Emergency Medical Full Policy Wording

Each policy’s Emergency Medical coverage is detailed below. View the coverage summary here.

April Travel Protection
April Travel Protection

1

Choice
April Travel Protection

Emergency Medical Benefits

$50,000 per person
$50,000 policy limit
Secondary coverage

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Full Policy Wording

MEDICAL AND DENTAL COVERAGE

We will pay this benefit, up to the amount on the Schedule, for the following covered expenses incurred by you, subject to the following:

1. Covered expenses will only be payable at the Usual and Customary level of payment; and

2. Benefits will be payable only for covered expense resulting from a Sickness that first manifests itself or an Injury that occurs while on a Trip; and

3. Benefits payable as a result of incurred covered expenses will only be paid after benefits have been paid under any Other Valid and Collectible Health Insurance in effect for you. This coverage is in excess to any other health insurance you have available to you at the time of the loss. You must submit your claim to that provider first. Any benefits you receive from your primary or supplementary insurance providers will be deducted from your claim with us.

Covered Expenses:

1. Expenses for the following Physician-ordered medical services: services of legally qualified Physicians and graduate nurses, charges for Hospital confinement and services, local ambulance services, prescription drugs and medicines, and therapeutic services, incurred by you while on your Trip; and

2. Expenses for emergency dental treatment incurred by you during a Trip up to the amount in the Schedule.

Your duties in the event of a Medical or Dental Expense:

1. You must provide us with all bills and reports for medical and/or dental expenses claimed.

2. You must provide any requested information related to the claimed expense(s), including but not limited to, an explanation of benefits from any other applicable insurance.

3. You must sign a patient authorization to release any information required by us, to investigate your claim.

Please refer to the Definitions, for an explanation of PreExisting Conditions, which are excluded under the Medical or Dental Expense Benefits.

2

Choice
April Travel Protection

Emergency Medical Benefits

$50,000 per person
$50,000 policy limit
Secondary coverage

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Full Policy Wording

MEDICAL AND DENTAL COVERAGE

We will pay this benefit, up to the amount on the Schedule, for the following covered expenses incurred by you, subject to the following:

1. Covered expenses will only be payable at the Usual and Customary level of payment; and

2. Benefits will be payable only for covered expense resulting from a Sickness that first manifests itself or an Injury that occurs while on a Trip; and

3. Benefits payable as a result of incurred covered expenses will only be paid after benefits have been paid under any Other Valid and Collectible Health Insurance in effect for you. This coverage is in excess to any other health insurance you have available to you at the time of the loss. You must submit your claim to that provider first. Any benefits you receive from your primary or supplementary insurance providers will be deducted from your claim with us.

Covered Expenses:

1. Expenses for the following Physician-ordered medical services: services of legally qualified Physicians and graduate nurses, charges for Hospital confinement and services, local ambulance services, prescription drugs and medicines, and therapeutic services, incurred by you while on your Trip; and

2. Expenses for emergency dental treatment incurred by you during a Trip up to the amount in the Schedule.

Your duties in the event of a Medical or Dental Expense:

1. You must provide us with all bills and reports for medical and/or dental expenses claimed.

2. You must provide any requested information related to the claimed expense(s), including but not limited to, an explanation of benefits from any other applicable insurance.

3. You must sign a patient authorization to release any information required by us, to investigate your claim.

Please refer to the Definitions, for an explanation of PreExisting Conditions, which are excluded under the Medical or Dental Expense Benefits.

Arch RoamRight
Arch RoamRight

3

Essential
Arch RoamRight

Emergency Medical Benefits

$15,000 per person
Secondary coverage

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Full Policy Wording

EMERGENCY ACCIDENT & SICKNESS MEDICAL EXPENSE

Benefits will be paid for covered Medical Expenses incurred, up to the Maximum Benefit Amount shown in the Schedule of Benefits, subject to the following: 1) covered Medical Expenses will only be payable at the Usual and Customary level of charges; 2) benefits will be payable only for covered Medical Expenses resulting from an Emergency Condition that first manifests itself or occurs while on Your Trip; 3) only Medical Expenses incurred during Your Trip will be reimbursed. Medical Expenses incurred after You return from Your Trip are not covered; and 4) benefits are subject to a $50 deductible for each occurrence.

Benefits will include up to $500 for expenses incurred during Your Trip for emergency dental treatment. Dental expenses incurred after Your Trip is completed are not covered.

“Emergency Condition” means an Injury or Sickness diagnosed by a Physician for which You have sudden and unexpected severe or acute symptoms requiring immediate care and the failure to obtain such care could reasonably result in serious deterioration of Your condition or place Your life in jeopardy. The severe or acute symptoms must occur while on Your Trip.

“Medical Expenses” means expenses incurred only for the following:

1. medical services (including charges for anesthetics, x-ray examinations or treatments, and laboratory tests) and supplies, prescription drugs, and therapeutic services ordered or prescribed by a Physician as Medically Necessary for treatment;

2. Hospital or ambulatory medical-surgical center services (including expenses for a cruise ship cabin or hotel room, not already included in the cost of Your Trip), if recommended by Your attending Physician and approved by Us or Our Program Assistance Provider as a substitute for a hospital room for recovery from Your Emergency Condition;

3. local Transportation Expense to and/or from a Hospital.

We will not pay benefits in excess of the Usual and Customary level of charges. We will not cover any expenses provided by another party at no cost to You or already included within the cost of the Trip.

We will advance payment to a Hospital, up to the Maximum Benefit Amount shown on the Schedule of Benefits, if needed to secure Your admission to a Hospital because of a covered Emergency Condition.

4

Preferred
Arch RoamRight

Emergency Medical Benefits

$50,000 per person
Secondary coverage

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Full Policy Wording

EMERGENCY ACCIDENT & SICKNESS MEDICAL EXPENSE

Benefits will be paid for covered Medical Expenses incurred, up to the Maximum Benefit Amount shown in the Schedule of Benefits, subject to the following: 1) covered Medical Expenses will only be payable at the Usual and Customary level of charges; 2) benefits will be payable only for covered Medical Expenses resulting from an Emergency Condition that first manifests itself or occurs while on Your Trip; 3) only Medical Expenses incurred during Your Trip will be reimbursed. Medical Expenses incurred after You return from Your Trip are not covered; and 4) benefits are subject to a $50 deductible for each occurrence.

Benefits will include up to $750 for expenses incurred during Your Trip for emergency dental treatment. Dental expenses incurred after Your Trip is completed are not covered.

“Emergency Condition” means an Injury or Sickness diagnosed by a Physician for which You have sudden and unexpected severe or acute symptoms requiring immediate care and the failure to obtain such care could reasonably result in serious deterioration of Your condition or place Your life in jeopardy. The severe or acute symptoms must occur while on Your Trip.

“Medical Expenses” means expenses incurred only for the following:

1. medical services (including charges for anesthetics, x-ray examinations or treatments, and laboratory tests) and supplies, prescription drugs, and therapeutic services ordered or prescribed by a Physician as Medically Necessary for treatment;

2. Hospital or ambulatory medical-surgical center services (including expenses for a cruise ship cabin or hotel room, not already included in the cost of Your Trip), if recommended by Your attending Physician and approved by Us or Our Program Assistance Provider as a substitute for a hospital room for recovery from Your Emergency Condition;

3. local Transportation Expense to and/or from a Hospital.

We will not pay benefits in excess of the Usual and Customary level of charges. We will not cover any expenses provided by another party at no cost to You or already included within the cost of the Trip.

We will advance payment to a Hospital, up to the Maximum Benefit Amount shown on the Schedule of Benefits, if needed to secure Your admission to a Hospital because of a covered Emergency Condition.

OPTIONAL MEDICAL COVERAGE UPGRADE

When You purchase this Medical Coverage Upgrade, the following coverage changes apply:

1. Additional Benefits will be paid up to the Maximum Benefit Amount shown in the Schedule of Benefits;

2. the deductible is waived.

5

Elite
Arch RoamRight

Emergency Medical Benefits

$50,000 per person
Secondary coverage

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Full Policy Wording

EMERGENCY ACCIDENT & SICKNESS MEDICAL EXPENSE

Benefits will be paid for covered Medical Expenses incurred, up to the Maximum Benefit Amount shown in the Schedule of Benefits, subject to the following: 1) covered Medical Expenses will only be payable at the Usual and Customary level of charges; 2) benefits will be payable only for covered Medical Expenses resulting from an Emergency Condition that first manifests itself or occurs while on Your Trip; 3) only Medical Expenses incurred during Your Trip will be reimbursed. Medical Expenses incurred after You return from Your Trip are not covered; and 4) benefits are subject to a $50 deductible for each occurrence.

Benefits will include up to $750 for expenses incurred during Your Trip for emergency dental treatment. Dental expenses incurred after Your Trip is completed are not covered.

“Emergency Condition” means an Injury or Sickness diagnosed by a Physician for which You have sudden and unexpected severe or acute symptoms requiring immediate care and the failure to obtain such care could reasonably result in serious deterioration of Your condition or place Your life in jeopardy. The severe or acute symptoms must occur while on Your Trip.

“Medical Expenses” means expenses incurred only for the following:

1. medical services (including charges for anesthetics, x-ray examinations or treatments, and laboratory tests) and supplies, prescription drugs, and therapeutic services ordered or prescribed by a Physician as Medically Necessary for treatment;

2. Hospital or ambulatory medical-surgical center services (including expenses for a cruise ship cabin or hotel room, not already included in the cost of Your Trip), if recommended by Your attending Physician and approved by Us or Our Program Assistance Provider as a substitute for a hospital room for recovery from Your Emergency Condition;

3. local Transportation Expense to and/or from a Hospital.

We will not pay benefits in excess of the Usual and Customary level of charges. We will not cover any expenses provided by another party at no cost to You or already included within the cost of the Trip.

We will advance payment to a Hospital, up to the Maximum Benefit Amount shown on the Schedule of Benefits, if needed to secure Your admission to a Hospital because of a covered Emergency Condition.

When you purchase the Emergency Medical upgrade, the following coverage changes apply:

1. Additional Benefits will be paid up to the Maximum Benefit Amount shown in the Schedule of Benefits;

2. the deductible is waived.

6

Multi-Trip
Arch RoamRight

Emergency Medical Benefits

$25,000 per person
Secondary coverage

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Full Policy Wording

EMERGENCY ACCIDENT & SICKNESS MEDICAL EXPENSE

Benefits will be paid for covered Medical Expenses incurred, up to the Maximum Benefit Amount shown in the Schedule of Benefits, subject to the following: 1) covered Medical Expenses will only be payable at the Usual and Customary level of charges; 2) benefits will be payable only for covered Medical Expenses resulting from an Emergency Condition that first manifests itself or occurs while on Your Trip; and 3) only Medical Expenses incurred during Your Trip will be reimbursed. Medical Expenses incurred after You return from Your Trip are not covered.

Benefits will include up to $750 for expenses incurred during Your Trip for emergency dental treatment. Dental expenses incurred after Your Trip is completed are not covered.

“Emergency Condition” means an Injury or Sickness diagnosed by a Physician for which You have sudden and unexpected severe or acute symptoms requiring immediate care and the failure to obtain such care could reasonably result in serious deterioration of Your condition or place Your life in jeopardy. The severe or acute symptoms must occur while on Your Trip.

“Medical Expenses” means expenses incurred only for the following:

1. medical services (including charges for anesthetics, x-ray examinations or treatments, and laboratory tests) and supplies, prescription drugs, and therapeutic services ordered or prescribed by a Physician as Medically Necessary for treatment;

2. Hospital or ambulatory medical-surgical center services (including expenses for a cruise ship cabin or hotel room, not already included in the cost of Your Trip), if recommended by Your attending Physician and approved by Us or Our Program Assistance Provider as a substitute for a hospital room for recovery from Your Emergency Condition;

3. local Transportation Expense to and/or from a Hospital.

We will not pay benefits in excess of the Usual and Customary level of charges. We will not cover any expenses provided by another party at no cost to You or already included within the cost of the Trip.

We will advance payment to a Hospital, up to the Maximum Benefit Amount shown on the Schedule of Benefits, if needed to secure Your admission to a Hospital because of a covered Emergency Condition.

AXA Assistance USA
AXA Assistance USA

7

Silver
AXA Assistance USA

Emergency Medical Benefits

$25,000 per person
Secondary coverage

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Full Policy Wording

EMERGENCY ACCIDENT MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Confirmation of Coverage, if You incur Covered Medical Expenses for Emergency Treatment of an Accidental Injury that occurs during the Trip.

Emergency Treatment means necessary medical treatment that must be performed during the Trip due to the serious and acute nature of the Accidental Injury.

Covered Medical Expenses are expenses incurred for necessary services and supplies: (a) listed below; and (b) ordered or prescribed by the attending Physician as Medically Necessary for treatment, that are limited to:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms;

c) charges for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;

d) ambulance service; and

e) drugs, medicines and therapeutic services.

The Company will not pay benefits in excess of the Reasonable and Customary Charges. The Company will not cover any expenses provided by another party at no cost to You or already included within the cost of the Trip.

The Company will pay benefits up to the Maximum Benefit shown on the Confirmation of Coverage for dental Emergency Treatment for Accidental Injury to Sound Natural Teeth. Both the Accidental Injury and the dental Emergency Treatment must occur during the Trip.

If You are Hospitalized due to an Accidental Injury that first occurred during the course of the Trip beyond the Scheduled Return Date, coverage under this benefit will be extended until You are released from the Hospital or until Maximum Benefits under this Certificate have been paid.

EMERGENCY SICKNESS MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Confirmation of Coverage, if You incur Covered Medical Expenses as a result of Emergency Treatment of a Sickness that first manifests itself during the Trip. Emergency Treatment means necessary medical treatment that must be performed during the Trip due to the serious and acute nature of the Sickness.

Covered Medical Expenses are expenses incurred for necessary services and supplies: (a) listed below; and (b) ordered or prescribed by the attending Physician as Medically Necessary for treatment, that are limited to:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms;

c) charge for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;

d) ambulance service; and

e) drugs, medicines and therapeutic services.

The Company will not pay benefits in excess of the Reasonable and Customary Charges. The Company will not cover any expenses provided by another party at no cost to You or already included within the cost of the Trip.

If You are Hospitalized due to a Sickness that first occurred during the course of the Trip beyond the Scheduled Return Date, coverage under this benefit will be extended until You are released from the Hospital or until Maximum Benefits under this Certificate have been paid.

8

Gold
AXA Assistance USA

Emergency Medical Benefits

$100,000 per person
Secondary coverage

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Full Policy Wording

EMERGENCY ACCIDENT MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Confirmation of Coverage, if You incur Covered Medical Expenses for Emergency Treatment of an Accidental Injury that occurs during the Trip.

Emergency Treatment means necessary medical treatment that must be performed during the Trip due to the serious and acute nature of the Accidental Injury.

Covered Medical Expenses are expenses incurred for necessary services and supplies: a) listed below; and b) ordered or prescribed by the attending Physician as Medically Necessary for treatment, that are limited to:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms;

c) charges for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;

d) ambulance service; and

e) drugs, medicines and therapeutic services.

The Company will not pay benefits in excess of the Reasonable and Customary Charges. The Company will not cover any expenses provided by another party at no cost to You or already included within the cost of the Trip.

The Company will pay benefits up to the Maximum Benefit shown on the Confirmation of Coverage for dental Emergency Treatment for Accidental Injury to Sound Natural Teeth. Both the Accidental Injury and the dental Emergency Treatment must occur during the Trip.

If You are Hospitalized due to an Accidental Injury that first occurred during the course of the Trip beyond the Scheduled Return Date, coverage under this benefit will be extended until You are released from the Hospital or until Maximum Benefits under this Certificate have been paid.

EMERGENCY SICKNESS MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Confirmation of Coverage, if You incur Covered Medical Expenses as a result of Emergency Treatment of a Sickness that first manifests itself during the Trip. Emergency Treatment means necessary medical treatment that must be performed during the Trip due to the serious and acute nature of the Sickness.

Covered Medical Expenses are expenses incurred for necessary services and supplies: a) listed below; and b) ordered or prescribed by the attending Physician as Medically Necessary for treatment, that are limited to:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms;

c) charge for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;

d) ambulance service; and

e) drugs, medicines and therapeutic services.

The Company will not pay benefits in excess of the Reasonable and Customary Charges. The Company will not cover any expenses provided by another party at no cost to You or already included within the cost of the Trip.

If You are Hospitalized due to a Sickness that first occurred during the course of the Trip beyond the Scheduled Return Date, coverage under this benefit will be extended until You are released from the Hospital or until Maximum Benefits under this Certificate have been paid.

9

Platinum
AXA Assistance USA

Emergency Medical Benefits

$250,000 per person
Primary coverage

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Full Policy Wording

EMERGENCY ACCIDENT MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Confirmation of Coverage, if You incur Covered Medical Expenses for Emergency Treatment of an Accidental Injury that occurs during the Trip.

Emergency Treatment means necessary medical treatment that must be performed during the Trip due to the serious and acute nature of the Accidental Injury.

Covered Medical Expenses are expenses incurred for necessary services and supplies: a) listed below; and b) ordered or prescribed by the attending Physician as Medically Necessary for treatment, that are limited to:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms; Hospital or ambulatory medical-surgical center services;

c) charges for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;

d) ambulance service; and

e) drugs, medicines and therapeutic services.

The Company will not pay benefits in excess of the Reasonable and Customary Charges. The Company will not cover any expenses provided by another party at no cost to You or already included within the cost of the Trip.

The Company will pay benefits up to the Maximum Benefit shown on the Confirmation of Coverage for dental Emergency Treatment for Accidental Injury to Sound Natural Teeth. Both the Accidental Injury and the dental Emergency Treatment must occur during the Trip.

If You are Hospitalized due to an Accidental Injury that first occurred during the course of the Trip beyond the Scheduled Return Date, coverage under this benefit will be extended until You are released from the Hospital or until Maximum Benefits under this Certificate have been paid.

EMERGENCY SICKNESS MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Confirmation of Coverage, if You incur Covered Medical Expenses as a result of Emergency Treatment of a Sickness that first manifests itself during the Trip. Emergency Treatment means necessary medical treatment that must be performed during the Trip due to the serious and acute nature of the Sickness.

Covered Medical Expenses are expenses incurred for necessary services and supplies: a) listed below; and b) ordered or prescribed by the attending Physician as Medically Necessary for treatment, that are limited to:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms;

c) charge for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;

d) ambulance service; and

e) drugs, medicines and therapeutic services.

The Company will not pay benefits in excess of the Reasonable and Customary Charges. The Company will not cover any expenses provided by another party at no cost to You or already included within the cost of the Trip.

If You are Hospitalized due to a Sickness that first occurred during the course of the Trip beyond the Scheduled Return Date, coverage under this benefit will be extended until You are released from the Hospital or until Maximum Benefits under this Certificate have been paid.

Azimuth Risk Solutions, LLC
Azimuth Risk Solutions, LLC

10

Beacon America incl US
Azimuth Risk Solutions, LLC

Emergency Medical Benefits

$60,000 per person
Secondary coverage

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Full Policy Wording

30 ELIGIBLE MEDICAL EXPENSES — Subject to the Terms of this insurance, which would include without, limitation the Deductible, Coinsurance, and limits and Sub-Limits set forth in the Schedule of Benefits/Limits, Section 21, and the Exclusions set forth in Section 31, below, the Scheme Administrator will reimburse the Participating Member for the following costs, charges and Expenses Incurred by the Participating Member with respect to an Illness or Injury suffered or sustained by the Participating Member while the Evidence of Insurance issued by the Master Policy is in effect, so long as the costs, charges or Expenses Incurred are Usual, Reasonable and Customary:

30.1 Charges Incurred At A Hospital For:

30.1.1 Daily room and board, and nursing services subject to the Schedule of Benefits/Limits;

30.1.2 Daily room and board, and nursing services in Intensive Care Unit; and

30.1.3 Use of operating, treatment or recovery room; and

30.1.4 Services and supplies that are routinely provided by the Hospital to persons for use while Inpatient; and

30.1.5 Emergency treatment of an Injury, even if Hospital confinement is not required; and

30.1.6 Emergency Room Treatment of an Illness; however, an additional $250 Deductible will and be required unless the Participating Member is directly admitted to the Hospital as Inpatient for further treatment of that Illness; and

30.2 Charges Incurred for Surgery At An Outpatient Surgical Facility:

30.2.1 Charges by a Physician for professional services rendered, which would include Surgery; and

30.2.2 Provided, however, that charges by or for an assistant surgeon will be limited and covered at the rate of twenty (20%) percent of the Usual, Reasonable and Customary
charge of the primary surgeon; and

30.2.3 Provided, further, that standby availability of a Physician or surgeon will not be deemed to be a professional service and is not eligible for coverage; and

30.2.4 Provided, however, that charges by or for a registered nurse anesthetist will be limited and covered at the rate of twenty (20%) percent of the Usual, Reasonable and Customary charge of the primary anesthesiologist; and

30.3 Other Charges Incurred For Surgery At A Hospital Or Outpatient Surgical Facility:

30.3.1 Which would include service and supplies; and

30.3.2 Dressings, sutures, casts or other supplies that are Medically Necessary; and

30.3.3 Diagnostic testing using radiology, ultrasonographic or laboratory services; and

30.3.4 Basic functional artificial limb(s) or eye(s), but not the replacement or repair thereof; and

30.3.5 Reconstructive Surgery that is directly related to a Surgery that is covered under this insurance; and

30.3.6 Radiation therapy or treatment, and chemotherapy; and

30.3.7 Hemodialysis and the charges by a Hospital for processing and administration of blood or blood components, but not the cost of the actual blood or blood components; and

30.3.8 Oxygen and other gasses and their administration; and

30.3.9 Anesthetics and their administration by a licensed anesthesiologist; and

30.3.10 Drugs that require prescription by a Physician for treatment of Illness or Injury, but not for the replacement of lost, stolen, damaged, expired or otherwise compromised drugs, and for a maximum supply of ninety (90) days of any one prescription; and

30.3.11 Care in a licensed Extended Care Facility upon direct transfer from an acute care Hospital; and

30.3.12 Home Nursing Care in bed by a qualified licensed professional, provided by a Home Health Care Agency upon direct transfer from an acute care Hospital; and

30.3.13 Emergency local ambulance transport necessarily incurred in connection with Illness or Hospital; and Injury resulting in Hospitalization; and

30.3.14 Emergency Dental, Acute onset of Pain Treatment, or Dental Surgery necessary to restore or replace sound natural teeth lost or damaged in an Accident that is covered under this insurance subject to the Schedule of Benefits and Limits; and

30.3.14.1 For policies purchased up to one-hundred and eighty (180) days; and

30.3.14.2 Up to $1,000.00 Sub-Limit per Policy Period for Emergency Dental as a result of an injury; and

30.3.14.3 Up to $500 Sub-Limit per Policy Period for Dental Treatment for Acute onset of pain; and

30.3.15 Physical therapy prescribed by a Physician and performed by a licensed physical therapist, and necessarily incurred to continue recovery from a covered Injury or covered Illness, up to the limit set forth in Schedule of Benefits and Limits; and

30.4 Charges Related to Terrorism — The Scheme Administrators will pay Eligible Medical Expenses for treatment of Injuries and Illnesses resulting from an Act of Terrorism, up to the limit set forth in Schedule of Benefits and Limits, provided all of the following conditions are met:

30.4.1 The Injury or Illness does not result from the use of any biological, chemical, Radioactive

30.4.2 The Participating Member has no direct or indirect involvement in the Act of Terrorism;

30.4.3 The Act of Terrorism is not in a country or location where the United States government has issued a travel warning that has been in effect within the one-hundred and eighty days (180) immediately prior to the Participating Member’s date of arrival; and

30.4.4 The Participating Member has not unreasonably failed or refused to depart a country or or nuclear agent, material, device or weapon; and location following the date a warning to leave that country or location is issued by the United States government.

