minor
Child(ren) must be pre-approved and arranged by the
Assistance Company.
Interruption of
Trip:
If You interrupt Your trip due to one of the following
reasons:
- Death of
Your Family Member; or
- Your home
made uninhabitable by fire or flood.
Benefits will be
paid up to the maximum stated in the Schedule of Benefits,
for the cost of reasonable, additional transportation
expenses for the cost of economy travel, less the value of
applied credit from an unused return travel ticket, needed
to reach Your return destination.
Loss of Checked
Luggage:
Benefits will be paid up to the maximum shown in the
Schedule of Benefits, for loss, theft or damage to baggage
and personal effects, checked with a Common Carrier provided
You have taken all reasonable measures to protect, save
and/or recover Your property at all times. There will be a
per article limit of $50.
Accidental Death
and Dismemberment:
Benefits shall be paid up to the maximum noted on the
Schedule of Benefits if You sustain an Accidental Injury.
The Injury must:
- Occur during
Your Term of Protection; and
- Occur within
60 days after the date of Accident causing such Loss.
Benefits payable
for any such Loss shall be according to the Table of Losses
noted below, as applicable to Your loss and if You incur
more than one loss as the result of one Accident, only the
largest of the amounts stated in the Schedule of Benefits
shall be payable.
|
Principal Sum |
|
Description of Loss (for Loss of) |
|
100% |
|
Life |
|
100% |
|
Both Hands
or Both Feet or Sight of Both Eyes |
|
100% |
|
One Hand and
One Foot |
|
100% |
|
Either Hand
or Foot and Sight of One Eye |
|
50% |
|
Either Hand
or Foot |
|
50% |
|
Sight of One
Eye |
|
100% |
|
Quadriplegia |
|
75% |
|
Paraplegia
(total paralysis of both lower limbs) |
|
50% |
|
Hemiplegia
(total paralysis of upper and lower limbs of one side of
the body) |
|
25% |
|
Uniplegia
(total paralysis of one limb) |
Excess Benefits:
All benefits, except Accidental Death and Dismemberment,
shall be in excess of all other valid and collectible
Insurance or other Indemnity and shall apply only when such
benefits are exhausted. Other valid and collectable
Insurance or other Indemnity for which benefits may be
payable are Insurance programs provided by:
- Individual,
group or blanket Insurance or coverage;
- Other
prepayment coverage provided on a group or individual basis;
- Any coverage
under labor management trustee plans, union welfare plans,
employer organizational plans, employee benefit organization
plans, or other arrangement of benefits for individuals of a
group;
- Any coverage
required or provided by any statue, socialized Insurance
program;
- Any no-fault
automobile Insurance;
-
Any third
party liability Insurance.
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