$50,000 per person
Emergency Medical can reimburse the costs to treat a medical emergency during a trip.
MEDICAL EXPENSE BENEFIT
If a covered Sickness or Injury occurs during the Policy Period, and the Covered Person requires medical or surgical treatment, benefits are payable for the following covered expenses that are incurred during the Benefit Period. The first covered expenses 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. All charges in excess of the allowable semiprivate rate are the responsibility of the Covered Person.
2. Hospital Emergency Room Visits: Emergency Room Visit for an Illness with no direct Hospital Admittance will be subject to an additional Deductible as outlined in the schedule of benefits.
3. Ancillary Hospital Expenses: Services and supplies as Medically Necessary and approved and covered by thePolicy including meals and special diets (only for the Covered Person), use of operating room and related facilities, use of intensive care and related services to include x-ray (including reading charges), laboratory and other diagnostic tests, drugs, medications, biological anesthesia and oxygen services, and administration of blood products. This does not include personal services of a non-medical nature.
4. Intensive Care Unit Expenses: Room and Board: 3 times the average semiprivate room rate when a CoveredPerson is Hospital Confined in a bed in the Intensive Care Unit and nursing services other than private duty nursing services.
5. Physician non-surgical treatment and examination expenses including the Physician’s initial visit, each Medically Necessary follow-up visit and consultation visits when referred by the attending Physician.
6. Physician’s Surgical Expenses.
7. Assistant Physician Surgical Expenses when Medically Necessary.
8. Anesthesiologist Expenses for pre-operative screening and administration of anesthesia during a surgical procedure on an outpatient basis.
9. Outpatient Medical Expenses.
10. Physician Visits.
11. Physiotherapy Physical Medicine/Chiropractic Expenses on an Inpatient or outpatient basis including treatment and office visits connected with such treatment when prescribed by a Physician, including diathermy, ultrasonic, whirlpool, heat treatments, adjustments, manipulation, or any form of physical therapy.
13. Emergency dental treatment and restoration of sound natural teeth, including x-rays, required as a result of an Accident or to relieve pain.
14. Prescription Drug Expenses including dressings, drugs and medicines prescribed by a Physician.
15. Emergency medical treatment of pregnancy.
16. Mental or nervous disorders. Benefits are provided for psychotherapeutic treatment and psychiatric counseling and treatment for an approved psychiatric diagnosis. A Physician or a licensed clinical psychologist must provide all mental health care services. Services of a clinical psychologist must be rendered in the provider’s office or in the outpatient department of a Hospital. Services Include treatment for Bulimia; Anorexia; Non-medical causes of insomnia. The following services are excluded: Aptitude testing, educational testing and services; Services for conditions not determined by Us as to be emotional or personality Sicknesses; Psychiatric services extending beyond the period necessary for evaluation and Diagnosis of mental deficiency or retardation; Services for mental disorders or Sickness which are not amenable to favorable modification; Bereavement; Family counseling of any kind; Marriage counseling of any kind.
17. Treatment for Cardiac Conditions up to the maximum as stated in the Schedule of Benefits.
AMBULANCE SERVICE BENEFITS
Ambulance Service Benefits are provided for medically necessary emergency ground or air ambulance transportation as required from the emergency site to the nearest Hospital able to provide the required level of care.