11

Beacon International excl US
Azimuth Risk Solutions, LLC

Emergency Medical Benefits

$60,000 per person
Secondary coverage

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Full Policy Wording

30 ELIGIBLE MEDICAL EXPENSES — Subject to the Terms of this insurance, which would include without, limitation the Deductible, Coinsurance, and limits and Sub-Limits set forth in the Schedule of Benefits/Limits, Section 21, and the Exclusions set forth in Section 31, below, the Scheme Administrator will reimburse the Participating Member for the following costs, charges and Expenses Incurred by the Participating Member with respect to an Illness or Injury suffered or sustained by the Participating Member while the Evidence of Insurance issued by the Master Policy is in effect, so long as the costs, charges or Expenses Incurred are Usual, Reasonable and Customary:

30.1 Charges Incurred At A Hospital For:

30.1.1 Daily room and board, and nursing services subject to the Schedule of Benefits/Limits;

30.1.2 Daily room and board, and nursing services in Intensive Care Unit; and

30.1.3 Use of operating, treatment or recovery room; and

30.1.4 Services and supplies that are routinely provided by the Hospital to persons for use while Inpatient; and

30.1.5 Emergency treatment of an Injury, even if Hospital confinement is not required; and

30.1.6 Emergency Room Treatment of an Illness; however, an additional $250 Deductible will and be required unless the Participating Member is directly admitted to the Hospital as Inpatient for further treatment of that Illness; and

30.2 Charges Incurred for Surgery At An Outpatient Surgical Facility:

30.2.1 Charges by a Physician for professional services rendered, which would include Surgery; and

30.2.2 Provided, however, that charges by or for an assistant surgeon will be limited and covered at the rate of twenty (20%) percent of the Usual, Reasonable and Customary
charge of the primary surgeon; and

30.2.3 Provided, further, that standby availability of a Physician or surgeon will not be deemed to be a professional service and is not eligible for coverage; and

30.2.4 Provided, however, that charges by or for a registered nurse anesthetist will be limited and covered at the rate of twenty (20%) percent of the Usual, Reasonable and Customary charge of the primary anesthesiologist; and

30.3 Other Charges Incurred For Surgery At A Hospital Or Outpatient Surgical Facility:

30.3.1 Which would include service and supplies; and

30.3.2 Dressings, sutures, casts or other supplies that are Medically Necessary; and

30.3.3 Diagnostic testing using radiology, ultrasonographic or laboratory services; and

30.3.4 Basic functional artificial limb(s) or eye(s), but not the replacement or repair thereof; and

30.3.5 Reconstructive Surgery that is directly related to a Surgery that is covered under this insurance; and

30.3.6 Radiation therapy or treatment, and chemotherapy; and

30.3.7 Hemodialysis and the charges by a Hospital for processing and administration of blood or blood components, but not the cost of the actual blood or blood components; and

30.3.8 Oxygen and other gasses and their administration; and

30.3.9 Anesthetics and their administration by a licensed anesthesiologist; and

30.3.10 Drugs that require prescription by a Physician for treatment of Illness or Injury, but not for the replacement of lost, stolen, damaged, expired or otherwise compromised drugs, and for a maximum supply of ninety (90) days of any one prescription; and

30.3.11 Care in a licensed Extended Care Facility upon direct transfer from an acute care Hospital; and

30.3.12 Home Nursing Care in bed by a qualified licensed professional, provided by a Home Health Care Agency upon direct transfer from an acute care Hospital; and

30.3.13 Emergency local ambulance transport necessarily incurred in connection with Illness or Hospital; and Injury resulting in Hospitalization; and

30.3.14 Emergency Dental, Acute onset of Pain Treatment, or Dental Surgery necessary to restore or replace sound natural teeth lost or damaged in an Accident that is covered under this insurance subject to the Schedule of Benefits and Limits; and

30.3.14.1 For policies purchased up to one-hundred and eighty (180) days; and

30.3.14.2 Up to $1,000.00 Sub-Limit per Policy Period for Emergency Dental as a result of an injury; and

30.3.14.3 Up to $500 Sub-Limit per Policy Period for Dental Treatment for Acute onset of pain; and

30.3.15 Physical therapy prescribed by a Physician and performed by a licensed physical therapist, and necessarily incurred to continue recovery from a covered Injury or covered Illness, up to the limit set forth in Schedule of Benefits and Limits; and

30.4 Charges Related to Terrorism — The Scheme Administrators will pay Eligible Medical Expenses for treatment of Injuries and Illnesses resulting from an Act of Terrorism, up to the limit set forth in Schedule of Benefits and Limits, provided all of the following conditions are met:

30.4.1 The Injury or Illness does not result from the use of any biological, chemical, Radioactive

30.4.2 The Participating Member has no direct or indirect involvement in the Act of Terrorism;

30.4.3 The Act of Terrorism is not in a country or location where the United States government has issued a travel warning that has been in effect within the one-hundred and eighty days (180) immediately prior to the Participating Member’s date of arrival; and

30.4.4 The Participating Member has not unreasonably failed or refused to depart a country or or nuclear agent, material, device or weapon; and location following the date a warning to leave that country or location is issued by the United States government.

Berkshire Hathaway Travel Protection
Berkshire Hathaway Travel Protection

12

ExactCare
Berkshire Hathaway Travel Protection

Emergency Medical Benefits

$25,000 per person
Primary coverage

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Full Policy Wording

MEDICAL EXPENSE BENEFIT

If, while on a Trip, You suffer an Injury or Sickness that requires You to be treated by a Physician, the Company will pay a benefit for Reasonable and Customary Charges, up to the Maximum Limit shown in the Schedule. The Company will reimburse You for Medically Necessary covered expenses incurred to treat such Injury or Sickness during the course of the Trip provided the initial documented treatment was received from a Physician during the Trip. The Injury must first occur or the Sickness must first begin while on an overnight Trip with a Destination of at least 100 miles from Your Primary Residence, while covered under this Policy. Pre‐existing medical conditions will be covered if the Pre‐ existing Medical Condition Waiver is in effect.

Covered Expenses:

The Company will reimburse the Insured for:
● services of a Physician or registered nurse (R.N.);
● Hospital charges;
● X‐rays;
● local ambulance services to or from a Hospital;
● artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices;
● the cost of emergency dental treatment only during a Trip limited to the Maximum Limit shown in the Schedule. Coverage for emergency dental treatment does not apply if treatment or expenses are incurred after the Insured has reached his/her Return Destination, regardless of the reason. The treatment must be given by a Physician or dentist.

Advance Payment: If You require admission to a Hospital, Berkshire Hathaway Specialty Concierge will arrange advance payment, if required. Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

13

ExactCare Value
Berkshire Hathaway Travel Protection

Emergency Medical Benefits

$15,000 per person
Secondary coverage

Start a New Search

Full Policy Wording

ACCIDENT SICKNESS MEDICAL EXPENSE BENEFIT

If, while on a Trip, You suffer an Injury or Sickness that requires You to be treated by a Physician, the Company will pay a benefit for Reasonable and Customary Charges, up to the Maximum Limit shown in the Schedule. The Company will reimburse You for Medically Necessary covered expenses incurred to treat such Injury or Sickness during the course of the Trip provided the initial documented treatment was received from a Physician during the Trip. The Injury must first occur or the Sickness must first begin while on an overnight Trip with a Destination of at least 100 miles from Your Primary Residence, while covered under this Policy.

Pre-existing medical conditions will be covered if the Pre-existing Medical Condition Waiver is in effect.

Covered Expenses:

The Company will reimburse the Insured for:

● services of a Physician or registered nurse (R.N.);
● Hospital charges;
● X-rays;
● local ambulance services to or from a Hospital;
● artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices;
● the cost of emergency dental treatment only during a Trip limited to the Maximum Limit shown in the Schedule. Coverage for emergency dental treatment does not apply if treatment or expenses are incurred after the Insured has reached his/her Return Destination, regardless of the reason. The treatment must be given by a Physician or dentist.

Advance Payment: If You require admission to a Hospital, the Berkshire Hathaway Specialty Concierge will arrange advance payment, if required. Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

Cat 70
Cat 70

14

Travel Plan
Cat 70

Emergency Medical Benefits

$500,000 per person
Primary coverage

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Full Policy Wording

EMERGENCY ACCIDENT AND EMERGENCY SICKNESS MEDICAL EXPENSE

We will pay Reasonable and Customary Charges up to the maximum limit shown on the Schedule of Benefits, subject to the Deductible, if You incur necessary Covered Expenses while on your Covered Trip and as a result of an Accidental Injury or Emergency Sickness that first manifests itself during the Covered Trip.

Covered Expenses for this benefit include but are not limited to:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms;

c) Hospital or ambulatory medical-surgical center services (this may also include expenses for a cruise ship cabin or

Hotel room, not already included in the cost of Your Covered Trip, if recommended as a substitute for a Hospital room for recovery from an Emergency Sickness);

d) charges for anesthetics (including administration);

e) x-ray examinations or treatments, and laboratory tests;

f) ambulance service;

g) drugs, medicines, prosthetics and therapeutic services and supplies; and

h) emergency dental treatment for the relief of pain.

We will pay benefits, up to the amount shown on the Schedule of Benefits, for emergency dental treatment for Accidental Injury to natural teeth.

We will not pay benefits in excess of the Reasonable and Customary Charges.

We will not cover any expenses incurred by another party at no cost to You or already included within the cost of the Covered Trip.

We will advance payment to a Hospital, up to the maximum shown on the Schedule of Benefits, if needed to secure Your admission to a Hospital during the Covered Trip because of Accidental Injury or Emergency Sickness.

Generali Global Assistance
Generali Global Assistance

15

Standard
Generali Global Assistance

Emergency Medical Benefits

$50,000 per person
Secondary coverage

Start a New Search

Full Policy Wording

We will pay this benefit, up to the amount on the Schedule, for the following covered expenses incurred by you, subject to the following:

1. Covered expenses will only be payable at the Usual and Customary level of payment; and

2. Benefits will be payable only for covered expenses resulting from a Sickness that first manifests itself or an Injury that occurs while on a Trip; and

3. Benefits payable as a result of incurred covered expenses will only be paid after benefits have been paid under any Other Valid and Collectible Health Insurance in effect for you. This coverage is in excess to any other health insurance you have available to you at the time of the loss. You must submit your claim to that provider first. Any benefits you receive from your primary or supplementary insurance providers will be deducted from your claim with us.

Covered Expenses:

1. Expenses for the following Physician-ordered medical services: services of legally qualified Physicians and graduate nurses, charges for Hospital confinement and services, local ambulance services, prescription drugs and medicines, and therapeutic services, incurred by you within one year from the date of your Sickness or Injury during a Trip; and

2. Expenses for emergency dental treatment incurred by you during a Trip up to the amount in the Schedule.

Your duties in the event of a Medical or Dental Expense:

1. You must provide us with all bills and reports for medical and/or dental expenses claimed.

2. You must provide any requested information related to the claimed expense(s), including but not limited to, an explanation of benefits from any other applicable insurance.

3. You must sign a patient authorization to release any information required by us, to investigate your claim.

Please refer to the Definitions, for an explanation of Pre- Existing Conditions, which are excluded under the Medical or Dental Expense Benefits.

Coordination of Benefits

If you reside in CT, ID, IL, and excess coverage for Medical and Dental Expense Benefits is not permitted, then coordination of benefit provisions in accordance with the laws and regulations in your state will apply in lieu of the excess coverage provisions.

16

Preferred
Generali Global Assistance

Emergency Medical Benefits

$150,000 per person
Secondary coverage

Start a New Search

Full Policy Wording

MEDICAL AND DENTAL COVERAGE

We will pay this benefit, up to the amount on the Schedule, for the following covered expenses incurred by you, subject to the following:

1. Covered expenses will only be payable at the Usual and Customary level of payment; and

2. Benefits will be payable only for covered expenses resulting from a Sickness that first manifests itself or an Injury that occurs while on a Trip; and

3. Benefits payable as a result of incurred covered expenses will only be paid after benefits have been paid under any Other Valid and Collectible Health Insurance in effect for you. This coverage is in excess to any other health insurance you have available to you at the time of the loss. You must submit your claim to that provider first. Any benefits you receive from your primary or supplementary insurance providers will be deducted from your claim with us.

Covered Expenses:

1. Expenses for the following Physician-ordered medical services: services of legally qualified Physicians and graduate nurses, charges for Hospital confinement and services, local ambulance services, prescription drugs and medicines, and therapeutic services, incurred by you within one year from the date of your Sickness or Injury during a Trip; and

2. Expenses for emergency dental treatment incurred by you during a Trip up to the amount in the Schedule.

Your duties in the event of a Medical or Dental Expense:

1. You must provide us with all bills and reports for medical and/or dental expenses claimed.

2. You must provide any requested information related to the claimed expense(s), including but not limited to, an explanation of benefits from any other applicable insurance.

3. You must sign a patient authorization to release any information required by us, to investigate your claim.

Please refer to the Definitions, for an explanation of Pre- Existing Conditions, which are excluded under the Medical or Dental Expense Benefits.

Coordination of Benefits

If you reside in CT, ID, IL, and excess coverage for Medical and Dental Expense Benefits is not permitted, then coordination of benefit provisions in accordance with the laws and regulations in your state will apply in lieu of the excess coverage provisions.

17

Premium
Generali Global Assistance

Emergency Medical Benefits

$250,000 per person
Secondary coverage

Start a New Search

Full Policy Wording

MEDICAL AND DENTAL COVERAGE

We will pay this benefit, up to the amount on the Schedule, for the following covered expenses incurred by you, subject to the following:

1. Covered expenses will only be payable at the Usual and Customary level of payment; and

2. Benefits will be payable only for covered expenses resulting from a Sickness that first manifests itself or an Injury that occurs while on a Trip; and

3. Benefits payable as a result of incurred covered expenses will only be paid after benefits have been paid under any Other Valid and Collectible Health Insurance in effect for you. This coverage is in excess to any other health insurance you have available to you at the time of the loss. You must submit your claim to that provider first. Any benefits you receive from your primary or supplementary insurance providers will be deducted from your claim with us.

Covered Expenses:

1. Expenses for the following Physician-ordered medical services: services of legally qualified Physicians and graduate nurses, charges for Hospital confinement and services, local ambulance services, prescription drugs and medicines, and therapeutic services, incurred by you within one year from the date of your Sickness or Injury during a Trip; and

2. Expenses for emergency dental treatment incurred by you during a Trip up to the amount in the Schedule.

Your duties in the event of a Medical or Dental Expense:

1. You must provide us with all bills and reports for medical and/or dental expenses claimed.

2. You must provide any requested information related to the claimed expense(s), including but not limited to, an explanation of benefits from any other applicable insurance.

3. You must sign a patient authorization to release any information required by us, to investigate your claim.

Please refer to the Definitions, for an explanation of Pre- Existing Conditions, which are excluded under the Medical or Dental Expense Benefits.

Coordination of Benefits

If you reside in CT, ID, IL, and excess coverage for Medical and Dental Expense Benefits is not permitted, then coordination of benefit provisions in accordance with the laws and regulations in your state will apply in lieu of the excess coverage provisions.

GeoBlue
GeoBlue

18

Voyager Choice
GeoBlue

Emergency Medical Benefits

$50,000 per person
Secondary coverage

Start a New Search

Full Policy Wording

Services and Supplies Provided by a Hospital

For any eligible condition not excluded under this Certificate including for Mental, Emotional or Functional Nervous Conditions or Disorders, and Substance Abuse, the Insurer will pay indicated benefits on Covered Expenses for:

1. Inpatient services and supplies provided by the Hospital except private room charges above the prevailing two-bed room rate of the facility.

Note: When outside the United States, this benefit will provide coverage for private rooms if that is all that is available or if the choice is between a ward or a more than two person room and a private room.

2. Outpatient services and supplies including those in connection with outpatient surgery performed at an Ambulatory Surgical Center.

3. Emergency Hospitalization and Emergency Medical Care provided in a Hospital emergency room, including professional air and ground ambulance services for transport to and from the Hospital for such Emergency Hospitalization and Emergency Medical Care.

Payment of Inpatient Covered Expenses are subject to these conditions:

1. Services must be those which are regularly provided and billed by the Hospital.

2. Services are provided only for the number of days required to treat the Covered Person’s Illness or Injury

Note: No benefits will be provided for personal items, such as TV, radio, guest trays, etc.

Note: Injuries and Illnesses resulting from Terrorism and pandemics are covered as any other Injury or Illness provided all of the following conditions are met:

1. The Covered Person had no direct or indirect involvement in the Terrorist Activity;

2. The Terrorist Activity or pandemic is not in a country or location where the United States movement has issued a travel warning that has been in effect with the three (3) months prior to the Covered Person’s date of arrival

3. The Covered Person has not unreasonably failed or refused to depart a country or location following the date a warning to leave that country or location is issued by the United State Government.

Professional and Other Services

The Insurer will pay Covered Expenses not excluded under this Certificate for:

1. Services of a Physician.

2. Services of an anesthesiologist or an anesthetist.

3. Outpatient diagnostic radiology and laboratory services.

4. Surgical implants.

5. The first pair of contact lenses or the first pair of eyeglasses when required as a result of a covered eye surgery.

6. Self-Administered injectable drugs.

7. Syringes when dispensed with self-administered injectable drugs (except insulin).

8. Blood transfusions, including blood processing and the cost of un-replaced blood and blood products.

9. Rental or purchase of Durable Medical Equipment and/or supplies that are all of the following:

a) ordered by a Physician;

b) of no further use when medical need ends;

c) usable only by the patient;

d) not primarily for the Covered Person’s comfort or hygiene;

e) not for environmental control;

f) not for exercise; and

g) manufactured specifically for medical use.

Note: Medical equipment and supplies must meet all of the above guidelines in order to be eligible for benefits under this Certificate of Coverage. The fact that a Physician prescribes or orders equipment or supplies does not necessarily qualify the equipment or supply for payment. The Insurer determines whether the item meets these conditions. Rental charges that exceed the reasonable purchase price of the equipment are not covered.

Ambulance Services

The following ambulance services are covered under this Certificate of Coverage:

1. Base charge, mileage and non-reusable supplies of a licensed ambulance company for ground or air service for transportation to and from a Hospital.

2. Monitoring, electrocardiograms (EKGs or ECGs), cardiac defibrillation, cardiopulmonary resuscitation (CPR) and administration of oxygen and intravenous (IV) solutions in connection with ambulance service. An appropriate licensed person must render the services.

The Insurer pays as stated in the Benefit Overview Matrix.

Complications of Pregnancy

Complications of Pregnancy are covered under this Certificate of Coverage as any other medical condition. Benefits for complications of pregnancy shall be provided for all Covered Persons.

Dental Care for an Accidental Injury

Benefits are payable for dental care for an Accidental Injury to natural teeth that occurs while the Covered Person is covered under this Plan, subject to the following:

1. services must be received during the six months following the date of Injury;

2. no benefits are available to replace or repair existing dental prostheses even if damaged in an eligible Accidental Injury; and

3. damage to natural teeth due to chewing or biting is not considered an Accidental Injury under this Certificate of Coverage.

In addition, the Certificate of Coverage provides benefits for up to three days of Inpatient Hospital services when a Hospital stay is ordered by a Physician and a Dentist for dental treatment required due to an unrelated medical condition. The Insurer determines whether the dental treatment could have been safely provided in another setting. Hospital stays for the purpose of administering general anesthesia are not considered Medically Necessary. The Insurer pays as stated in the Benefit Overview Matrix.

Dental Care for Relief of Pain

Benefits are payable for dental care for Relief of Pain to the teeth that occurs while the Covered Person is covered under this Certificate of Coverage. Services must be received while covered during the Trip Coverage Period. The Insurer pays as stated in the Benefit Overview Matrix.

Physical and/or Occupational Therapy/Medicine, Including spinal manipulations and other specified therapies including acupuncture

Charges incurred for the following rehabilitative therapies, if prescribed by a Physician to restore function loss due to an illness or injury covered under this Certificate of Coverage: physical, occupational, chelation, massage, hearing and cardiac/pulmonary therapy. Additionally, coverage shall also be provided for chiropractic care delivered by a currently licensed chiropractor acting within the scope of his or her practice. The coverage shall include initial diagnosis and clinically appropriate and Medically Necessary services and supplies required to treat the diagnosed disorder, subject to the terms and conditions of the Certificate of Coverage; Acupuncture that treats a covered illness or injury provided by Doctor of Acupuncture.

Therapies excluded under this coverage include, but are not limited to: speech therapy, vocational rehabilitation, behavioral training, gym or swim therapy, dance therapy, marital counseling, legal or financial counseling, biofeedback, neuro-feedback, hypnosis, sleep therapy, employment counseling, back to school, return to work services, work hardening programs, driving safety, and services, training, educational therapy or other non-medical ancillary services for learning disabilities, developmental delays or intellectual disabilities.

These Covered Expenses are Limited as stated in the Benefit Overview Matrix.

Benefits for Claims resulting from downhill skiing and scuba diving

The Insurer will pay Covered Expenses for claims resulting from downhill (alpine) skiing. It will also pay Covered Expenses resulting from scuba diving provided that the diver is certified by the Professional Association of Diving Instructors (PADI) or the National Association of Underwater Instructors (NAUI), or equivalent governing body, or provided that he/she is diving under the supervision of a certified instructor. These Covered Expenses are Limited as stated in the Benefit Overview Matrix.

19

Voyager Essential
GeoBlue

Emergency Medical Benefits

$50,000 per person
Secondary coverage

Start a New Search

Full Policy Wording

Services and Supplies Provided by a Hospital

For any eligible condition not excluded under this Certificate including for Mental, Emotional or Functional Nervous Conditions or Disorders, and Substance Abuse, the Insurer will pay indicated benefits on Covered Expenses for:

1. Inpatient services and supplies provided by the Hospital except private room charges above the prevailing two-bed room rate of the facility.

Note: When outside the United States, this benefit will provide coverage for private rooms if that is all that is available or if the choice is between a ward or a more than two person room and a private room.

2. Outpatient services and supplies including those in connection with outpatient surgery performed at an Ambulatory Surgical Center.

3. Emergency Hospitalization and Emergency Medical Care provided in a Hospital emergency room, including professional air and ground ambulance services for transport to and from the Hospital for such Emergency Hospitalization and Emergency Medical Care.

Payment of Inpatient Covered Expenses are subject to these conditions:

1. Services must be those which are regularly provided and billed by the Hospital.

2. Services are provided only for the number of days required to treat the Covered Person’s Illness or Injury

Note: No benefits will be provided for personal items, such as TV, radio, guest trays, etc.

Note: Injuries and Illnesses resulting from Terrorism and pandemics are covered as any other Injury or Illness provided all of the following conditions are met:

1. The Covered Person had no direct or indirect involvement in the Terrorist Activity;

2. The Terrorist Activity or pandemic is not in a country or location where the United States movement has issued a travel warning that has been in effect with the three (3) months prior to the Covered Person’s date of arrival

3. The Covered Person has not unreasonably failed or refused to depart a country or location following the date a warning to leave that country or location is issued by the United State Government.

Professional and Other Services

The Insurer will pay Covered Expenses not excluded under this Certificate for:

1. Services of a Physician.

2. Services of an anesthesiologist or an anesthetist.

3. Outpatient diagnostic radiology and laboratory services.

4. Surgical implants.

5. The first pair of contact lenses or the first pair of eyeglasses when required as a result of a covered eye surgery.

6. Self-Administered injectable drugs.

7. Syringes when dispensed with self-administered injectable drugs (except insulin).

8. Blood transfusions, including blood processing and the cost of un-replaced blood and blood products.

9. Rental or purchase of Durable Medical Equipment and/or supplies that are all of the following:

a) ordered by a Physician;

b) of no further use when medical need ends;

c) usable only by the patient;

d) not primarily for the Covered Person’s comfort or hygiene;

e) not for environmental control;

f) not for exercise; and

g) manufactured specifically for medical use.

Note: Medical equipment and supplies must meet all of the above guidelines in order to be eligible for benefits under this Certificate of Coverage. The fact that a Physician prescribes or orders equipment or supplies does not necessarily qualify the equipment or supply for payment. The Insurer determines whether the item meets these conditions. Rental charges that exceed the reasonable purchase price of the equipment are not covered.

Ambulance Services

The following ambulance services are covered under this Certificate of Coverage:

1. Base charge, mileage and non-reusable supplies of a licensed ambulance company for ground or air service for transportation to and from a Hospital.

2. Monitoring, electrocardiograms (EKGs or ECGs), cardiac defibrillation, cardiopulmonary resuscitation (CPR) and administration of oxygen and intravenous (IV) solutions in connection with ambulance service. An appropriate licensed person must render the services.

The Insurer pays as stated in the Benefit Overview Matrix.

Complications of Pregnancy

Complications of Pregnancy are covered under this Certificate of Coverage as any other medical condition. Benefits for complications of pregnancy shall be provided for all Covered Persons.

Dental Care for an Accidental Injury

Benefits are payable for dental care for an Accidental Injury to natural teeth that occurs while the Covered Person is covered under this Plan, subject to the following:

1. services must be received during the six months following the date of Injury;

2. no benefits are available to replace or repair existing dental prostheses even if damaged in an eligible Accidental Injury; and

3. damage to natural teeth due to chewing or biting is not considered an Accidental Injury under this Certificate of Coverage.

In addition, the Certificate of Coverage provides benefits for up to three days of Inpatient Hospital services when a Hospital stay is ordered by a Physician and a Dentist for dental treatment required due to an unrelated medical condition. The Insurer determines whether the dental treatment could have been safely provided in another setting. Hospital stays for the purpose of administering general anesthesia are not considered Medically Necessary. The Insurer pays as stated in the Benefit Overview Matrix.

Dental Care for Relief of Pain

Benefits are payable for dental care for Relief of Pain to the teeth that occurs while the Covered Person is covered under this Certificate of Coverage. Services must be received while covered during the Trip Coverage Period. The Insurer pays as stated in the Benefit Overview Matrix.

Physical and/or Occupational Therapy/Medicine, Including spinal manipulations and other specified therapies including acupuncture

Charges incurred for the following rehabilitative therapies, if prescribed by a Physician to restore function loss due to an illness or injury covered under this Certificate of Coverage: physical, occupational, chelation, massage, hearing and cardiac/pulmonary therapy. Additionally, coverage shall also be provided for chiropractic care delivered by a currently licensed chiropractor acting within the scope of his or her practice. The coverage shall include initial diagnosis and clinically appropriate and Medically Necessary services and supplies required to treat the diagnosed disorder, subject to the terms and conditions of the Certificate of Coverage; Acupuncture that treats a covered illness or injury provided by Doctor of Acupuncture.

Therapies excluded under this coverage include, but are not limited to: speech therapy, vocational rehabilitation, behavioral training, gym or swim therapy, dance therapy, marital counseling, legal or financial counseling, biofeedback, neuro-feedback, hypnosis, sleep therapy, employment counseling, back to school, return to work services, work hardening programs, driving safety, and services, training, educational therapy or other non-medical ancillary services for learning disabilities, developmental delays or intellectual disabilities.

These Covered Expenses are Limited as stated in the Benefit Overview Matrix.

Benefits for Claims resulting from downhill skiing and scuba diving

The Insurer will pay Covered Expenses for claims resulting from downhill (alpine) skiing. It will also pay Covered Expenses resulting from scuba diving provided that the diver is certified by the Professional Association of Diving Instructors (PADI) or the National Association of Underwater Instructors (NAUI), or equivalent governing body, or provided that he/she is diving under the supervision of a certified instructor. These Covered Expenses are Limited as stated in the Benefit Overview Matrix.

20

Trekker Choice excl US
GeoBlue

Emergency Medical Benefits

$250,000 per person
Secondary coverage

Start a New Search

Full Policy Wording

Services and Supplies Provided by a Hospital

For any eligible condition not excluded under this Certificate other than for Mental, Emotional or Functional Nervous Conditions or Disorders, and Substance Abuse, the Insurer will pay indicated benefits on Covered Expenses for:

1. Inpatient services and supplies provided by the Hospital except private room charges above the prevailing two-bed room rate of the facility.

Note: When outside the United States, this benefit will provide coverage for private rooms if that is all that is available or if the choice is between a ward or a more than two person room and a private room.

2. Outpatient services and supplies including those in connection with outpatient surgery performed at an Ambulatory Surgical Center.

3. Emergency Hospitalization and Emergency Medical Care provided in a Hospital emergency room, including professional air and ground ambulance services for transport to and from the Hospital for such Emergency Hospitalization and Emergency Medical Care.

Payment of Inpatient Covered Expenses are subject to these conditions:

1. Services must be those which are regularly provided and billed by the Hospital.

2. Services are provided only for the number of days required to treat the Covered Person’s Illness or Injury

Note: No benefits will be provided for personal items, such as TV, radio, guest trays, etc.

Note: Injuries and Illnesses resulting from Terrorism and pandemics are covered as any other Injury or Illness provided all of the following conditions are met:

1. The Covered Person had no direct or indirect involvement in the Terrorist Activity;

2. The Terrorist Activity or pandemic is not in a country or location where the United States movement has issued a travel warning that has been in effect with the three (3) months prior to the Covered Person’s date of arrival

3. The Covered Person has not unreasonably failed or refused to depart a country or location following the date a warning to leave that country or location is issued by the United State Government.

Professional and Other Services

The Insurer will pay Covered Expenses not excluded under this Certificate for:

1. Services of a Physician.

2. Services of an anesthesiologist or an anesthetist.

3. Outpatient diagnostic radiology and laboratory services.

4. Surgical implants.

5. The first pair of contact lenses or the first pair of eyeglasses when required as a result of a covered eye surgery.

6. Self-Administered injectable drugs.

7. Syringes when dispensed with self-administered injectable drugs (except insulin).

8. Blood transfusions, including blood processing and the cost of un-replaced blood and blood products.

9. Rental or purchase of Durable Medical Equipment and/or supplies that are all of the following:

a) ordered by a Physician;

b) of no further use when medical need ends;

c) usable only by the patient;

d) not primarily for the Covered Person’s comfort or hygiene;

e) not for environmental control;

f) not for exercise; and

g) manufactured specifically for medical use.

Note: Medical equipment and supplies must meet all of the above guidelines in order to be eligible for benefits under this Certificate of Coverage. The fact that a Physician prescribes or orders equipment or supplies does not necessarily qualify the equipment or supply for payment. The Insurer determines whether the item meets these conditions. Rental charges that exceed the reasonable purchase price of the equipment are not covered.

Ambulance Services

The following ambulance services are covered under this Certificate of Coverage:

1. Base charge, mileage and non-reusable supplies of a licensed ambulance company for ground or air service for transportation to and from a Hospital.

2. Monitoring, electrocardiograms (EKGs or ECGs), cardiac defibrillation, cardiopulmonary resuscitation (CPR) and administration of oxygen and intravenous (IV) solutions in connection with ambulance service. An appropriate licensed person must render the services.

The Insurer pays as stated in the Benefit Overview Matrix.

Complications of Pregnancy

Complications of Pregnancy are covered under this Certificate of Coverage as any other medical condition. Benefits for complications of pregnancy shall be provided for all Covered Persons.

Dental Care for an Accidental Injury

Benefits are payable for dental care for an Accidental Injury to natural teeth that occurs while the Covered Person is covered under this Plan, subject to the following:

1. services must be received during the six months following the date of Injury;

2. no benefits are available to replace or repair existing dental prostheses even if damaged in an eligible Accidental Injury; and

3. damage to natural teeth due to chewing or biting is not considered an Accidental Injury under this Certificate of Coverage.

In addition, the Certificate of Coverage provides benefits for up to three days of Inpatient Hospital services when a Hospital stay is ordered by a Physician and a Dentist for dental treatment required due to an unrelated medical condition. The Insurer determines whether the dental treatment could have been safely provided in another setting. Hospital stays for the purpose of administering general anesthesia are not considered Medically Necessary. The Insurer pays as stated in the Benefit Overview Matrix.

Dental Care for Relief of Pain

Benefits are payable for dental care for Relief of Pain to the teeth that occurs while the Covered Person is covered under this Certificate of Coverage. Services must be received while covered during the Trip Coverage Period. The Insurer pays as stated in the Benefit Overview Matrix.

Physical and/or Occupational Therapy/Medicine, Including spinal manipulations and other specified therapies including acupuncture
Charges incurred for the following rehabilitative therapies, if prescribed by a Physician to restore function loss due to an illness or injury covered under this Certificate of Coverage: physical, occupational, chelation, massage, hearing and cardiac/pulmonary therapy. Additionally, coverage shall also be provided for chiropractic care delivered by a currently licensed chiropractor acting within the scope of his or her practice. The coverage shall include initial diagnosis and clinically appropriate and Medically Necessary services and supplies required to treat the diagnosed disorder, subject to the terms and conditions of the Certificate of Coverage; Acupuncture that treats a covered illness or injury provided by Doctor of Acupuncture.

Therapies excluded under this coverage include, but are not limited to: speech therapy, vocational rehabilitation, behavioral training, gym or swim therapy, dance therapy, marital counseling, legal or financial counseling, biofeedback, neuro-feedback, hypnosis, sleep therapy, employment counseling, back to school, return to work services, work hardening programs, driving safety, and services, training, educational therapy or other non-medical ancillary services for learning disabilities, developmental delays or intellectual disabilities.

These Covered Expenses are Limited as stated in the Benefit Overview Matrix.

Benefits for Claims resulting from downhill skiing and scuba diving

The Insurer will pay Covered Expenses for claims resulting from downhill (alpine) skiing. It will also pay Covered Expenses resulting from scuba diving provided that the diver is certified by the Professional Association of Diving Instructors (PADI) or the National Association of Underwater Instructors (NAUI), or equivalent governing body, or provided that he/she is diving under the supervision of a certified instructor. These Covered Expenses are Limited as stated in the Benefit Overview Matrix.

21

Trekker Essential excl US
GeoBlue

Emergency Medical Benefits

$50,000 per person
Secondary coverage

Start a New Search

Full Policy Wording

Services and Supplies Provided by a Hospital

For any eligible condition not excluded under this Certificate other than for Mental, Emotional or Functional Nervous Conditions or Disorders, and Substance Abuse, the Insurer will pay indicated benefits on Covered Expenses for:

1. Inpatient services and supplies provided by the Hospital except private room charges above the prevailing two-bed room rate of the facility.

Note: When outside the United States, this benefit will provide coverage for private rooms if that is all that is available or if the choice is between a ward or a more than two person room and a private room.

2. Outpatient services and supplies including those in connection with outpatient surgery performed at an Ambulatory Surgical Center.

3. Emergency Hospitalization and Emergency Medical Care provided in a Hospital emergency room, including professional air and ground ambulance services for transport to and from the Hospital for such Emergency Hospitalization and Emergency Medical Care.

Payment of Inpatient Covered Expenses are subject to these conditions:

1. Services must be those which are regularly provided and billed by the Hospital.

2. Services are provided only for the number of days required to treat the Covered Person’s Illness or Injury

Note: No benefits will be provided for personal items, such as TV, radio, guest trays, etc.

Note: Injuries and Illnesses resulting from Terrorism and pandemics are covered as any other Injury or Illness provided all of the following conditions are met:

1. The Covered Person had no direct or indirect involvement in the Terrorist Activity;

2. The Terrorist Activity or pandemic is not in a country or location where the United States movement has issued a travel warning that has been in effect with the three (3) months prior to the Covered Person’s date of arrival

3. The Covered Person has not unreasonably failed or refused to depart a country or location following the date a warning to leave that country or location is issued by the United State Government.

Professional and Other Services

The Insurer will pay Covered Expenses not excluded under this Certificate for:

1. Services of a Physician.

2. Services of an anesthesiologist or an anesthetist.

3. Outpatient diagnostic radiology and laboratory services.

4. Surgical implants.

5. The first pair of contact lenses or the first pair of eyeglasses when required as a result of a covered eye surgery.

6. Self-Administered injectable drugs.

7. Syringes when dispensed with self-administered injectable drugs (except insulin).

8. Blood transfusions, including blood processing and the cost of un-replaced blood and blood products.

9. Rental or purchase of Durable Medical Equipment and/or supplies that are all of the following:

a) ordered by a Physician;

b) of no further use when medical need ends;

c) usable only by the patient;

d) not primarily for the Covered Person’s comfort or hygiene;

e) not for environmental control;

f) not for exercise; and

g) manufactured specifically for medical use.

Note: Medical equipment and supplies must meet all of the above guidelines in order to be eligible for benefits under this Certificate of Coverage. The fact that a Physician prescribes or orders equipment or supplies does not necessarily qualify the equipment or supply for payment. The Insurer determines whether the item meets these conditions. Rental charges that exceed the reasonable purchase price of the equipment are not covered.

Ambulance Services

The following ambulance services are covered under this Certificate of Coverage:

1. Base charge, mileage and non-reusable supplies of a licensed ambulance company for ground or air service for transportation to and from a Hospital.

2. Monitoring, electrocardiograms (EKGs or ECGs), cardiac defibrillation, cardiopulmonary resuscitation (CPR) and administration of oxygen and intravenous (IV) solutions in connection with ambulance service. An appropriate licensed person must render the services.

The Insurer pays as stated in the Benefit Overview Matrix.

Complications of Pregnancy

Complications of Pregnancy are covered under this Certificate of Coverage as any other medical condition. Benefits for complications of pregnancy shall be provided for all Covered Persons.

Dental Care for an Accidental Injury

Benefits are payable for dental care for an Accidental Injury to natural teeth that occurs while the Covered Person is covered under this Plan, subject to the following:

1. services must be received during the six months following the date of Injury;

2. no benefits are available to replace or repair existing dental prostheses even if damaged in an eligible Accidental Injury; and

3. damage to natural teeth due to chewing or biting is not considered an Accidental Injury under this Certificate of Coverage.

In addition, the Certificate of Coverage provides benefits for up to three days of Inpatient Hospital services when a Hospital stay is ordered by a Physician and a Dentist for dental treatment required due to an unrelated medical condition. The Insurer determines whether the dental treatment could have been safely provided in another setting. Hospital stays for the purpose of administering general anesthesia are not considered Medically Necessary. The Insurer pays as stated in the Benefit Overview Matrix.

Dental Care for Relief of Pain

Benefits are payable for dental care for Relief of Pain to the teeth that occurs while the Covered Person is covered under this Certificate of Coverage. Services must be received while covered during the Trip Coverage Period. The Insurer pays as stated in the Benefit Overview Matrix.

Physical and/or Occupational Therapy/Medicine, Including spinal manipulations and other specified therapies including acupuncture
Charges incurred for the following rehabilitative therapies, if prescribed by a Physician to restore function loss due to an illness or injury covered under this Certificate of Coverage: physical, occupational, chelation, massage, hearing and cardiac/pulmonary therapy. Additionally, coverage shall also be provided for chiropractic care delivered by a currently licensed chiropractor acting within the scope of his or her practice. The coverage shall include initial diagnosis and clinically appropriate and Medically Necessary services and supplies required to treat the diagnosed disorder, subject to the terms and conditions of the Certificate of Coverage; Acupuncture that treats a covered illness or injury provided by Doctor of Acupuncture.

Therapies excluded under this coverage include, but are not limited to: speech therapy, vocational rehabilitation, behavioral training, gym or swim therapy, dance therapy, marital counseling, legal or financial counseling, biofeedback, neuro-feedback, hypnosis, sleep therapy, employment counseling, back to school, return to work services, work hardening programs, driving safety, and services, training, educational therapy or other non-medical ancillary services for learning disabilities, developmental delays or intellectual disabilities.

These Covered Expenses are Limited as stated in the Benefit Overview Matrix.

Benefits for Claims resulting from downhill skiing and scuba diving

The Insurer will pay Covered Expenses for claims resulting from downhill (alpine) skiing. It will also pay Covered Expenses resulting from scuba diving provided that the diver is certified by the Professional Association of Diving Instructors (PADI) or the National Association of Underwater Instructors (NAUI), or equivalent governing body, or provided that he/she is diving under the supervision of a certified instructor. These Covered Expenses are Limited as stated in the Benefit Overview Matrix.

Global Guardian Air Ambulance
Global Guardian Air Ambulance

22

Air Ambulance Card - Standard Annual
Global Guardian Air Ambulance

Emergency Medical Benefits

No coverage

Start a New Search

Full Policy Wording

There is no Emergency Medical coverage with this plan.

23

Air Ambulance Card - Extended Stay 6 Months
Global Guardian Air Ambulance

Emergency Medical Benefits

No coverage

Start a New Search

Full Policy Wording

There is no Emergency Medical coverage with this plan.

24

Air Ambulance Card - Extended Stay 12 Months
Global Guardian Air Ambulance

Emergency Medical Benefits

No coverage

Start a New Search

Full Policy Wording

There is no Emergency Medical coverage with this plan.

HTH Travel Insurance
HTH Travel Insurance

25

TripProtector Preferred
HTH Travel Insurance

Emergency Medical Benefits

$500,000 per person accident
$500,000 per person sickness
Secondary coverage

Start a New Search

Full Policy Wording

ACCIDENT MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Confirmation of Coverage subject to any Deductible shown on the Confirmation of Coverage, if You incur Covered Medical Expenses for Treatment of an Accidental Injury that occurs during the Trip.

Treatment means necessary medical treatment that must be performed during the Trip due to the serious and acute nature of the Accidental Injury.

Covered Medical Expenses are expenses incurred for necessary services and supplies: (a) listed below; and (b) ordered or prescribed by the attending Physician as Medically Necessary for treatment, that are limited to:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms;

c) charges for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;

d) ambulance service;

e) drugs, medicines and therapeutic services.

The Company will not pay benefits in excess of the Reasonable and Customary Charges. The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

The Company will pay benefits up to the Maximum Benefit shown on the Confirmation of Coverage for dental Treatment for Accidental Injury to Sound Natural Teeth. Both the Accidental Injury and the dental Treatment must occur during the Trip.

If You are Hospitalized due to an Accidental Injury that first occurred during the course of the Trip beyond the Scheduled Return Date, overage under this benefit will be extended until You are released from the Hospital or until Maximum Benefits under this Certificate have been paid.

SICKNESS MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Confirmation of Coverage subject to any Deductible shown on the Confirmation of Coverage, if You incur Covered Medical Expenses as a result of Treatment of a Sickness that first manifests itself during the Trip.

Treatment means necessary medical treatment that must be performed during the Trip due to the serious and acute nature of the Sickness.

Covered Medical Expenses are expenses incurred for necessary services and supplies: (a) listed below; and (b) ordered or prescribed by the attending Physician as Medically Necessary for treatment, that are limited to:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms;

c) charge for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;

d) ambulance service;

e) drugs, medicines and therapeutic services.

The Company will not pay benefits in excess of the Reasonable and Customary Charges. The Company will not cover any expenses provided by another party at no cost to You or already included within the cost of the Trip.

If You are Hospitalized due to a Sickness that first occurred during the course of the Trip beyond the Scheduled Return Date, coverage under this benefit will be extended until You are released from the Hospital or until Maximum Benefits under this Certificate have been paid.

26

TripProtector Economy
HTH Travel Insurance

Emergency Medical Benefits

$75,000 per person accident
$75,000 per person sickness
Secondary coverage

Start a New Search

Full Policy Wording

ACCIDENT MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Confirmation of Coverage subject to any Deductible shown on the Confirmation of Coverage, if You incur Covered Medical Expenses for Treatment of an Accidental Injury that occurs during the Trip.

Treatment means necessary medical treatment that must be performed during the Trip due to the serious and acute nature of the Accidental Injury.

Covered Medical Expenses are expenses incurred for necessary services and supplies: (a) listed below; and (b) ordered or prescribed by the attending Physician as Medically Necessary for treatment, that are limited to:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms;

c) charges for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;

d) ambulance service; and

e) drugs, medicines and therapeutic services.

The Company will not pay benefits in excess of the Reasonable and Customary Charges. The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

The Company will pay benefits up to the Maximum Benefit shown on the Confirmation of Coverage for dental Treatment for Accidental Injury to Sound Natural Teeth. Both the Accidental Injury and the dental Treatment must occur during the Trip.

If You are Hospitalized due to an Accidental Injury that first occurred during the course of the Trip beyond the Scheduled Return Date, overage under this benefit will be extended until You are released from the Hospital or until Maximum Benefits under this Certificate have been paid.

SICKNESS MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Confirmation of Coverage subject to any Deductible shown on the Confirmation of Coverage, if You incur Covered Medical Expenses as a result of Treatment of a Sickness that first manifests itself during the Trip.

Treatment means necessary medical treatment that must be performed during the Trip due to the serious and acute nature of the Sickness.

Covered Medical Expenses are expenses incurred for necessary services and supplies: (a) listed below; and (b) ordered or prescribed by the attending Physician as Medically Necessary for treatment, that are limited to:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms;

c) charge for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;

d) ambulance service;

e) drugs, medicines and therapeutic services.

The Company will not pay benefits in excess of the Reasonable and Customary Charges. The Company will not cover any expenses provided by another party at no cost to You or already included within the cost of the Trip.

If You are Hospitalized due to a Sickness that first occurred during the course of the Trip beyond the Scheduled Return Date, coverage under this benefit will be extended until You are released from the Hospital or until Maximum Benefits under this Certificate have been paid.

27

TripProtector Classic
HTH Travel Insurance

Emergency Medical Benefits

$250,000 per person accident
$250,000 per person sickness
Secondary coverage

Start a New Search

Full Policy Wording

ACCIDENT MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Confirmation of Coverage subject to any Deductible shown on the Confirmation of Coverage, if You incur Covered Medical Expenses for Treatment of an Accidental Injury that occurs during the Trip.

Treatment means necessary medical treatment that must be performed during the Trip due to the serious and acute nature of the Accidental Injury.

Covered Medical Expenses are expenses incurred for necessary services and supplies: (a) listed below; and (b) ordered or prescribed by the attending Physician as Medically Necessary for treatment, that are limited to:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms;

c) charges for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;

d) ambulance service; and

e) drugs, medicines and therapeutic services.

The Company will not pay benefits in excess of the Reasonable and Customary Charges. The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

The Company will pay benefits up to the Maximum Benefit shown on the Confirmation of Coverage for dental Treatment for Accidental Injury to Sound Natural Teeth. Both the Accidental Injury and the dental Treatment must occur during the Trip.

If You are Hospitalized due to an Accidental Injury that first occurred during the course of the Trip beyond the Scheduled Return Date, overage under this benefit will be extended until You are released from the Hospital or until Maximum Benefits under this Certificate have been paid.

SICKNESS MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Confirmation of Coverage subject to any Deductible shown on the Confirmation of Coverage, if You incur Covered Medical Expenses as a result of Treatment of a Sickness that first manifests itself during the Trip.

Treatment means necessary medical treatment that must be performed during the Trip due to the serious and acute nature of the Sickness.

Covered Medical Expenses are expenses incurred for necessary services and supplies: (a) listed below; and (b) ordered or prescribed by the attending Physician as Medically Necessary for treatment, that are limited to:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms;

c) charge for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;

d) ambulance service;

e) drugs, medicines and therapeutic services.

The Company will not pay benefits in excess of the Reasonable and Customary Charges. The Company will not cover any expenses provided by another party at no cost to You or already included within the cost of the Trip.

If You are Hospitalized due to a Sickness that first occurred during the course of the Trip beyond the Scheduled Return Date, coverage under this benefit will be extended until You are released from the Hospital or until Maximum Benefits under this Certificate have been paid.

IMG
IMG

28

Patriot America
IMG

Emergency Medical Benefits

$50,000 per person
Secondary coverage

Start a New Search

Full Policy Wording

ELIGIBLE MEDICAL EXPENSES:

Subject to the Terms of this insurance, and the insurance plan shown in the Declaration, the Company will reimburse the Insured Person up to the amount shown in the BENEFIT SUMMARY for the following costs, Charges and expenses incurred by the Insured Person during the Period of Coverage with respect to an Illness or Injury suffered or sustained by the Insured Person during the Period of Coverage and while this Certificate is in effect, so long as the Illness or Injury is covered under this Certificate, Charges are Usual, Reasonable and Customary and are incurred for Treatment or supplies that are Medically Necessary (“Eligible Medical Expenses”):

(1) Charges incurred at a Hospital for:

a) daily room and board, nursing services, and Ancillary Services not to exceed the average semi-private room rate. A private room will be considered when no semi-private room is available or if medical necessity warrants this type of room. The private room rate is not to exceed the average private room rate.

b) daily room and board, nursing services, and Ancillary Services in an Intensive Care Unit

c) use of operating, Treatment or recovery room

d) services and supplies which are routinely provided by the Hospital to persons for use while an Inpatient

e) Emergency Treatment of an Injury, even if Hospital confinement is not required

f) Emergency Treatment of an Illness; however, an additional Deductible (as shown in the BENEFIT SUMMARY) will be required unless the Insured Person is directly admitted to the Hospital as Inpatient for further Treatment of that Illness

(2) Charges incurred for Surgery at an Outpatient Surgical Facility, including services and supplies

(3) Charges by a Physician for professional services rendered, including Surgery; provided, however, that Charges by or for an assistant surgeon will be limited and covered at the rate of up to twenty percent (20%) of the Usual, Reasonable and Customary charge of the primary surgeon; and provided, further, that the standby availability of a Physician or surgeon will not be deemed to be a professional service and is not eligible for coverage

(4) Charges incurred for:

a) dressings, sutures, casts or other supplies which are Medically Necessary

b) diagnostic testing using Radiology, ultrasonography or laboratory services. Laboratory services billed for professional component fees are covered if the pathologist has direct involvement in providing a written report or verbal consultation for specimen-specific pathology services

c) Implant devices that are Medically Necessary; however, any Implants provided outside the PPO network are limited to a payment of no more than one hundred fifty percent (150%) of the established invoice price and/or list price for that item

d) basic functional artificial limbs, eye or larynx or breast prostheses, but not the replacement or repair thereof

e) reconstructive Surgery when the Surgery is incidental to and follows Surgery which was covered hereunder

f) radiation therapy or Treatment, and chemotherapy

g) hemodialysis for the Treatment of acute renal failure only and the Charges by a Hospital for processing and administration of blood or blood components

h) oxygen and other gases and their administration

i) anesthetics and their administration by a Physician

j) drugs which require prescription by a Physician for Treatment of Illness or Injury, but not for the replacement of lost, stolen, damaged, expired or otherwise compromised drugs, and for a maximum supply of ninety (90) days of any one

(1) prescription

k) care in a licensed Extended Care Facility upon direct transfer from an acute care Hospital

l) Home Nursing Care in bed by a qualified licensed professional, provided by a Home Health Care Agency upon direct transfer from an acute care Hospital

m) Emergency Local Ambulance Transport necessarily incurred in connection with:

(i) an Injury

(ii) an Illness resulting in Hospital confinement as an Inpatient.

n) Interfacility Ambulance Transfer must be a result of an Inpatient Hospital Admission, Medically Necessary and from one licensed health care Facility to another licensed health care Facility via air or land ambulance

o) chiropractic services prescribed by a Physician and performed by a professional chiropractor, and necessarily incurred to continue recovery from a covered Injury or covered Illness; services include manipulations, x-rays and laboratory tests ordered by the chiropractor

p) physical therapy prescribed by a Physician and performed by a professional physical therapist, and necessarily incurred to continue recovery from a covered Injury or covered Illness

q) Durable Medical Equipment, as defined herein, deemed to be Medically Necessary

(5) Charges incurred for Treatment at an Urgent Care Center

(6) Charges incurred for Treatment at a Walk-in Clinic

(7) Charges for Treatment of an Injury to the foot due to an Accident covered hereunder

(8) Charges for Treatment of an Illness for which foot Surgery is Medically Necessary and determined to be the only appropriate method of Treatment

(9) Charges for Dental Treatment as follows up to the amount shown in the BENEFIT SUMMARY:

a) Charges for Treatment following Traumatic Dental Injury from a covered Accident that resulted in physical Injury to the Insured Person

b) Charges for necessary Dental Treatment of Unexpected pain to sound natural teeth

c) Charges incurred for non-emergency Dental Treatment necessary due to an Accident covered hereunder

(10) Charges for value-added tax (VAT) or like tax incurred on Eligible Medical Expenses

29

Patriot International
IMG

Emergency Medical Benefits

$50,000 per person
Secondary coverage

Start a New Search

Full Policy Wording

G. ELIGIBLE MEDICAL EXPENSES:

Subject to the Terms of this insurance, and the insurance plan shown in the Declaration, the Company will reimburse the Insured Person up to the amount shown in the BENEFIT SUMMARY for the following costs, Charges and expenses incurred by the Insured Person during the Period of Coverage with respect to an Illness or Injury suffered or sustained by the Insured Person during the Period of Coverage and while this Certificate is in effect, so long as the Illness or Injury is covered under this Certificate, Charges are Usual, Reasonable and Customary and are incurred for Treatment or supplies that are Medically Necessary (“Eligible Medical Expenses”):

(1) Charges incurred at a Hospital for:

a) daily room and board, nursing services, and Ancillary Services not to exceed the average semi-private room rate. A private room will be considered when no semi-private room is available or if medical necessity warrants this type of room. The private room rate is not to exceed the average private room rate.

b) daily room and board, nursing services, and Ancillary Services in an Intensive Care Unit

c) use of operating, Treatment or recovery room

d) services and supplies which are routinely provided by the Hospital to persons for use while an Inpatient

e) Emergency Treatment of an Injury, even if Hospital confinement is not required

f) Emergency Treatment of an Illness; however, an additional Deductible (as shown in the BENEFIT SUMMARY) will be required unless the Insured Person is directly admitted to the Hospital as Inpatient for further Treatment of that Illness

(2) Charges incurred for Surgery at an Outpatient Surgical Facility, including services and supplies

(3) Charges by a Physician for professional services rendered, including Surgery; provided, however, that Charges by or for an assistant surgeon will be limited and covered at the rate of up to twenty percent (20%) of the Usual, Reasonable and Customary charge of the primary surgeon; and provided, further, that the standby availability of a Physician or surgeon will not be deemed to be a professional service and is not eligible for coverage

(4) Charges incurred for:

a) dressings, sutures, casts or other supplies which are Medically Necessary

b) diagnostic testing using Radiology, ultrasonography or laboratory services. Laboratory services billed for professional component fees are covered if the pathologist has direct involvement in providing a written report or verbal consultation for specimen-specific pathology services

c) Implant devices that are Medically Necessary; however, any Implants provided outside the PPO network are limited to a payment of no more than one hundred fifty percent (150%) of the established invoice price and/or list price for that item

d) basic functional artificial limbs, eye or larynx or breast prostheses, but not the replacement or repair thereof

e) reconstructive Surgery when the Surgery is incidental to and follows Surgery which was covered hereunder

f) radiation therapy or Treatment, and chemotherapy

g) hemodialysis for the Treatment of acute renal failure only and the Charges by a Hospital for processing and administration of blood or blood components

h) oxygen and other gases and their administration

i) anesthetics and their administration by a Physician

j) drugs which require prescription by a Physician for Treatment of Illness or Injury, but not for the replacement of lost, stolen, damaged, expired or otherwise compromised drugs, and for a maximum supply of ninety (90) days of any one (1) prescription

k) care in a licensed Extended Care Facility upon direct transfer from an acute care Hospital

l) Home Nursing Care in bed by a qualified licensed professional, provided by a Home Health Care Agency upon direct transfer from an acute care Hospital

m) Emergency Local Ambulance Transport necessarily incurred in connection with:

(i) an Injury

(ii) an Illness resulting in Hospital confinement as an Inpatient.

n) Interfacility Ambulance Transfer must be a result of an Inpatient Hospital Admission, Medically Necessary and from one licensed health care Facility to another licensed health care Facility via air or land ambulance

o) chiropractic services prescribed by a Physician and performed by a professional chiropractor, and necessarily incurred to continue recovery from a covered Injury or covered Illness; services include manipulations, x-rays and laboratory tests ordered by the chiropractor

p) physical therapy prescribed by a Physician and performed by a professional physical therapist, and necessarily incurred to continue recovery from a covered Injury or covered Illness

q) Durable Medical Equipment, as defined herein, deemed to be Medically Necessary

(5) Charges incurred for Treatment at an Urgent Care Center

(6) Charges incurred for Treatment at a Walk-in Clinic

(7) Charges for Treatment of an Injury to the foot due to an Accident covered hereunder

(8) Charges for Treatment of an Illness for which foot Surgery is Medically Necessary and determined to be the only appropriate method of Treatment

(9) Charges for Dental Treatment as follows up to the amount shown in the BENEFIT SUMMARY:

a) Charges for Treatment following Traumatic Dental Injury from a covered Accident that resulted in physical Injury to the Insured Person

b) Charges for necessary Dental Treatment of Unexpected pain to sound natural teeth

c) Charges incurred for non-emergency Dental Treatment necessary due to an Accident covered hereunder

(10) Charges for value-added tax (VAT) or like tax incurred on Eligible Medical Expenses

30

Patriot Multi-Trip America
IMG

Emergency Medical Benefits

$1,000,000 per person
Secondary coverage

Start a New Search

Full Policy Wording

G. ELIGIBLE MEDICAL EXPENSES – Subject to the Terms of this insurance, including without limitation the Deductible, and the various limits and sub-limits set forth in the Schedule of Benefits/Limits contained in Section C, above, and the Exclusions set forth in Section T, below, the Company will reimburse the Insured Person for the following costs, charges and expenses (“Charges”) incurred by the Insured Person during the Period of Coverage or any applicable Benefit Period with respect to an Illness or Injury suffered or sustained by the Insured Person during the Period of Coverage and while this Certificate is in effect, so long as the Charges are Usual, Reasonable and Customary and are incurred for Treatment or supplies that are Medically Necessary (“Eligible Medical Expenses”):

(1) Charges incurred at a Hospital for:

(a) daily room and board and nursing services not to exceed the average semi-private room rate; and

(b) daily room and board and nursing services in an Intensive Care Unit; and

c) use of operating, Treatment or recovery room; and

(d) services and supplies which are routinely provided by the Hospital to persons for use while Inpatient; and

(e) Emergency Treatment of an Injury, even if Hospital confinement is not required; and

(f) Emergency Treatment of an Illness; however an additional $250 deductible will be required unless the Insured Person is directly admitted to the Hospital as Inpatient for further Treatment of that Illness;

(2) Charges incurred for Surgery at an Outpatient Surgical facility, including services and supplies; and

(3) Charges by a Physician for professional services rendered, including Surgery; provided, however, that charges by or for an assistant surgeon will be limited and covered at the rate of twenty percent (20%) of the Usual, Reasonable and Customary charge of the primary surgeon; and provided, further, that standby availability of a Physician or surgeon will not be deemed to be a professional service and is not eligible for coverage; and

(4) Charges incurred for:

(a) dressings, sutures, casts or other supplies that are Medically Necessary; and

(b) diagnostic testing using radiology, ultrasonographic or laboratory services (psychometric, behavioral and educational testing are not included); and

c) Implant devices that are Medically Necessary; however any Implants provided by a non-PPO provider are limited to payment of no more than 150% of the established invoice price and/or list price for that item.; and

(d) subject to the Terms of Sections T(10)(b), © and (d), basic functional artificial limbs, eye or larynx or breast prostheses, but not the replacement or repair thereof; and

(e) hemodialysis and the Charges by a Hospital for processing and administration of blood or blood components, but not the cost of the actual blood or blood components; and

(f) oxygen and other gasses and their administration; and

(g) anesthetics and their administration by a Physician; and

(h) drugs which require prescription by a Physician for Treatment of Illness or Injury, but not for the replacement of lost, stolen, damaged, expired or otherwise compromised drugs, and for a maximum supply of ninety (90) days of any one prescription; and

(i) care in a licensed Extended Care Facility upon direct transfer from an acute care Hospital; and

(j) Home Nursing Care in bed by a qualified licensed professional, provided by a Home Health Care Agency upon direct transfer from an acute care Hospital; and

(k) Emergency Local Ambulance Transport necessarily incurred in connection with Injury; and

(l) Emergency Local Ambulance Transport necessarily incurred in connection with an Illness resulting in Hospitalization; and

(m) Accident-related Dental Treatment and Dental Surgery, as necessary to restore or replace sound natural teeth lost or damaged in an Accident leading to an Injury that is covered under this insurance; and

(n) physical therapy prescribed by a Physician and performed by a professional physical therapist, and necessarily incurred to continue recovery from a covered Injury or covered Illness; and

(o) Medically Necessary rental of Durable Medical Equipment, up to the purchase price.

(5) Subject to the Terms of Section T, Exclusions, subsection 1 (e) “War; Military Action” and Section T, subsection 2. “Terrorism”, below, and subject also to the Deductible, Coinsurance and limits and sublimits set forth in Section C of the Certificate “Schedule of Benefits/Limits,” the Company will pay and/or reimburse the Insured Person up to $50,000 for the Eligible Medical Expenses described in Sections G. 1-4, a-o of the Certificate arising out of Injury or Illness incurred by the Insured Person as a result of or in connection with an act of Terrorism while this insurance is in effect.

31

Patriot Multi-Trip International
IMG

Emergency Medical Benefits

$1,000,000 per person
Secondary coverage

Start a New Search

Full Policy Wording

G. ELIGIBLE MEDICAL EXPENSES – Subject to the Terms of this insurance, including without limitation the Deductible, and the various limits and sub-limits set forth in the Schedule of Benefits/Limits contained in Section C, above, and the Exclusions set forth in Section T, below, the Company will reimburse the Insured Person for the following costs, charges and expenses (“Charges”) incurred by the Insured Person during the Period of Coverage or any applicable Benefit Period with respect to an Illness or Injury suffered or sustained by the Insured Person during the Period of Coverage and while this Certificate is in effect, so long as the Charges are Usual, Reasonable and Customary and are incurred for Treatment or supplies that are Medically Necessary (“Eligible Medical Expenses”):

(1) Charges incurred at a Hospital for:

(a) daily room and board and nursing services not to exceed the average semi-private room rate; and

(b) daily room and board and nursing services in an Intensive Care Unit; and

c) use of operating, Treatment or recovery room; and

(d) services and supplies which are routinely provided by the Hospital to persons for use while Inpatient; and

(e) Emergency Treatment of an Injury, even if Hospital confinement is not required; and

(f) Emergency Treatment of an Illness; however an additional $250 deductible will be required unless the Insured Person is directly admitted to the Hospital as Inpatient for further Treatment of that Illness;

(2) Charges incurred for Surgery at an Outpatient Surgical facility, including services and supplies; and

(3) Charges by a Physician for professional services rendered, including Surgery; provided, however, that charges by or for an assistant surgeon will be limited and covered at the rate of twenty percent (20%) of the Usual, Reasonable and Customary charge of the primary surgeon; and provided, further, that standby availability of a Physician or surgeon will not be deemed to be a professional service and is not eligible for coverage; and

(4) Charges incurred for:

(a) dressings, sutures, casts or other supplies that are Medically Necessary; and

(b) diagnostic testing using radiology, ultrasonographic or laboratory services (psychometric, behavioral and educational testing are not included); and

c) Implant devices that are Medically Necessary; however any Implants provided by a non-PPO provider are limited to payment of no more than 150% of the established invoice price and/or list price for that item.; and

(d) subject to the Terms of Sections T(10)(b), © and (d), basic functional artificial limbs, eye or larynx or breast prostheses, but not the replacement or repair thereof; and

(e) hemodialysis and the Charges by a Hospital for processing and administration of blood or blood components, but not the cost of the actual blood or blood components; and

(f) oxygen and other gasses and their administration; and

(g) anesthetics and their administration by a Physician; and

(h) drugs which require prescription by a Physician for Treatment of Illness or Injury, but not for the replacement of lost, stolen, damaged, expired or otherwise compromised drugs, and for a maximum supply of ninety (90) days of any one prescription; and

(i) care in a licensed Extended Care Facility upon direct transfer from an acute care Hospital; and

(j) Home Nursing Care in bed by a qualified licensed professional, provided by a Home Health Care Agency upon direct transfer from an acute care Hospital; and

(k) Emergency Local Ambulance Transport necessarily incurred in connection with Injury; and

(l) Emergency Local Ambulance Transport necessarily incurred in connection with an Illness resulting in Hospitalization; and

(m) Accident-related Dental Treatment and Dental Surgery, as necessary to restore or replace sound natural teeth lost or damaged in an Accident leading to an Injury that is covered under this insurance; and

(n) physical therapy prescribed by a Physician and performed by a professional physical therapist, and necessarily incurred to continue recovery from a covered Injury or covered Illness; and

(o) Medically Necessary rental of Durable Medical Equipment, up to the purchase price.

(5) Subject to the Terms of Section T, Exclusions, subsection 1 (e) “War; Military Action” and Section T, subsection 2. “Terrorism”, below, and subject also to the Deductible, Coinsurance and limits and sublimits set forth in Section C of the Certificate “Schedule of Benefits/Limits,” the Company will pay and/or reimburse the Insured Person up to $50,000 for the Eligible Medical Expenses described in Sections G. 1-4, a-o of the Certificate arising out of Injury or Illness incurred by the Insured Person as a result of or in connection with an act of Terrorism while this insurance is in effect.

32

Patriot America Plus
IMG

Emergency Medical Benefits

$50,000 per person
Secondary coverage

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Full Policy Wording

ELIGIBLE MEDICAL EXPENSES:

Subject to the Terms of this insurance, and the insurance plan shown in the Declaration, the Company will reimburse the Insured Person up to the amount shown in the BENEFIT SUMMARY for the following costs, Charges and expenses incurred by the Insured Person during the Period of Coverage with respect to an Illness or Injury suffered or sustained by the Insured Person during the Period of Coverage and while this Certificate is in effect, so long as the Illness or Injury is covered under this Certificate, Charges are Usual, Reasonable and Customary and are incurred for Treatment or supplies that are Medically Necessary (“Eligible Medical Expenses”):

(1) Charges incurred at a Hospital for:

a) daily room and board, nursing services, and Ancillary Services not to exceed the average semi-private room rate. A private room will be considered when no semi-private room is available or if medical necessity warrants this type of room. The private room rate is not to exceed the average private room rate.

b) daily room and board, nursing services, and Ancillary Services in an Intensive Care Unit

c) use of operating, Treatment or recovery room

d) services and supplies which are routinely provided by the Hospital to persons for use while an Inpatient

e) Emergency Treatment of an Injury, even if Hospital confinement is not required

f) Emergency Treatment of an Illness; however, an additional Deductible (as shown in the BENEFIT SUMMARY) will be required unless the Insured Person is directly admitted to the Hospital as Inpatient for further Treatment of that Illness

(2) Charges incurred for Surgery at an Outpatient Surgical Facility, including services and supplies

(3) Charges by a Physician for professional services rendered, including Surgery; provided, however, that Charges by or for an assistant surgeon will be limited and covered at the rate of up to twenty percent (20%) of the Usual, Reasonable and Customary charge of the primary surgeon; and provided, further, that the standby availability of a Physician or surgeon will not be deemed to be a professional service and is not eligible for coverage

(4) Charges incurred for:

a) dressings, sutures, casts or other supplies which are Medically Necessary

b) diagnostic testing using Radiology, ultrasonography or laboratory services. Laboratory services billed for professional component fees are covered if the pathologist has direct involvement in providing a written report or verbal consultation for specimen-specific pathology services

c) Implant devices that are Medically Necessary; however, any Implants provided outside the PPO network are limited to a payment of no more than one hundred fifty percent (150%) of the established invoice price and/or list price for that item

d) basic functional artificial limbs, eye or larynx or breast prostheses, but not the replacement or repair thereof

e) reconstructive Surgery when the Surgery is incidental to and follows Surgery which was covered hereunder

f) radiation therapy or Treatment, and chemotherapy

g) hemodialysis for the Treatment of acute renal failure only and the Charges by a Hospital for processing and administration of blood or blood components

h) oxygen and other gases and their administration

i) anesthetics and their administration by a Physician

j) drugs which require prescription by a Physician for Treatment of Illness or Injury, but not for the replacement of lost, stolen, damaged, expired or otherwise compromised drugs, and for a maximum supply of ninety (90) days of any one

(1) prescription

k) care in a licensed Extended Care Facility upon direct transfer from an acute care Hospital

l) Home Nursing Care in bed by a qualified licensed professional, provided by a Home Health Care Agency upon direct transfer from an acute care Hospital

m) Emergency Local Ambulance Transport necessarily incurred in connection with:

(i) an Injury

(ii) an Illness resulting in Hospital confinement as an Inpatient.

n) Interfacility Ambulance Transfer must be a result of an Inpatient Hospital Admission, Medically Necessary and from one licensed health care Facility to another licensed health care Facility via air or land ambulance

o) chiropractic services prescribed by a Physician and performed by a professional chiropractor, and necessarily incurred to continue recovery from a covered Injury or covered Illness; services include manipulations, x-rays and laboratory tests ordered by the chiropractor

p) physical therapy prescribed by a Physician and performed by a professional physical therapist, and necessarily incurred to continue recovery from a covered Injury or covered Illness

q) Durable Medical Equipment, as defined herein, deemed to be Medically Necessary

(5) Charges incurred for Treatment at an Urgent Care Center

(6) Charges incurred for Treatment at a Walk-in Clinic

(7) Charges for Treatment of an Injury to the foot due to an Accident covered hereunder

(8) Charges for Treatment of an Illness for which foot Surgery is Medically Necessary and determined to be the only appropriate method of Treatment

(9) Charges for Dental Treatment as follows up to the amount shown in the BENEFIT SUMMARY:

a) Charges for Treatment following Traumatic Dental Injury from a covered Accident that resulted in physical Injury to the Insured Person

b) Charges for necessary Dental Treatment of Unexpected pain to sound natural teeth

c) Charges incurred for non-emergency Dental Treatment necessary due to an Accident covered hereunder

(10) Charges for value-added tax (VAT) or like tax incurred on Eligible Medical Expenses

iTravelInsured
iTravelInsured

33

Travel Lite
iTravelInsured

Emergency Medical Benefits

$100,000 per person
Secondary coverage

Start a New Search

Full Policy Wording

Accident & Sickness Medical Expense

Benefits will be paid for the Covered Expense incurred, up to the Maximum Benefit Amount shown in the Schedule of Benefits, as a result of a Covered Accidental Injury or covered Sickness, which first occurs during Your Trip (of a duration of ninety (90) days or less for Sickness). Only Covered Expenses incurred during Your Trip (of duration of ninety (90) days or less for Sickness) will be reimbursed. Expenses incurred after Your Trip are not covered.

Benefits will include one thousand dollars ($1,000) for expenses incurred during Your Trip for emergency dental treatment. Only expenses for emergency dental treatment to natural teeth incurred during Your Trip will be reimbursed. Expenses incurred after Your Trip are not covered.

Benefits will not be paid in excess of the Usual and Customary Charges.

Advance payment will be made to a Hospital, up to the Maximum Benefit Amount, if needed to secure Your admission to a Hospital, because of a Covered Accidental Injury or covered Sickness. The Program Medical Advisor will coordinate advance payment to the Hospital.

For the purpose of this benefit:

“Covered Expense” means expense incurred only for the following:

1. The medical services, prescription drugs, therapeutic services and supplies ordered or prescribed by a Legally Qualified Physician as Medically Necessary for treatment;

2. Hospital or ambulatory medical-surgical center services (including expenses for a cruise ship cabin or hotel room, not already included in the cost of the Your Trip, if recommended as a substitute for a Hospital room for recovery from a Covered Accidental Injury or covered Sickness);

3. Transportation furnished by a professional ambulance company to and/or from a Hospital.

These benefits will not duplicate any benefits payable under the Policy or any coverage(s) attached to the Policy.

34

Travel SE
iTravelInsured

Emergency Medical Benefits

$150,000 per person
Primary coverage

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Full Policy Wording

Accident & Sickness Medical Expense

Benefits will be paid for the Covered Expense incurred, up to the Maximum Benefit Amount shown in the Schedule of Benefits, as a result of a Covered Accidental Injury or covered Sickness, which first occurs during Your Trip (of a duration of ninety (90) days or less for Sickness). Only Covered Expenses incurred during Your Trip (of duration of ninety (90) days or less for Sickness) will be reimbursed. Expenses incurred after Your Trip are not covered.

Benefits will include one thousand dollars ($1,000) for expenses incurred during Your Trip for emergency dental treatment. Only expenses for emergency dental treatment to natural teeth incurred during Your Trip will be reimbursed. Expenses incurred after Your Trip are not covered.

Benefits will not be paid in excess of the Usual and Customary Charges.

Advance payment will be made to a Hospital, up to the Maximum Benefit Amount, if needed to secure Your admission to a Hospital, because of a Covered Accidental Injury or covered Sickness. The Program Medical Advisor will coordinate advance payment to the Hospital.

For the purpose of this benefit:

“Covered Expense” means expense incurred only for the following:

1. The medical services, prescription drugs, therapeutic services and supplies ordered or prescribed by a Legally Qualified Physician as Medically Necessary for treatment;

2. Hospital or ambulatory medical-surgical center services (including expenses for a cruise ship cabin or hotel room, not already included in the cost of the Your Trip, if recommended as a substitute for a Hospital room for recovery from a Covered Accidental Injury or covered Sickness);

3. Transportation furnished by a professional ambulance company to and/or from a Hospital.

These benefits will not duplicate any benefits payable under the Policy or any coverage(s) attached to the Policy.

35

Travel LX
iTravelInsured

Emergency Medical Benefits

$500,000 per person
Primary coverage

Start a New Search

Full Policy Wording

Accident & Sickness Medical Expense

Benefits will be paid for the Covered Expense incurred, up to the Maximum Benefit Amount shown in the Schedule of Benefits, as a result of a Covered Accidental Injury or covered Sickness, which first occurs during Your Trip (of a duration of ninety (90) days or less for Sickness). Only Covered Expenses incurred during Your Trip (of duration of ninety (90) days or less for Sickness) will be reimbursed. Expenses incurred after Your Trip are not covered.

Benefits will include one thousand dollars ($1,000) for expenses incurred during Your Trip for emergency dental treatment. Only expenses for emergency dental treatment to natural teeth incurred during Your Trip will be reimbursed. Expenses incurred after Your Trip are not covered.

Benefits will not be paid in excess of the Usual and Customary Charges.

Advance payment will be made to a Hospital, up to the Maximum Benefit Amount, if needed to secure Your admission to a Hospital, because of a Covered Accidental Injury or covered Sickness. The Program Medical Advisor will coordinate advance payment to the Hospital.

For the purpose of this benefit:

“Covered Expense” means expense incurred only for the following:

1. The medical services, prescription drugs, therapeutic services and supplies ordered or prescribed by a Legally Qualified Physician as Medically Necessary for treatment;

2. Hospital or ambulatory medical-surgical center services (including expenses for a cruise ship cabin or hotel room, not already included in the cost of the Your Trip, if recommended as a substitute for a Hospital room for recovery from a Covered Accidental Injury or covered Sickness);

3. Transportation furnished by a professional ambulance company to and/or from a Hospital.

These benefits will not duplicate any benefits payable under the Policy or any coverage(s) attached to the Policy.

John Hancock Insurance Agency, Inc.
John Hancock Insurance Agency, Inc.

36

Bronze
John Hancock Insurance Agency, Inc.

Emergency Medical Benefits

$50,000 per person
Primary coverage

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Full Policy Wording

EMERGENCY ACCIDENT AND EMERGENCY SICKNESS MEDICAL EXPENSE

We will pay Reasonable and Customary Charges up to the maximum limit shown on the Schedule of Benefits, subject to the Deductible, if You incur necessary Covered Expenses while on your Covered Trip and as a result of an Accidental Injury or Emergency Sickness that first manifests itself during the Covered Trip.

Covered Expenses for this benefit include but are not limited to:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms;

c) Hospital or ambulatory medical-surgical center services (this may also include expenses for a cruise ship cabin or Hotel room, not already included in the cost of Your Covered Trip, if recommended as a substitute for a Hospital room for recovery from an Emergency Sickness);

d) charges for anesthetics (including administration);

e) x-ray examinations or treatments, and laboratory tests;

f) ambulance service;

g) drugs, medicines, prosthetics and therapeutic services and supplies; and

h) emergency dental treatment for the relief of pain.

We will pay benefits, up to the amount shown on the Schedule of Benefits, for emergency dental treatment for Accidental Injury to natural teeth.

We will not pay benefits in excess of the Reasonable and Customary Charges.

We will not cover any expenses incurred by another party at no cost to You or already included within the cost of the Covered Trip.

We will advance payment to a Hospital, up to the maximum shown on the Schedule of Benefits, if needed to secure Your admission to a Hospital during the Covered Trip because of Accidental Injury or Emergency Sickness.

37

Silver
John Hancock Insurance Agency, Inc.

Emergency Medical Benefits

$100,000 per person
Primary coverage

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Full Policy Wording

EMERGENCY ACCIDENT AND EMERGENCY SICKNESS MEDICAL EXPENSE

We will pay Reasonable and Customary Charges up to the maximum limit shown on the Schedule of Benefits, subject to the Deductible, if You incur necessary Covered Expenses while on your Covered Trip and as a result of an Accidental Injury or Emergency Sickness that first manifests itself during the Covered Trip.

Covered Expenses for this benefit include but are not limited to:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms;

c) Hospital or ambulatory medical-surgical center services (this may also include expenses for a cruise ship cabin or Hotel room, not already included in the cost of Your Covered Trip, if recommended as a substitute for a Hospital room for recovery from an Emergency Sickness);

d) charges for anesthetics (including administration);

e) x-ray examinations or treatments, and laboratory tests;

f) ambulance service;

g) drugs, medicines, prosthetics and therapeutic services and supplies; and

h) emergency dental treatment for the relief of pain.

We will pay benefits, up to the amount shown on the Schedule of Benefits, for emergency dental treatment for Accidental Injury to natural teeth.

We will not pay benefits in excess of the Reasonable and Customary Charges.

We will not cover any expenses incurred by another party at no cost to You or already included within the cost of the Covered Trip.

We will advance payment to a Hospital, up to the maximum shown on the Schedule of Benefits, if needed to secure Your admission to a Hospital during the Covered Trip because of Accidental Injury or Emergency Sickness.

38

Gold
John Hancock Insurance Agency, Inc.

Emergency Medical Benefits

$250,000 per person
Primary coverage

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Full Policy Wording

EMERGENCY ACCIDENT AND EMERGENCY SICKNESS MEDICAL EXPENSE

We will pay Reasonable and Customary Charges up to the maximum limit shown on the Schedule of Benefits, subject to the Deductible, if You incur necessary Covered Expenses while on your Covered Trip and as a result of an Accidental Injury or Emergency Sickness that first manifests itself during the Covered Trip.

Covered Expenses for this benefit include but are not limited to:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms;

c) Hospital or ambulatory medical-surgical center services (this may also include expenses for a cruise ship cabin or Hotel room, not already included in the cost of Your Covered Trip, if recommended as a substitute for a Hospital room for recovery from an Emergency Sickness);

d) charges for anesthetics (including administration);

e) x-ray examinations or treatments, and laboratory tests;

f) ambulance service;

g) drugs, medicines, prosthetics and therapeutic services and supplies; and

h) emergency dental treatment for the relief of pain.

We will pay benefits, up to the amount shown on the Schedule of Benefits, for emergency dental treatment for Accidental Injury to natural teeth.

We will not pay benefits in excess of the Reasonable and Customary Charges.

We will not cover any expenses incurred by another party at no cost to You or already included within the cost of the Covered Trip.

We will advance payment to a Hospital, up to the maximum shown on the Schedule of Benefits, if needed to secure Your admission to a Hospital during the Covered Trip because of Accidental Injury or Emergency Sickness.

MedjetAssist
MedjetAssist

39

Annual Membership
MedjetAssist

Emergency Medical Benefits

No coverage

Start a New Search

Full Policy Wording

There is no Emergency Medical coverage with this plan.

40

MedjetAssist Extended Stay
MedjetAssist

Emergency Medical Benefits

No coverage

Start a New Search

Full Policy Wording

There is no Emergency Medical coverage with this plan.

41

MedjetAssist Short Term Plan
MedjetAssist

Emergency Medical Benefits

No coverage

Start a New Search

Full Policy Wording

There is no Emergency Medical coverage with this plan.

Nationwide Mutual Insurance Company
Nationwide Mutual Insurance Company

42

Essential
Nationwide Mutual Insurance Company

Emergency Medical Benefits

$75,000 per person accident
$75,000 per person sickness
Secondary coverage

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Full Policy Wording

EMERGENCY SICKNESS MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Confirmation of Coverage, if You incur Covered Medical Expenses as a result of Emergency Treatment of a Sickness that first manifests itself during the Trip.

Emergency Treatment means necessary medical treatment that must be performed during the Trip due to the serious and acute nature of the Sickness.

Covered Medical Expenses are expenses incurred for necessary services and supplies: (a) listed below; and (b) ordered or prescribed by the attending Physician as Medically Necessary for treatment, that are limited to:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms; Hospital or ambulatory medical-surgical center services (this will also include expenses for a Cruise ship cabin or hotel room, not already included in the cost of Your Trip, if recommended as a substitute for a Hospital room for recovery from a Sickness);

c) charge for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;

d) ambulance service; and

e) drugs, medicines and therapeutic services.

The Company will not pay benefits in excess of the Reasonable and Customary Charges. The Company will not cover any expenses provided by another party at no cost to You or already included within the cost of the Trip.

If You are Hospitalized due to a Sickness that first occurred during the course of the Trip beyond the Scheduled Return Date, coverage under this benefit will be extended until You are released from the Hospital or until Maximum Benefits under this Certificate have been paid.

EMERGENCY ACCIDENT MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Confirmation of Coverage, if You incur Covered Medical Expenses for Emergency Treatment of an Accidental Injury that occurs during the Trip.

Emergency Treatment means necessary medical treatment that must be performed during the Trip due to the serious and acute nature of the Accidental Injury.

Covered Medical Expenses are expenses incurred for necessary services and supplies: (a) listed below; and (b) ordered or prescribed by the attending Physician as Medically Necessary for treatment, that are limited to:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms; Hospital or ambulatory medical-surgical center services (this will also include expenses for a Cruise ship cabin or hotel room, not already included in the cost of Your Trip, if recommended as a substitute for a Hospital room for recovery from an Accidental Injury);

c) charges for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;

d) ambulance service;

e) drugs, medicines and therapeutic services.

The Company will not pay benefits in excess of the Reasonable and Customary Charges. The Company will not cover any expenses provided by another party at no cost to You or already included within the cost of the Trip.

The Company will pay benefits up to the Maximum Benefit shown on the Confirmation of Coverage for dental Emergency Treatment for Accidental Injury to Sound Natural Teeth. Both the Accidental Injury and the dental Emergency Treatment must occur during the Trip.

If You are Hospitalized due to an Accidental Injury that first occurred during the course of the Trip beyond the Scheduled Return Date, coverage under this benefit will be extended until You are released from the Hospital or until Maximum Benefits under this Certificate have been paid.

43

Prime
Nationwide Mutual Insurance Company

Emergency Medical Benefits

$150,000 per person accident
$150,000 per person sickness
Secondary coverage

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Full Policy Wording

EMERGENCY ACCIDENT MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Confirmation of Coverage, if You incur Covered Medical Expenses for Emergency Treatment of an Accidental Injury that occurs during the Trip.

Emergency Treatment means necessary medical treatment that must be performed during the Trip due to the serious and acute nature of the Accidental Injury.
Covered Medical Expenses are expenses incurred for necessary services and supplies: (a) listed below; and (b) ordered or prescribed by the attending Physician as Medically Necessary for treatment, that are limited to:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms; Hospital or ambulatory medical-surgical center services (this will also include expenses for a Cruise ship cabin or hotel room, not already included in the cost of Your Trip, if recommended as a substitute for a Hospital room for recovery from an Accidental Injury);

c) charges for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;

d) ambulance service; and

e) drugs, medicines and therapeutic services.

The Company will not pay benefits in excess of the Reasonable and Customary Charges. The Company will not cover any expenses provided by another party at no cost to You or already included within the cost of the Trip.

The Company will pay benefits up to the Maximum Benefit shown on the Confirmation of Coverage for dental Emergency Treatment for Accidental Injury to Sound Natural Teeth. Both the Accidental Injury and the dental Emergency Treatment must occur during the Trip.

If You are Hospitalized due to an Accidental Injury that first occurred during the course of the Trip beyond the Scheduled Return Date, coverage under this benefit will be extended until You are released from the Hospital or until Maximum Benefits under this Certificate have been paid.

EMERGENCY SICKNESS MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Confirmation of Coverage, if You incur Covered Medical Expenses as a result of Emergency Treatment of a Sickness that first manifests itself during the Trip.

Emergency Treatment means necessary medical treatment that must be performed during the Trip due to the serious and acute nature of the Sickness.

Covered Medical Expenses are expenses incurred for necessary services and supplies: (a) listed below; and (b) ordered or prescribed by the attending Physician as Medically Necessary for treatment, that are limited to:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms; Hospital or ambulatory medical-surgical center services (this will also include expenses for a Cruise ship cabin or hotel room, not already included in the cost of Your Trip, if recommended as a substitute for a Hospital room for recovery from a Sickness);

c) charge for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;

d) ambulance service; and

e) drugs, medicines and therapeutic services.

The Company will not pay benefits in excess of the Reasonable and Customary Charges. The Company will not cover any expenses provided by another party at no cost to You or already included within the cost of the Trip.

If You are Hospitalized due to a Sickness that first occurred during the course of the Trip beyond the Scheduled Return Date, coverage under this benefit will be extended until You are released from the Hospital or until Maximum Benefits under this Certificate have been paid.

Seven Corners Inc
Seven Corners Inc

44

RoundTrip Choice
Seven Corners Inc

Emergency Medical Benefits

$100,000 per person
Secondary coverage

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Full Policy Wording

ACCIDENT & SICKNESS MEDICAL EXPENSE

Benefits will be paid for the Covered Expense incurred, up to the Maximum Benefit Amount shown in the Schedule of Benefits, as a result of a Covered Accidental Injury or covered Sickness, which first occurs during Your Trip (of a duration of 90 days or less for Sickness). Only Covered Expenses incurred during Your Trip (of duration of 90 days or less for Sickness) will be reimbursed. Expenses incurred after Your Trip are not covered.

Benefits will include up to $750 expenses for emergency dental treatment due to Injury to natural teeth. Benefits will not be paid in excess of the Usual and Customary Charges.

Advance payment will be made to a Hospital, up to the Maximum Benefit Amount, if needed to secure Your admission to a Hospital, because of a Covered Accidental Injury or covered Sickness. The authorized travel assistance company will coordinate advance payment to the Hospital. For the purpose of this benefit:

“Covered Expense” means expense incurred only for the following:

1. The medical services, prescription drugs, prosthetics, and therapeutic services and supplies ordered or prescribed by a Legally Qualified Physician as Medically Necessary for treatment;

2. Hospital or ambulatory medical-surgical center services (including expenses for a cruise ship cabin or hotel room, not already included in the cost of the Your Trip, if recommended as a substitute for a hospital room for recovery from a Covered Accidental Injury or covered Sickness);

3. Transportation furnished by a professional ambulance company to and/or from a Hospital.

These benefits will not duplicate any benefits payable under the Policy or any coverage(s) attached to the Policy.

45

RoundTrip Economy
Seven Corners Inc

Emergency Medical Benefits

$10,000 per person
Secondary coverage

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Full Policy Wording

ACCIDENT & SICKNESS MEDICAL EXPENSE

Benefits will be paid for the Covered Expense incurred, up to the Maximum Benefit Amount shown in the Schedule of Benefits, as a result of a Covered Accidental Injury or covered Sickness, which first occurs during Your Trip (of a duration of 90 days or less for Sickness). Only Covered Expenses incurred during Your Trip (of duration of 90 days or less for Sickness) will be reimbursed. Expenses incurred after Your Trip are not covered.

Benefits will include up to $750 for expenses for emergency dental treatment due to Injury to natural teeth.

Benefits will not be paid in excess of the Usual and Customary Charges.

Advance payment will be made to a Hospital, up to the Maximum Benefit Amount, if needed to secure Your admission to a Hospital, because of a Covered Accidental Injury or covered Sickness. The authorized travel assistance company will coordinate advance payment to the Hospital.

For the purpose of this benefit:

“Covered Expense” means expense incurred only for the following:

1. The medical services, prescription drugs, prosthetics, and therapeutic services and supplies ordered or prescribed by a Legally Qualified Physician as Medically Necessary for treatment;

2. Hospital or ambulatory medical-surgical center services (including expenses for a cruise ship cabin or hotel room, not already included in the cost of the Your Trip, if recommended as a substitute for a hospital room for recovery from a Covered Accidental Injury or covered Sickness);

3. Transportation furnished by a professional ambulance company to and/or from a Hospital.

These benefits will not duplicate any benefits payable under the Policy or any coverage(s) attached to the Policy.

46

RoundTrip Elite
Seven Corners Inc

Emergency Medical Benefits

$250,000 per person
Secondary coverage

Start a New Search

Full Policy Wording

ACCIDENT & SICKNESS MEDICAL EXPENSE

Benefits will be paid for the Covered Expense incurred, up to the Maximum Benefit Amount shown in the Schedule of Benefits, as a result of a Covered Accidental Injury or covered Sickness, which first occurs during Your Trip (of a duration of 90 days or less for Sickness). Only Covered Expenses incurred during Your Trip (of duration of 90 days or less for Sickness) will be reimbursed. Expenses incurred after Your Trip are not covered.

Benefits will include up to $750 expenses for emergency dental treatment due to Injury to natural teeth.

Benefits will not be paid in excess of the Usual and Customary Charges.

Advance payment will be made to a Hospital, up to the Maximum Benefit Amount, if needed to secure Your admission to a Hospital, because of a Covered Accidental Injury or covered Sickness. The authorized travel assistance company will coordinate advance payment to the Hospital.

For the purpose of this benefit:

“Covered Expense” means expense incurred only for the following:

1. The medical services, prescription drugs, prosthetics, and therapeutic services and supplies ordered or prescribed by a Legally Qualified Physician as Medically Necessary for treatment;

2. Hospital or ambulatory medical-surgical center services (including expenses for a cruise ship cabin or hotel room, not already included in the cost of the Your Trip, if recommended as a substitute for a hospital room for recovery from a Covered Accidental Injury or covered Sickness);

3. Transportation furnished by a professional ambulance company to and/or from a Hospital.

These benefits will not duplicate any benefits payable under the Policy or any coverage(s) attached to the Policy.

47

Liaison Travel Economy excl US
Seven Corners Inc

Emergency Medical Benefits

$50,000 per person
Secondary coverage

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Full Policy Wording

Medical Covered Expenses

Subject to the terms of the Certificate, the Company will reimburse You for Covered Expenses up to the Medical Maximum shown in the Schedule of Benefits for the following medical Expenses that are incurred as the result of and within the Benefit Period:

a) Hospital Expenses for room and board that do not exceed the Hospital’s average charge for semi‐ private accommodations, Inpatient Treatment, Surgery, operating room, Intensive Care, nursing services, and services and supplies routinely provided by the Hospital to Inpatients;

b) Outpatient Treatment or Surgery;

c) Administration of anesthetics;

d) Medication, x‐ray services, laboratory tests and services, use of radium and radioactive isotopes, oxygen, blood transfusions, and iron lungs;

e) Dressings, drugs, and medicines that can only be obtained upon a written prescription of a Physician or Surgeon;

f) Physical therapy if recommended by a Physician for the Treatment of a specific Disablement and if administered by a licensed physical therapist;

g) Hotel room when the Insured Person, otherwise necessarily confined in a Hospital, is under the care of a duly‐qualified Physician in a hotel room due to unavailability of a Hospital room due to capacity or distance or to any other circumstances beyond the reasonable control of the Insured Person;

h) Artificial limbs, eyes, larynx, and orthotic appliances other than for replacement of such items;

i) Home Health Care up to the amount set forth in the Schedule of Benefits per Period of Coverage; and

j) Care in a licensed Extended Care Facility upon direct transfer from an acute care Hospital.

The exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this Section 3.2.

48

Liaison Travel Choice excl US
Seven Corners Inc

Emergency Medical Benefits

$50,000 per person
Secondary coverage

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Full Policy Wording

Medical Covered Expenses

Subject to the terms of the Certificate, the Company will reimburse You for Covered Expenses up to the Medical Maximum shown in the Schedule of Benefits for the following medical Expenses that are incurred as the result of and within the Benefit Period:

a) Hospital Expenses for room and board that do not exceed the Hospital’s average charge for semiprivate accommodations, Inpatient Treatment, Surgery, operating room, Intensive Care, nursing services, and services and supplies routinely provided by the Hospital to Inpatients;

b) Outpatient Treatment or Surgery;

c) Administration of anesthetics;

d) Medication, x-ray services, laboratory tests and services, use of radium and radioactive isotopes, oxygen, blood transfusions, and iron lungs;

e) Dressings, drugs, and medicines that can only be obtained upon a written prescription of a Physician or Surgeon;

f) Physical therapy if recommended by a Physician for the Treatment of a specific Disablement and if administered by a licensed physical therapist;

g) Hotel room when the Insured Person, otherwise necessarily confined in a Hospital, is under the care of a duly-qualified Physician in a hotel room due to unavailability of a Hospital room due to capacity or distance or to any other circumstances beyond the reasonable control of the Insured Person;

h) Artificial limbs, eyes, larynx, and orthotic appliances other than for replacement of such items;

i) Home Health Care up to the amount set forth in the Schedule of Benefits per Period of Coverage; and

j) Care in a licensed Extended Care Facility upon direct transfer from an acute care Hospital.

The exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this Section 3.2.

49

Liaison Travel Elite excl US
Seven Corners Inc

Emergency Medical Benefits

$50,000 per person
Secondary coverage

Start a New Search

Full Policy Wording

Medical Covered Expenses

Subject to the terms of the Certificate, the Company will reimburse You for Covered Expenses up to the Medical Maximum shown in the Schedule of Benefits for the following medical Expenses that are incurred as the result of and within the Benefit Period:

a) Hospital Expenses for room and board that do not exceed the Hospital’s average charge for semi-private accommodations, Inpatient Treatment, Surgery, operating room, Intensive Care, nursing services, and services and supplies routinely provided by the Hospital to Inpatients;

b) Outpatient Treatment or Surgery;

c) Administration of anesthetics;

d) Medication, x-ray services, laboratory tests and services, use of radium and radioactive isotopes, oxygen, blood transfusions, and iron lungs;

e) Dressings, drugs, and medicines that can only be obtained upon a written prescription of a Physician or Surgeon;

f) Physical therapy if recommended by a Physician for the Treatment of a specific Disablement and if administered by a licensed physical therapist;

g) Hotel room when the Insured Person, otherwise necessarily confined in a Hospital, is under the care of a duly-qualified Physician in a hotel room due to unavailability of a Hospital room due to capacity or distance or to any other circumstances beyond the reasonable control of the Insured Person;

h) Artificial limbs, eyes, larynx, and orthotic appliances other than for replacement of such items;

i) Home Health Care up to the amount set forth in the Schedule of Benefits per Period of Coverage; and

j) Care in a licensed Extended Care Facility upon direct transfer from an acute care Hospital.

The exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this Section 3.2.

Tin Leg
Tin Leg

50

Economy
Tin Leg

Emergency Medical Benefits

$20,000 per person
Secondary coverage

Start a New Search

Full Policy Wording

ACCIDENT SICKNESS MEDICAL EXPENSE BENEFIT

If, while on a Trip, You suffer an Injury or Sickness that requires You to be treated by a Physician, the Company will pay a benefit for Reasonable and Customary Charges, up to the Maximum Limit shown in the Schedule. The Company will reimburse You for Medically Necessary covered expenses incurred to treat such Injury or Sickness during the course of the Trip provided the initial documented treatment was received from a Physician during the Trip. The Injury must first occur or the Sickness must first begin while on an overnight Trip with a Destination of at least 100 miles from Your Primary Residence, while covered under this Policy.

Covered Expenses:

The Company will reimburse the Insured for:

- services of a Physician or registered nurse (R.N.);
- Hospital charges;
- X-rays;
- local ambulance services to or from a Hospital;
- artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices;
- the cost of emergency dental treatment only during a Trip limited to the Maximum Limit shown in the Schedule. Coverage for emergency dental treatment does not apply if treatment or expenses are incurred after the Insured has reached his/her Return Destination, regardless of the reason. The treatment must be given by a Physician or dentist.

Advance Payment: If You require admission to a Hospital, Tin Leg will arrange advance payment, if required. Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

51

Standard
Tin Leg

Emergency Medical Benefits

$30,000 per person
Secondary coverage

Start a New Search

Full Policy Wording

ACCIDENT SICKNESS MEDICAL EXPENSE BENEFIT

If, while on a Trip, You suffer an Injury or Sickness that requires You to be treated by a Physician, the Company will pay a benefit for reasonable and customary charges, up to the Maximum Limit shown in the Schedule. The Company will reimburse You for Medically Necessary covered expenses incurred to treat such Injury or Sickness during the course of the Trip provided the initial documented treatment was received from a Physician during the Trip. The Injury must first occur or the Sickness must first begin while on an overnight Trip with a Destination of at least 100 miles from Your Primary Residence, while covered under this Policy. Pre-existing medical conditions will be covered if the Preexisting Medical Condition Waiver is in effect.

Covered Expenses: The Company will reimburse the Insured for:

- services of a Physician or registered nurse (R.N.);
- Hospital charges;
- X-rays;
- local ambulance services to or from a Hospital;
- artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices;
- the cost of emergency dental treatment only during a Trip limited to the Maximum Limit shown in the Schedule. Coverage for emergency dental treatment does not apply if treatment or expenses are incurred after the Insured has reached his/her Return Destination, regardless of the reason. The treatment must be given by a Physician or dentist.

Advance Payment: If You require admission to a Hospital, Tin Leg will arrange advance payment, if required. Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

52

Luxury
Tin Leg

Emergency Medical Benefits

$100,000 per person
Primary coverage

Start a New Search

Full Policy Wording

MEDICAL EXPENSE BENEFIT

If, while on a Trip, You suffer an Injury or Sickness that requires You to be treated by a Physician, the Company will pay a benefit for Reasonable and Customary Charges, up to the Maximum Limit shown in the Schedule. The Company will reimburse You for Medically Necessary covered expenses incurred to treat such Injury or Sickness during the course of the Trip provided the initial documented treatment was received from a Physician during the Trip. The Injury must first occur or the Sickness must first begin while on an overnight Trip with a Destination of at least 100 miles from Your Primary Residence, while covered under this Policy. Pre-existing medical conditions will be covered if the Pre-existing Medical Condition Waiver is in effect.

Covered Expenses:

The Company will reimburse the Insured for:

● services of a Physician or registered nurse (R.N.);
● Hospital charges;
● X-rays;
● local ambulance services to or from a Hospital;
● artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices;
● the cost of emergency dental treatment only during a Trip limited to the Maximum Limit shown in the Schedule. Coverage for emergency dental treatment does not apply if treatment or expenses are incurred after the Insured has reached his/her Return Destination, regardless of the reason. The treatment must be given by a Physician or dentist.

Advance Payment: If You require admission to a Hospital, Tin Leg will arrange advance payment, if required. Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

Travel Insured International
Travel Insured International

53

Worldwide Trip Protector Lite
Travel Insured International

Emergency Medical Benefits

$10,000 per person
Secondary coverage

Start a New Search

Full Policy Wording

ACCIDENT & SICKNESS MEDICAL EXPENSE

Benefits will be paid for the Covered Expense incurred, up to the Maximum Benefit Amount shown in the Confirmation of Benefits as a result of a Covered Accidental Injury or covered Sickness, which first occurs during Your Trip (of a duration of 90 days or less for Sickness). Only Covered Expenses incurred during Your Trip (of duration of 90 days or less for Sickness) will be reimbursed. Expenses incurred after Your Trip are not covered.

Benefits will include up to $750 expenses for emergency dental treatment due to Injury to natural teeth.

Benefits will not be paid in excess of the Usual and Customary Charges.

Advance payment will be made to a Hospital, up to the Maximum Benefit Amount, if needed to secure Your admission to a Hospital, because of a Covered Accidental Injury or covered Sickness. The authorized travel assistance company will coordinate advance payment to the Hospital.

For the purpose of this benefit:

“Covered Expense” means expense incurred only for the following:

1. The medical services, prescription drugs, prosthetics, and therapeutic services and supplies ordered or prescribed by a Legally Qualified Physician as Medically Necessary for treatment;

2. Hospital or ambulatory medical-surgical center services (including expenses for a cruise ship cabin or hotel room, not already included in the cost of the Your Trip, if recommended as a substitute for a hospital room for recovery from a Covered Accidental Injury or covered Sickness);

3. Transportation furnished by a professional ambulance company to and/or from a Hospital.

These benefits will not duplicate any benefits payable under the Policy or any coverage(s) attached to the Policy.

54

Worldwide Trip Protector Plus
Travel Insured International

Emergency Medical Benefits

$100,000 per person
Primary coverage

Start a New Search

Full Policy Wording

ACCIDENT & SICKNESS MEDICAL EXPENSE

Benefits will be paid for the Covered Expense incurred, up to the Maximum Benefit Amount shown in the Confirmation of Benefits as a result of a Covered Accidental Injury or covered Sickness, which first occurs during Your Trip (of a duration of 90 days or less for Sickness). Only Covered Expenses incurred during Your Trip (of duration of 90 days or less for Sickness) will be reimbursed. Expenses incurred after Your Trip are not covered.

Benefits will include up to $750 expenses for emergency dental treatment due to Injury to natural teeth.

Benefits will not be paid in excess of the Usual and Customary Charges.

Advance payment will be made to a Hospital, up to the Maximum Benefit Amount, if needed to secure Your admission to a Hospital, because of a Covered Accidental Injury or covered Sickness. The authorized travel assistance company will coordinate advance payment to the Hospital.

For the purpose of this benefit:

“Covered Expense” means expense incurred only for the following:

1. The medical services, prescription drugs, prosthetics, and therapeutic services and supplies ordered or prescribed by a Legally Qualified Physician as Medically Necessary for treatment;

2. Hospital or ambulatory medical-surgical center services (including expenses for a cruise ship cabin or hotel room, not already included in the cost of the Your Trip, if recommended as a substitute for a hospital room for recovery from a Covered Accidental Injury or covered Sickness);

3. Transportation furnished by a professional ambulance company to and/or from a Hospital.

These benefits will not duplicate any benefits payable under the Policy or any coverage(s) attached to the Policy.

55

Worldwide Trip Protector
Travel Insured International

Emergency Medical Benefits

$100,000 per person
Secondary coverage

Start a New Search

Full Policy Wording

ACCIDENT & SICKNESS MEDICAL EXPENSE

Benefits will be paid for the Covered Expense incurred, up to the Maximum Benefit Amount shown in the Confirmation of Benefits as a result of a Covered Accidental Injury or covered Sickness, which first occurs during Your Trip (of a duration of 90 days or less for Sickness). Only Covered Expenses incurred during Your Trip (of duration of 90 days or less for Sickness) will be reimbursed. Expenses incurred after Your Trip are not covered.

Benefits will include up to $750 expenses for emergency dental treatment due to Injury to natural teeth.

Benefits will not be paid in excess of the Usual and Customary Charges.

Advance payment will be made to a Hospital, up to the Maximum Benefit Amount, if needed to secure Your admission to a Hospital, because of a Covered Accidental Injury or covered Sickness. The authorized travel assistance company will coordinate advance payment to the Hospital.

For the purpose of this benefit:

“Covered Expense” means expense incurred only for the following:

1. The medical services, prescription drugs, prosthetics, and therapeutic services and supplies ordered or prescribed by a Legally Qualified Physician as Medically Necessary for treatment;

2. Hospital or ambulatory medical-surgical center services (including expenses for a cruise ship cabin or hotel room, not already included in the cost of the Your Trip, if recommended as a substitute for a hospital room for recovery from a Covered Accidental Injury or covered Sickness);

3. Transportation furnished by a professional ambulance company to and/or from a Hospital.

These benefits will not duplicate any benefits payable under the Policy or any coverage(s) attached to the Policy.

Travelex Insurance Services
Travelex Insurance Services

56

Travel Basic
Travelex Insurance Services

Emergency Medical Benefits

$15,000 per person
Primary coverage

Start a New Search

Full Policy Wording

MEDICAL EXPENSE BENEFIT

If, while on a Trip, You suffer an Injury or Sickness that requires You to be treated by a Physician, the Company will pay a benefit for Reasonable and Customary Charges, up to the Maximum Limit shown in the Schedule. The Company will reimburse You for Medically Necessary covered expenses incurred to treat such Injury or Sickness during the course of the Trip provided the initial documented treatment was received from a Physician during the Trip. The Injury must first occur or the Sickness must first begin while on an overnight Trip with a Destination of at least 100 miles from Your Primary Residence, while covered under this Policy. Pre-existing medical conditions will be covered if the Pre-existing Medical Condition Waiver is in effect.

Covered Expenses:

The Company will reimburse the Insured for:

● services of a Physician or registered nurse (R.N.);

● Hospital charges;

● X-rays;

● local ambulance services to or from a Hospital;

● artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices;

● the cost of emergency dental treatment only during a Trip limited to the Maximum Limit shown in the Schedule. Coverage for emergency dental treatment does not apply if treatment or expenses are incurred after the Insured has reached his/her Return Destination, regardless of the reason. The treatment must be given by a Physician or dentist.

Advance Payment: If You require admission to a Hospital, the Travel Insurance Administrator will arrange advance payment, if required. Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

57

Travel Select
Travelex Insurance Services

Emergency Medical Benefits

$50,000 per person
Primary coverage

Start a New Search

Full Policy Wording

MEDICAL EXPENSE BENEFIT

If, while on a Trip, You suffer an Injury or Sickness that requires You to be treated by a Physician, the Company will pay a benefit for Reasonable and Customary Charges, up to the Maximum Limit shown in the Schedule. The Company will reimburse You for Medically Necessary covered expenses incurred to treat such Injury or Sickness during the course of the Trip provided the initial documented treatment was received from a Physician during the Trip. The Injury must first occur or the Sickness must first begin while on an overnight Trip with a Destination of at least 100 miles from Your Primary Residence, while covered under this Policy. Pre-existing medical conditions will be covered if the Preexisting Medical Condition Waiver is in effect.

Covered Expenses:

The Company will reimburse the Insured for:
- services of a Physician or registered nurse (R.N.);
- Hospital charges;
- X-rays;
- local ambulance services to or from a Hospital;
- artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices;
- the cost of emergency dental treatment only during a Trip limited to the Maximum Limit shown in the Schedule. Coverage for emergency dental treatment does not apply if treatment or expenses are incurred after the Insured has reached his/her Return Destination, regardless of the reason. The treatment must be given by a Physician or dentist.

Advance Payment: If You require admission to a Hospital, the Travel Insurance Administrator will arrange advance payment, if required. Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

TravelSafe
TravelSafe

58

Basic
TravelSafe

Emergency Medical Benefits

$35,000 per person
Primary coverage

Start a New Search

Full Policy Wording

ACCIDENT & SICKNESS MEDICAL EXPENSE

Benefits will be paid for the Covered Expense incurred, up to the Maximum Benefit Amount shown in the Confirmation of Benefits, as a result of a covered Injury or covered Sickness, which first occurs during Your Trip. Only Covered Expenses incurred during Your Trip will be reimbursed. Expenses incurred after Your Trip are not covered.

Benefits will include up to $750 for expenses incurred during Your Trip for emergency dental treatment. Only expenses for emergency dental treatment to natural teeth incurred during Your Trip will be reimbursed. Expenses incurred after Your Trip are not covered.

Benefits will not be paid in excess of the Usual and Customary Charges.

Advance payment will be made to a Hospital, up to the Maximum Benefit Amount, if needed to secure Your admission to a Hospital, because of a covered Injury or covered Sickness. The Program Medical Advisor will coordinate advance payment to the Hospital.

For the purpose of this benefit:
“Covered Expense” means expense incurred only for the following:

1. The medical services, prescription drugs and therapeutic services ordered or prescribed by a Legally Qualified Physician as Medically Necessary for treatment;

2. Hospital or ambulatory medical-surgical center services (including expenses for a cruise ship cabin or hotel room, not already included in the cost of the Your Trip, if recommended as a substitute for a hospital room for recovery from a covered Injury or covered Sickness);

3. Transportation furnished by a professional ambulance company to and/or from a Hospital.

These benefits will not duplicate any benefits payable under the Policy or any coverage(s) attached to the Policy.

59

Classic
TravelSafe

Emergency Medical Benefits

$100,000 per person
Primary coverage

Start a New Search

Full Policy Wording

ACCIDENT & SICKNESS MEDICAL EXPENSE

Benefits will be paid for the Covered Expense incurred, up to the Maximum Benefit Amount shown in the Confirmation of Benefits, as a result of a covered Injury or covered Sickness, which first occurs during Your Trip. Only Covered Expenses incurred during Your Trip will be reimbursed. Expenses incurred after Your Trip are not covered.

Benefits will include up to $750 for expenses incurred during Your Trip for emergency dental treatment. Only expenses for emergency dental treatment to natural teeth incurred during Your Trip will be reimbursed. Expenses incurred after Your Trip are not covered.

Benefits will not be paid in excess of the Usual and Customary Charges.

Advance payment will be made to a Hospital, up to the Maximum Benefit Amount, if needed to secure Your admission to a Hospital, because of a covered Injury or covered Sickness. The Program Medical Advisor will coordinate advance payment to the Hospital.

For the purpose of this benefit:

“Covered Expense” means expense incurred only for the following:

1. The medical services, prescription drugs and therapeutic services ordered or prescribed by a Legally Qualified Physician as Medically Necessary for treatment;

2. Hospital or ambulatory medical-surgical center services (including expenses for a cruise ship cabin or hotel room, not already included in the cost of the Your Trip, if recommended as a substitute for a hospital room for recovery from a covered Injury or covered Sickness);

3. Transportation furnished by a professional ambulance company to and/or from a Hospital.

These benefits will not duplicate any benefits payable under the Policy or any coverage(s) attached to the Policy.

60

Classic Plus
TravelSafe

Emergency Medical Benefits

$100,000 per person
Primary coverage

Start a New Search

Full Policy Wording

ACCIDENT & SICKNESS MEDICAL EXPENSE

Benefits will be paid for the Covered Expense incurred, up to the Maximum Benefit Amount shown in the Confirmation of Benefits, as a result of a covered Injury or covered Sickness, which first occurs during Your Trip. Only Covered Expenses incurred during Your Trip will be reimbursed. Expenses incurred after Your Trip are not covered.

Benefits will include up to $750 for expenses incurred during Your Trip for emergency dental treatment. Only expenses for emergency dental treatment to natural teeth incurred during Your Trip will be reimbursed. Expenses incurred after Your Trip are not covered.

Benefits will not be paid in excess of the Usual and Customary Charges.

Advance payment will be made to a Hospital, up to the Maximum Benefit Amount, if needed to secure Your admission to a Hospital, because of a covered Injury or covered Sickness. The Program Medical Advisor will coordinate advance payment to the Hospital.

For the purpose of this benefit:
“Covered Expense” means expense incurred only for the following:

1. The medical services, prescription drugs and therapeutic services ordered or prescribed by a Legally Qualified Physician as Medically Necessary for treatment;

2. Hospital or ambulatory medical-surgical center services (including expenses for a cruise ship cabin or hotel room, not already included in the cost of the Your Trip, if recommended as a substitute for a hospital room for recovery from a covered Injury or covered Sickness);

3. Transportation furnished by a professional ambulance company to and/or from a Hospital.

These benefits will not duplicate any benefits payable under the Policy or any coverage(s) attached to the Policy.

Trawick International
Trawick International

61

Safe Travels USA
Trawick International

Emergency Medical Benefits

$50,000 per person
Primary coverage

Start a New Search

Full Policy Wording

Covered Medical Expenses Benefit

If a covered Injury or Illness occurs during the Policy Period and you require medical or surgical treatment; this plan will pay, subject to the selected deductible, applicable co-insurance and benefit maximums, the following Covered Expenses, up to the selected policy maximum. The first charges must be incurred within 90 days after the date of the Covered Accident or Sickness. No benefits will be paid for any expenses incurred which are in excess of Usual and Customary Charges.

1. Hospital Room and Board Expenses: the average daily rate for a semi private room when a Covered Person is Hospital Confined and general nursing care is provided and charged for by the Hospital. In computing the number of days payable under this benefit, the date of admission will be counted but not the date of discharge.

2. Ancillary Hospital Expenses: services and supplies including operating room, laboratory tests, anesthesia and medicines when Hospital Confined. This does not include personal services of a non-medical nature.

3. Daily Intensive Care Unit Expenses: three times the average semi private room rate when a Covered Person is Hospital Confined in a bed in the Intensive Care Unit and nursing services other than private duty nursing services.

4. Medical Emergency Care (room and supplies) Expenses: incurred within 72 hours of an Accident or Sickness and including the attending Doctor’s charges, X-rays, laboratory procedures, use of the emergency room and supplies.

5. Doctor Non-Surgical Treatment and Examination Expenses including the Doctor’s initial visit, each Medically Necessary follow-up visit and consultation visits when referred by the attending Doctor.

6. Doctor’s Surgical Expenses.

7. Assistant Surgeon Expenses when Medically Necessary.

8. Anesthesiologist Expenses for pre-operative screening and administration of anesthesia during a surgical procedure whether on an inpatient or outpatient basis.

9. Physiotherapy Physical Medicine/Chiropractic Expenses on an inpatient or outpatient basis including treatment and office visits connected with such treatment when prescribed by a Doctor, including diathermy, ultrasonic, whirlpool, heat treatments, adjustments, manipulation, or any form of physical therapy and limited to $50 per visit, one visit per day and 10 visits per Policy Period.

10. X-ray Expenses (including reading charges).

11. Dental Expenses up to $250 due to Accidents or emergency alleviation of pain including dental x-rays for the repair or treatment of each tooth that is whole, sound and a natural tooth at the time of the Accident or emergency alleviation of dental pain.

12. Ambulance Expenses for transportation from the emergency site to the Hospital.

13. Prescription Drug Expenses including dressings, drugs and medicines prescribed by a Doctor.

14. Medical Services and Supplies: expenses for blood and blood transfusions; oxygen and its administration.

15. Emergency medical treatment of pregnancy up to $1,000 per Policy Period.

16. Mental or nervous disorders or rest cures up to $2,500 per Policy Period.

17. Emergency Room Illness with no direct Hospital Admission – $200 additional deductible per visit. Only applies when receiving care in an emergency room for an Illness that does not result in a hospital admittance.

18. Emergency Room Injury/Accident or Illness with direct Hospital Admission – Usual customary charge to the selected Medical Maximum.

62

Safe Travels International excl US
Trawick International

Emergency Medical Benefits

$50,000 per person
Primary coverage

Start a New Search

Full Policy Wording

Covered Medical Expenses Benefit

If a covered Injury or Illness occurs during the Policy Period and you require medical or surgical treatment; this plan will pay, subject to the selected deductible, applicable co-insurance and benefit maximums, the following Covered Expenses, up to the selected policy maximum. The first charges must be incurred within 90 days after the date of the Covered Accident or Sickness. No benefits will be paid for any expenses incurred which are in excess of Usual and Customary Charges. All benefits are in U.S. Dollar amounts

1. Hospital Room and Board Expenses: the average daily rate for a semi private room when a Covered Person is Hospital Confined and general nursing care is provided and charged for by the Hospital. In computing the number of days payable under this benefit, the date of admission will be counted but not the date of discharge.

2. Ancillary Hospital Expenses: services and supplies including operating room, laboratory tests, anesthesia and medicines when Hospital Confined. This does not include personal services of a non-medical nature.

3. Daily Intensive Care Unit Expenses: three times the average semi private room rate when a Covered Person is Hospital Confined in a bed in the Intensive Care Unit and nursing services other than private duty nursing services.

4. Medical Emergency Care (room and supplies) Expenses: incurred within 72 hours of an Accident or Sickness and including the attending Doctor’s charges, X-rays, laboratory procedures, use of the emergency room and supplies.

5. Doctor Non-Surgical Treatment and Examination Expenses including the Doctor’s initial visit, each Medically Necessary follow-up visit and consultation visits when referred by the attending Doctor.

6. Doctor’s Surgical Expenses.

7. Assistant Surgeon Expenses when Medically Necessary.

8. Anesthesiologist Expenses for pre-operative screening and administration of anesthesia during a surgical procedure whether on an inpatient or outpatient basis.

9. Physiotherapy Physical Medicine/Chiropractic Expenses on an inpatient or outpatient basis including treatment and office visits connected with such treatment when prescribed by a Doctor, including diathermy, ultrasonic, whirlpool, heat treatments, adjustments, manipulation, or any form of physical therapy and limited to $50 per visit, one visit per day and 10 visits per Policy Period.

10. X-ray Expenses (including reading charges).

11. Dental Expenses up to $500 due to Accidents or emergency alleviation of pain including dental x-rays for the repair or treatment of each tooth that is whole, sound and a natural tooth at the time of the Accident or emergency alleviation of dental pain.

12. Ambulance Expenses for transportation from the emergency site to the Hospital.

13. Prescription Drug Expenses including dressings, drugs and medicines prescribed by a Doctor.

14. Medical Services and Supplies: expenses for blood and blood transfusions; oxygen and its administration.

15. Emergency medical treatment of pregnancy up to $2,500 per Policy Period.

16. Mental or nervous disorders or rest cures up to $2,500 per Policy Period.

63

Safe Travels International Cost Saver excl US
Trawick International

Emergency Medical Benefits

$50,000 per person
Primary coverage

Start a New Search

Full Policy Wording

Covered Medical Expenses Benefit

If a covered Injury or Illness occurs during the Policy Period and you require medical or surgical treatment; this plan will pay, subject to the selected deductible, applicable co-insurance and benefit maximums, the following Covered Expenses, up to the selected policy maximum. The first charges must be incurred within 90 days
after the date of the Covered Accident or Sickness. No benefits will be paid for any expenses incurred which are in excess of Usual and Customary Charges.

1. Hospital Room and Board Expenses: the average daily rate for a semi private room when a Covered Person is Hospital Confined and general nursing care is provided and charged for by the Hospital. In computing the number of days payable under this benefit, the date of admission will be counted but not the date of discharge.

2. Ancillary Hospital Expenses: services and supplies including operating room, laboratory tests, anesthesia and medicines when Hospital Confined. This does not include personal services of a non-medical nature.

3. Daily Intensive Care Unit Expenses: three times the average semi private room rate when a Covered Person is Hospital Confined in a bed in the Intensive Care Unit and nursing services other than private duty nursing services.

4. Medical Emergency Care (room and supplies) Expenses: incurred within 72 hours of an Accident or Sickness and including the attending Doctor’s charges, X-rays, laboratory procedures, use of the emergency room and supplies.

5. Doctor Non-Surgical Treatment and Examination Expenses including the Doctor’s initial visit, each Medically Necessary follow-up visit and consultation visits when referred by the attending Doctor.

6. Doctor’s Surgical Expenses.

7. Assistant Surgeon Expenses when Medically Necessary.

8. Anesthesiologist Expenses for pre-operative screening and administration of anesthesia during a surgical procedure whether on an inpatient or outpatient basis.

9. Physiotherapy Physical Medicine/Chiropractic Expenses on an inpatient or outpatient basis including treatment and office visits connected with such treatment when prescribed by a Doctor, including diathermy, ultrasonic, whirlpool, heat treatments, adjustments, manipulation, or any form of physical therapy and limited to $50 per visit, one visit per day and 10 visits per Policy Period.

10. X-ray Expenses (including reading charges).

11. Dental Expenses up to $500 due to Accidents or emergency alleviation of pain including dental x-rays for the repair or treatment of each tooth that is whole, sound and a natural tooth at the time of the Accident or emergency alleviation of dental pain.

12. Ambulance Expenses for transportation from the emergency site to the Hospital.

13. Prescription Drug Expenses including dressings, drugs and medicines prescribed by a Doctor.

14. Medical Services and Supplies: expenses for blood and blood transfusions; oxygen and its administration.

15. Emergency medical treatment of pregnancy up to $2,500 per Policy Period.

16. Mental or nervous disorders or rest cures up to $2,500 per Policy Period.

PRIMARY INSURANCE

We will pay Accident and Sickness Medical Expenses up to the Maximum Benefit as outlined in the Schedule of Benefits and after each Insured satisfies any Deductible, without regard to any other Health Care Plan benefits payable for the Insured. We will pay these benefits without regard to any Coordination of Benefits provision in any other Health Care Plan.

64

Safe Travels 3 In 1
Trawick International

Emergency Medical Benefits

No coverage

Start a New Search

Full Policy Wording

There is no Emergency Medical coverage with this plan.

65

Safe Travels Single Trip
Trawick International

Emergency Medical Benefits

$75,000 per person
Secondary coverage

Start a New Search

Full Policy Wording

EMERGENCY ACCIDENT MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Confirmation of Coverage, if You incur Covered Medical Expenses for Emergency Treatment of an Accidental Injury that occurs during the Trip.

Emergency Treatment means necessary medical treatment that must be performed during the Trip due to the serious and acute nature of the Accidental Injury.

Covered Medical Expenses are expenses incurred for necessary services and supplies: (a) listed below; and (b) ordered or prescribed by the attending Physician as Medically Necessary for treatment, that are limited to:

a) the services of a Physician;
b) charges for Hospital confinement and use of operating rooms;
c) charges for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;
d) ambulance service; and
e) drugs, medicines and therapeutic services.

EMERGENCY SICKNESS MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Confirmation of Coverage, if You incur Covered Medical Expenses as a result of Emergency Treatment of a Sickness that first manifests itself during the Trip.
Emergency Treatment means necessary medical treatment that must be performed during the Trip due to the serious and acute nature of the Sickness.

Covered Medical Expenses are expenses incurred for necessary services and supplies: (a) listed below; and (b) ordered or prescribed by the attending Physician as Medically Necessary for treatment, that are limited to:

a) the services of a Physician;
b) charges for Hospital confinement and use of operating rooms;
c) charge for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;
d) ambulance service; and
e) drugs, medicines and therapeutic services.

The Company will not pay benefits in excess of the Reasonable and Customary Charges. The Company will not cover any expenses provided by another party at no cost to You or already included within the cost of the Trip.

The Company will pay benefits up to the Maximum Benefit shown on the Confirmation of Coverage for dental Emergency Treatment for Accidental Injury to Sound Natural Teeth. Both the Accidental Injury and the dental Emergency Treatment must occur during the Trip.

If You are Hospitalized due to a Sickness that first occurred during the course of the Trip beyond the Scheduled Return Date, coverage under this benefit will be extended until You are released from the Hospital or until Maximum Benefits under this Certificate have been paid.

66

Safe Travels First Class
Trawick International

Emergency Medical Benefits

$150,000 per person
Secondary coverage

Start a New Search

Full Policy Wording

EMERGENCY SICKNESS MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Confirmation of Coverage, if You incur Covered Medical Expenses as a result of Emergency Treatment of a Sickness that first manifests itself during the Trip.

Emergency Treatment means necessary medical treatment that must be performed during the Trip due to the serious and acute nature of the Sickness.

Covered Medical Expenses are expenses incurred for necessary services and supplies: (a) listed below; and (b) ordered or prescribed by the attending Physician as Medically Necessary for treatment, that are limited to:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms;

c) charge for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;

d) ambulance service; and

e) drugs, medicines and therapeutic services.

The Company will not pay benefits in excess of the Reasonable and Customary Charges. The Company will not cover any expenses provided by another party at no cost to You or already included within the cost of the Trip.

If You are Hospitalized due to a Sickness that first occurred during the course of the Trip beyond the Scheduled Return Date, coverage under this benefit will be extended until You are released from the Hospital or until Maximum Benefits under this Certificate have been paid.

EMERGENCY ACCIDENT MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Confirmation of Coverage, if You incur Covered Medical Expenses for Emergency Treatment of an Accidental Injury that occurs during the Trip.

Emergency Treatment means necessary medical treatment that must be performed during the Trip due to the serious and acute nature of the Accidental Injury.

Covered Medical Expenses are expenses incurred for necessary services and supplies: (a) listed below; and (b) ordered or prescribed by the attending Physician as Medically Necessary for treatment, that are limited to:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms; Hospital or ambulatory medical-surgical center services;

c) charges for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;

d) ambulance service; and

e) drugs, medicines and therapeutic services.

The Company will not pay benefits in excess of the Reasonable and Customary Charges. The Company will not cover any expenses provided by another party at no cost to You or already included within the cost of the Trip.

The Company will pay benefits up to the Maximum Benefit shown on the Confirmation of Coverage for dental Emergency Treatment for Accidental Injury to Sound Natural Teeth. Both the Accidental Injury and the dental Emergency Treatment must occur during the Trip.

If You are Hospitalized due to an Accidental Injury that first occurred during the course of the Trip beyond the Scheduled Return Date, coverage under this benefit will be extended until You are released from the Hospital or until Maximum Benefits under this Certificate have been paid.

USA-Assist Worldwide Protection
USA-Assist Worldwide Protection

67

Global Travel Medical Diamond
USA-Assist Worldwide Protection

Emergency Medical Benefits

$1,000,000 per occurrence
Secondary coverage

Start a New Search

Full Policy Wording

MEDICAL EXPENSES

USA-Assist ® Global Travel Medical Insurance plan shall pay Reasonable and Customary charges for Covered Expenses, excess of the chosen Deductible and Coinsurance up to the selected Medical Maximum, incurred by You due to an Accidental Injury or Illness which occurred during the Period of Coverage outside Your Home Country (except as provided under the Home Country Coverage). All bodily disorders 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, the Disablement shall be considered a continuation of the prior Disablement and not a separate Disablement. The initial Treatment of an Injury or Illness must occur within thirty (30) days of the date of Injury or onset of Illness. Only such expenses which are specifically enumerated in the following list of charges and incurred within one hundred eighty (180) days from the date of Accident or onset of Illness and which are not excluded, shall be considered Covered Expenses:

1. 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 semi-private room and board accommodations.

2. Charges made for Intensive Care or Coronary Care charges and nursing services.

3. Charges made for diagnosis, Treatment and Surgery by a Physician.

4. Charges made for an operating room.

5. Charges made for Outpatient Treatment, same as any other Treatment covered on an Inpatient basis.

6. This includes ambulatory Surgical centers, Physicians’ Outpatient visits/examinations, clinic care, and Surgical opinion consultations.

7. Charges made for the cost and administration of anesthetics.

8. 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.

9. Charges for physiotherapy, if recommended by a Physician for the Treatment of a specific Disablement and administered by a licensed physiotherapist.

10. Dressings, drugs, and Medicines that can only be obtained upon a written prescription of a Physician or Surgeon.

11. 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 to the maximum stated in the Schedule of Benefits, 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 air ambulance transportation to the nearest metropolitan area shall be considered a Covered Expense.

HOSPITAL INDEMNITY

If You are confined to a Hospital as a registered Inpatient as the result of an Illness or Injury which occurs during Your Period of Coverage, this plan will pay benefits up to the maximum stated in the Schedule of Benefits per day of confinement, in addition to any other Covered Expense, up to a maximum of thirty (30) days. Only available for travel outside the United States

DENTAL

Accident Coverage – This plan shall pay in excess of the chosen Deductible and Coinsurance up to the maximum stated in the Schedule of Benefits, for emergency Treatment to repair or replace Sound Natural Teeth damaged as the result of a covered Accident. Only those injuries caused by external contact with a foreign object are covered. You are not covered if you break a tooth while eating or biting into a foreign object. Only available to programs purchased for 1 month or more.

Sudden Relief of Pain – This plan shall pay in excess of the chosen Deductible and Coinsurance up to the maximum stated in the Schedule of Benefits, for emergency Treatment for the relief of pain to Sound Natural Teeth. Only available to programs purchased for 1 month or more.

68

Global Travel Medical Executive
USA-Assist Worldwide Protection

Emergency Medical Benefits

$25,000 per occurrence
Secondary coverage

Start a New Search

Full Policy Wording

MEDICAL EXPENSES

USA-Assist ® Global Travel Medical Insurance plan shall pay Reasonable and Customary charges for Covered Expenses, excess of the chosen Deductible and Coinsurance up to the selected Medical Maximum, incurred by You due to an Accidental Injury or Illness which occurred during the Period of Coverage outside Your Home Country (except as provided under the Home Country Coverage). All bodily disorders 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, the Disablement shall be considered a continuation of the prior Disablement and not a separate Disablement. The initial Treatment of an Injury or Illness must occur within thirty (30) days of the date of Injury or onset of Illness. Only such expenses which are specifically enumerated in the following list of charges and incurred within one hundred eighty (180) days from the date of Accident or onset of Illness and which are not excluded, shall be considered Covered Expenses:

1. 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 semi-private room and board accommodations.

2. Charges made for Intensive Care or Coronary Care charges and nursing services.

3. Charges made for diagnosis, Treatment and Surgery by a Physician.

4. Charges made for an operating room.

5. Charges made for Outpatient Treatment, same as any other Treatment covered on an Inpatient basis.

6. This includes ambulatory Surgical centers, Physicians’ Outpatient visits/examinations, clinic care, and Surgical opinion consultations.

7. Charges made for the cost and administration of anesthetics.

8. 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.

9. Charges for physiotherapy, if recommended by a Physician for the Treatment of a specific Disablement and administered by a licensed physiotherapist.

10. Dressings, drugs, and Medicines that can only be obtained upon a written prescription of a Physician or Surgeon.

11. 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 to the maximum stated in the Schedule of Benefits, 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 air ambulance transportation to the nearest metropolitan area shall be considered a Covered Expense.

HOSPITAL INDEMNITY

If You are confined to a Hospital as a registered Inpatient as the result of an Illness or Injury which occurs during Your Period of Coverage, this plan will pay benefits up to the maximum stated in the Schedule of Benefits per day of confinement, in addition to any other Covered Expense, up to a maximum of thirty (30) days. Only available for travel outside the United States

DENTAL

Accident Coverage – This plan shall pay in excess of the chosen Deductible and Coinsurance up to the maximum stated in the Schedule of Benefits, for emergency Treatment to repair or replace Sound Natural Teeth damaged as the result of a covered Accident. Only those injuries caused by external contact with a foreign object are covered. You are not covered if you break a tooth while eating or biting into a foreign object. Only available to programs purchased for 1 month or more.

Sudden Relief of Pain – This plan shall pay in excess of the chosen Deductible and Coinsurance up to the maximum stated in the Schedule of Benefits, for emergency Treatment for the relief of pain to Sound Natural Teeth. Only available to programs purchased for 1 month or more.

69

Global Travel Medical Gold
USA-Assist Worldwide Protection

Emergency Medical Benefits

$50,000 per occurrence
Secondary coverage

Start a New Search

Full Policy Wording

MEDICAL EXPENSES

USA-Assist ® Global Travel Medical Insurance plan shall pay Reasonable and Customary charges for Covered Expenses, excess of the chosen Deductible and Coinsurance up to the selected Medical Maximum, incurred by You due to an Accidental Injury or Illness which occurred during the Period of Coverage outside Your Home Country (except as provided under the Home Country Coverage). All bodily disorders 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, the Disablement shall be considered a continuation of the prior Disablement and not a separate Disablement. The initial Treatment of an Injury or Illness must occur within thirty (30) days of the date of Injury or onset of Illness. Only such expenses which are specifically enumerated in the following list of charges and incurred within one hundred eighty (180) days from the date of Accident or onset of Illness and which are not excluded, shall be considered Covered Expenses:

1. 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 semi-private room and board accommodations.

2. Charges made for Intensive Care or Coronary Care charges and nursing services.

3. Charges made for diagnosis, Treatment and Surgery by a Physician.

4. Charges made for an operating room.

5. Charges made for Outpatient Treatment, same as any other Treatment covered on an Inpatient basis.

6. This includes ambulatory Surgical centers, Physicians’ Outpatient visits/examinations, clinic care, and Surgical opinion consultations.

7. Charges made for the cost and administration of anesthetics.

8. 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.

9. Charges for physiotherapy, if recommended by a Physician for the Treatment of a specific Disablement and administered by a licensed physiotherapist.

10. Dressings, drugs, and Medicines that can only be obtained upon a written prescription of a Physician or Surgeon.

11. 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 to the maximum stated in the Schedule of Benefits, 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 air ambulance transportation to the nearest metropolitan area shall be considered a Covered Expense.

HOSPITAL INDEMNITY

If You are confined to a Hospital as a registered Inpatient as the result of an Illness or Injury which occurs during Your Period of Coverage, this plan will pay benefits up to the maximum stated in the Schedule of Benefits per day of confinement, in addition to any other Covered Expense, up to a maximum of thirty (30) days. Only available for travel outside the United States

DENTAL

Accident Coverage – This plan shall pay in excess of the chosen Deductible and Coinsurance up to the maximum stated in the Schedule of Benefits, for emergency Treatment to repair or replace Sound Natural Teeth damaged as the result of a covered Accident. Only those injuries caused by external contact with a foreign object are covered. You are not covered if you break a tooth while eating or biting into a foreign object. Only available to programs purchased for 1 month or more.

Sudden Relief of Pain – This plan shall pay in excess of the chosen Deductible and Coinsurance up to the maximum stated in the Schedule of Benefits, for emergency Treatment for the relief of pain to Sound Natural Teeth. Only available to programs purchased for 1 month or more.

70

Global Travel Medical Platinum
USA-Assist Worldwide Protection

Emergency Medical Benefits

$150,000 per occurrence
Secondary coverage

Start a New Search

Full Policy Wording

MEDICAL EXPENSES

USA-Assist ® Global Travel Medical Insurance plan shall pay Reasonable and Customary charges for Covered Expenses, excess of the chosen Deductible and Coinsurance up to the selected Medical Maximum, incurred by You due to an Accidental Injury or Illness which occurred during the Period of Coverage outside Your Home Country (except as provided under the Home Country Coverage). All bodily disorders 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, the Disablement shall be considered a continuation of the prior Disablement and not a separate Disablement. The initial Treatment of an Injury or Illness must occur within thirty (30) days of the date of Injury or onset of Illness. Only such expenses which are specifically enumerated in the following list of charges and incurred within one hundred eighty (180) days from the date of Accident or onset of Illness and which are not excluded, shall be considered Covered Expenses:

1. 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 semi-private room and board accommodations.

2. Charges made for Intensive Care or Coronary Care charges and nursing services.

3. Charges made for diagnosis, Treatment and Surgery by a Physician.

4. Charges made for an operating room.

5. Charges made for Outpatient Treatment, same as any other Treatment covered on an Inpatient basis.

6. This includes ambulatory Surgical centers, Physicians’ Outpatient visits/examinations, clinic care, and Surgical opinion consultations.

7. Charges made for the cost and administration of anesthetics.

8. 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.

9. Charges for physiotherapy, if recommended by a Physician for the Treatment of a specific Disablement and administered by a licensed physiotherapist.

10. Dressings, drugs, and Medicines that can only be obtained upon a written prescription of a Physician or Surgeon.

11. 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 to the maximum stated in the Schedule of Benefits, 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 air ambulance transportation to the nearest metropolitan area shall be considered a Covered Expense.

HOSPITAL INDEMNITY

If You are confined to a Hospital as a registered Inpatient as the result of an Illness or Injury which occurs during Your Period of Coverage, this plan will pay benefits up to the maximum stated in the Schedule of Benefits per day of confinement, in addition to any other Covered Expense, up to a maximum of thirty (30) days. Only available for travel outside the United States

DENTAL

Accident Coverage – This plan shall pay in excess of the chosen Deductible and Coinsurance up to the maximum stated in the Schedule of Benefits, for emergency Treatment to repair or replace Sound Natural Teeth damaged as the result of a covered Accident. Only those injuries caused by external contact with a foreign object are covered. You are not covered if you break a tooth while eating or biting into a foreign object. Only available to programs purchased for 1 month or more.

Sudden Relief of Pain – This plan shall pay in excess of the chosen Deductible and Coinsurance up to the maximum stated in the Schedule of Benefits, for emergency Treatment for the relief of pain to Sound Natural Teeth. Only available to programs purchased for 1 month or more.

71

Global Travel Medical Standard
USA-Assist Worldwide Protection

Emergency Medical Benefits

$12,500 per occurrence
Secondary coverage

Start a New Search

Full Policy Wording

MEDICAL EXPENSES

USA-Assist ® Global Travel Medical Insurance plan shall pay Reasonable and Customary charges for Covered Expenses, excess of the chosen Deductible and Coinsurance up to the selected Medical Maximum, incurred by You due to an Accidental Injury or Illness which occurred during the Period of Coverage outside Your Home Country (except as provided under the Home Country Coverage). All bodily disorders 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, the Disablement shall be considered a continuation of the prior Disablement and not a separate Disablement. The initial Treatment of an Injury or Illness must occur within thirty (30) days of the date of Injury or onset of Illness. Only such expenses which are specifically enumerated in the following list of charges and incurred within one hundred eighty (180) days from the date of Accident or onset of Illness and which are not excluded, shall be considered Covered Expenses:

1. 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 semi-private room and board accommodations.

2. Charges made for Intensive Care or Coronary Care charges and nursing services.

3. Charges made for diagnosis, Treatment and Surgery by a Physician.

4. Charges made for an operating room.

5. Charges made for Outpatient Treatment, same as any other Treatment covered on an Inpatient basis.

6. This includes ambulatory Surgical centers, Physicians’ Outpatient visits/examinations, clinic care, and Surgical opinion consultations.

7. Charges made for the cost and administration of anesthetics.

8. 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.

9. Charges for physiotherapy, if recommended by a Physician for the Treatment of a specific Disablement and administered by a licensed physiotherapist.

10. Dressings, drugs, and Medicines that can only be obtained upon a written prescription of a Physician or Surgeon.

11. 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 to the maximum stated in the Schedule of Benefits, 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 air ambulance transportation to the nearest metropolitan area shall be considered a Covered Expense.

HOSPITAL INDEMNITY

If You are confined to a Hospital as a registered Inpatient as the result of an Illness or Injury which occurs during Your Period of Coverage, this plan will pay benefits up to the maximum stated in the Schedule of Benefits per day of confinement, in addition to any other Covered Expense, up to a maximum of thirty (30) days. Only available for travel outside the United States

DENTAL

Accident Coverage – This plan shall pay in excess of the chosen Deductible and Coinsurance up to the maximum stated in the Schedule of Benefits, for emergency Treatment to repair or replace Sound Natural Teeth damaged as the result of a covered Accident. Only those injuries caused by external contact with a foreign object are covered. You are not covered if you break a tooth while eating or biting into a foreign object. Only available to programs purchased for 1 month or more.

Sudden Relief of Pain – This plan shall pay in excess of the chosen Deductible and Coinsurance up to the maximum stated in the Schedule of Benefits, for emergency Treatment for the relief of pain to Sound Natural Teeth. Only available to programs purchased for 1 month or more.

72

Global Travel Medical Titanium
USA-Assist Worldwide Protection

Emergency Medical Benefits

$500,000 per occurrence
Secondary coverage

Start a New Search

Full Policy Wording

MEDICAL EXPENSES

USA-Assist ® Global Travel Medical Insurance plan shall pay Reasonable and Customary charges for Covered Expenses, excess of the chosen Deductible and Coinsurance up to the selected Medical Maximum, incurred by You due to an Accidental Injury or Illness which occurred during the Period of Coverage outside Your Home Country (except as provided under the Home Country Coverage). All bodily disorders 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, the Disablement shall be considered a continuation of the prior Disablement and not a separate Disablement. The initial Treatment of an Injury or Illness must occur within thirty (30) days of the date of Injury or onset of Illness. Only such expenses which are specifically enumerated in the following list of charges and incurred within one hundred eighty (180) days from the date of Accident or onset of Illness and which are not excluded, shall be considered Covered Expenses:

1. 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 semi-private room and board accommodations.

2. Charges made for Intensive Care or Coronary Care charges and nursing services.

3. Charges made for diagnosis, Treatment and Surgery by a Physician.

4. Charges made for an operating room.

5. Charges made for Outpatient Treatment, same as any other Treatment covered on an Inpatient basis.

6. This includes ambulatory Surgical centers, Physicians’ Outpatient visits/examinations, clinic care, and Surgical opinion consultations.

7. Charges made for the cost and administration of anesthetics.

8. 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.

9. Charges for physiotherapy, if recommended by a Physician for the Treatment of a specific Disablement and administered by a licensed physiotherapist.

10. Dressings, drugs, and Medicines that can only be obtained upon a written prescription of a Physician or Surgeon.

11. 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 to the maximum stated in the Schedule of Benefits, 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 air ambulance transportation to the nearest metropolitan area shall be considered a Covered Expense.

HOSPITAL INDEMNITY

If You are confined to a Hospital as a registered Inpatient as the result of an Illness or Injury which occurs during Your Period of Coverage, this plan will pay benefits up to the maximum stated in the Schedule of Benefits per day of confinement, in addition to any other Covered Expense, up to a maximum of thirty (30) days. Only available for travel outside the United States

DENTAL

Accident Coverage – This plan shall pay in excess of the chosen Deductible and Coinsurance up to the maximum stated in the Schedule of Benefits, for emergency Treatment to repair or replace Sound Natural Teeth damaged as the result of a covered Accident. Only those injuries caused by external contact with a foreign object are covered. You are not covered if you break a tooth while eating or biting into a foreign object. Only available to programs purchased for 1 month or more.

Sudden Relief of Pain – This plan shall pay in excess of the chosen Deductible and Coinsurance up to the maximum stated in the Schedule of Benefits, for emergency Treatment for the relief of pain to Sound Natural Teeth. Only available to programs purchased for 1 month or more.

73

GlobalTrip Classic
USA-Assist Worldwide Protection

Emergency Medical Benefits

$100,000 per person
Secondary coverage

Start a New Search

Full Policy Wording

You are eligible for medical benefits, arising from a Medical Emergency, in excess of US$ 50 per Occurrence Deductible, up to the benefit amount shown on Your certificate for:

1. Eligible Medical Expenses incurred as a result of an accidental Injury which occurs or Sickness which first manifests itself during the Trip. You must receive initial Medical Treatment for Injury or Sickness within 15 days after the date of the accident that caused the Injury or the onset of Sickness. All treatments must be received within 26 weeks following the date of the accident or after onset of Sickness.

2. Benefits will include expenses for emergency dental treatment not to exceed US$ 750.

3. Advance payment will be made to a Hospital, subject to the applicable benefit amount, if needed to secure Your admission to a Hospital because of Sickness or Injury which first occurs during the course of the Trip. The authorized Administrator will coordinate advance payment to the Hospital.

In all cases, benefits will not be paid in excess of the Reasonable, Usual and Customary Charges.

Limitation of Benefits: Once You are deemed medically stable to return to Your country of residence (with or without a medical escort) either in the opinion of the Insurer or by virtue of discharge from hospital, Your emergency is considered to have ended, whereupon any further consultation, treatment, recurrence or complication related to the medical emergency will no longer be eligible for coverage under this policy.

74

GlobalTrip Saver
USA-Assist Worldwide Protection

Emergency Medical Benefits

$50,000 per person
Secondary coverage

Start a New Search

Full Policy Wording

You are eligible for medical benefits, arising from a Medical Emergency, in excess of US$ 50 per Occurrence Deductible, up to the benefit amount shown on Your certificate for:

1. Eligible Medical Expenses incurred as a result of an accidental Injury which occurs or Sickness which first manifests itself during the Trip. You must receive initial Medical Treatment for Injury or Sickness within 15 days after the date of the accident that caused the Injury or the onset of Sickness. All treatments must be received within 26 weeks following the date of the accident or after onset of Sickness.

2. Benefits will include expenses for emergency dental treatment not to exceed US$ 750.

3. Advance payment will be made to a Hospital, subject to the applicable benefit amount, if needed to secure Your admission to a Hospital because of Sickness or Injury which first occurs during the course of the Trip. The authorized Administrator will coordinate advance payment to the Hospital.

In all cases, benefits will not be paid in excess of the Reasonable, Usual and Customary Charges.

Limitation of Benefits: Once You are deemed medically stable to return to Your country of residence (with or without a medical escort) either in the opinion of the Insurer or by virtue of discharge from hospital, Your emergency is considered to have ended, whereupon any further consultation, treatment, recurrence or complication related to the medical emergency will no longer be eligible for coverage under this policy.

75

GlobalTrip Plus
USA-Assist Worldwide Protection

Emergency Medical Benefits

$500,000 per person
Secondary coverage

Start a New Search

Full Policy Wording

You are eligible for medical benefits, arising from a Medical Emergency, in excess of US$ 50 per Occurrence Deductible, up to the benefit amount shown on Your certificate for:

1. Eligible Medical Expenses incurred as a result of an accidental Injury which occurs or Sickness which first manifests itself during the Trip. You must receive initial Medical Treatment for Injury or Sickness within 15 days after the date of the accident that caused the Injury or the onset of Sickness. All treatments must be received within 26 weeks following the date of the accident or after onset of Sickness.

2. Benefits will include expenses for emergency dental treatment not to exceed US$ 750.

3. Advance payment will be made to a Hospital, subject to the applicable benefit amount, if needed to secure Your admission to a Hospital because of Sickness or Injury which first occurs during the course of the Trip. The authorized Administrator will coordinate advance payment to the Hospital.

In all cases, benefits will not be paid in excess of the Reasonable, Usual and Customary Charges.

Limitation of Benefits: Once You are deemed medically stable to return to Your country of residence (with or without a medical escort) either in the opinion of the Insurer or by virtue of discharge from hospital, Your emergency is considered to have ended, whereupon any further consultation, treatment, recurrence or complication related to the medical emergency will no longer be eligible for coverage under this policy.

76

GlobalTrip High Medical
USA-Assist Worldwide Protection

Emergency Medical Benefits

$1,000,000 per person
Secondary coverage

Start a New Search

Full Policy Wording

You are eligible for medical benefits, arising from a Medical Emergency, in excess of US$ 50 per Occurrence Deductible, up to the benefit amount shown on Your certificate for:

1. Eligible Medical Expenses incurred as a result of an accidental Injury which occurs or Sickness which first manifests itself during the Trip. You must receive initial Medical Treatment for Injury or Sickness within 15 days after the date of the accident that caused the Injury or the onset of Sickness. All treatments must be received within 26 weeks following the date of the accident or after onset of Sickness.

2. Benefits will include expenses for emergency dental treatment not to exceed US$ 750.

3. Advance payment will be made to a Hospital, subject to the applicable benefit amount, if needed to secure Your admission to a Hospital because of Sickness or Injury which first occurs during the course of the Trip. The authorized Administrator will coordinate advance payment to the Hospital.

In all cases, benefits will not be paid in excess of the Reasonable, Usual and Customary Charges.

Limitation of Benefits: Once You are deemed medically stable to return to Your country of residence (with or without a medical escort) either in the opinion of the Insurer or by virtue of discharge from hospital, Your emergency is considered to have ended, whereupon any further consultation, treatment, recurrence or complication related to the medical emergency will no longer be eligible for coverage under this policy.