COMPLETE BROCHURE & RATES
lobal Medical InsuranceSM
Gold Plan
Underwritten by SIRIUS International Insurance Corporation
Long-Term, Comprehensive Worldwide Medical Coverage for
Individuals and Families

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Global Medical Insurance provides US$5,000,000 of lifetime coverage with a full range of benefits suited for individuals and families. The plan offers two options: worldwide coverage or worldwide coverage excluding the USA and Canada. Both options provide coverage 24 hours a day, and you have the freedom to choose any doctor or hospital for treatment. When you select Global Medical Insurance you receive our commitment to deliver world class health benefits, medical assistance and total peace of mind.

As part of the eligibility requirements for Global Medical Insurance, U.S. citizens must reside abroad or plan to leave the US on their effective date and plan to reside abroad for at least six of the next 12 months. Non-U.S. citizens may reside anywhere, including their country of citizenship, although certain eligibility restrictions may apply to non-US citizens residing in the United States.

If you are interested in this plan, you may also want to review Global Basic Insurance. It offers somewhat reduced benefit levels which also reduces the cost of the coverage. To see a comparison of these two plans, please click here.

You also have the option of adding Global Term Life Insurance^SM and Global Daily Indemnity^SM to your Global Medical Insurance coverage.

Global Term Life Insurance
Global Term Life Insurance provides protection for your family at the time of a traumatic loss and is available with no additional underwriting. This coverage is available for a standard annual premium of $240 and includes an Accidental Death and Dismemberment benefit.

Global Daily Indemnity
Global Daily Indemnity pays you US$100 for each covered overnight hospital stay other than those related to maternity.

Lifetime Eligibility
Lifetime medical coverage is available if you are enrolled in the Global Medical Insurance plan by your 65th birthday and maintain continuous coverage to age 75. Prior to your 75th birthday you will receive a summary of benefits of a new plan, Global Senior Plan®, and an enrollment form for coverage. There is no additional medical underwriting. You simply need to review the benefits, and complete and return the enrollment form with your premium.

Optional Maternity Rider: >>>>>>>>>>US$50,000 lifetime maximum Benefits include: •Pre- and post-natal care •Maximum of US$5,000 for normal delivery for each pregnancy •Maximum of US$7,500 for C-section delivery for each pregnancy •Well baby care and treatment of newborn for first 31 days •Child wellness benefits of up to US$200 maximum per period of coverage (not subject to deductible or coinsurance) for eligible newborn children for the first 12 months. Must be selected at time of initial purchase of plan • Benefits available after 10 months of continuous coverage • Eligible newborn children may be added without evidence of insurability as long as an application form is submitted within 31 days of birth • Benefits will be reduced by 50% for births that occur the 11th or 12th month of continuous coverage.

The foregoing list is only a summary of available benefits and coverages, and is subject to the specific terms and conditions of the plan concerning eligible benefits, limitations, eligibility and exclusions. Please refer to the certificate wording for a complete description, which is available upon request.

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Pre-Existing Conditions
After coverage has been in effect for 24 continuous months, Global Medical Insurance^sm provides a US$50,000 lifetime benefit with a maximum of US$5,000 per policy period for pre-existing conditions that existed at or prior to the effective date. This benefit is payable whether or not you have received consultation or treatment for the condition(s) during the 24-month period. This is important since few pre-existing conditions remain free from consultation or treatment and often do not qualify for coverage in standard plans. Global Medical Insurance^sm does not “rider” or charge additional premium for pre-existing conditions. If you disclose a pre-existing condition at the time of application, and we accept you into the plan, you will be covered for eligible medical expenses, after 24 months.

The following illnesses which exist, manifest themselves or are treated or have treatment recommended prior to or during the first 180 days of coverage from the initial effective date are considered pre-existing conditions: tonsillectomy, adenoidectomy, hemorrhoids or hemorrhoidectomy, disorders of the reproductive system, hysterectomy, hernia, gall stones or kidney stones, any condition of the breast, any condition of the prostate.

OTHER EXCLUSIONS AND LIMITATIONS*

• Routine physical examinations first 12 months
• Maternity and newborn-first 12 months
• Mental and nervous-first 12 months
• Organized amateur or professional sports
• Treatment not ordered or received by a physician
• Treatment or supplies not medically necessary
• Investigational, experimental or research procedures
• Custodial care
• Weight modification
• Elective cosmetic or plastic surgery
• Treatment of impotency
• Contraceptive medication or treatment
• Drug and alcohol abuse treatment
• Organ transplants not specifically listed
• Devices to correct sight or hearing
• Routine foot care
• Treatment by a relative or family member
• Treatment as a result of war or riot
• Treatment resulting from illegal activities
• Speech therapy
• Persons HIV+ at effective date
• Services and treatment eligible for payment by any government or other insurance

Claims Information

CLAIMS PROCEDURE
Once approved for Global Medical Insurance^sm you will receive a fulfillment kit that includes an Identification card and Claim Forms. When you receive treatment, original itemized bills must be received by Plan Administrator within 90 days of services. Eligible itemized bills submitted to Plan Administrator will be automatically converted from local currencies. If you are filing an overseas claim, please remember to include the Overseas Benefit Form with the Claim Form and other necessary documentation that you forward to the Plan Administrator.

CLAIM FILING ALTERNATIVES

Direct Payment to Providers
In many cases the Plan Administrator works directly with the hospital or clinic, including those outside our PPO, for payment of eligible medical expenses. To file a claim, complete the Claim Form and submit it with original itemized bills. In this case, you will be responsible for your deductible, coinsurance amounts and non-eligible expenses.

Reimbursement
If you have received treatment and need to be reimbursed for out-of-pocket medical expenses, complete the Claim Form and submit your original itemized bills and paid receipts within 90 days. We will reimburse your eligible medical expenses after applying the deductible and coinsurance.

Please remember to submit your bills and receipts as soon as you receive them. Do not hold them until the end of the year. The Plan Administrator will apply eligible medical expenses to your deductible and coinsurance throughout the year.

Coverage is free for two children aged 9 or younger when both parents are covered under the plan.

PRE-CERTIFICATION
Pre-certification (notification of illness or accident) simply means calling the company prior to treatment. The following treatments must be pre-certified:

• Any surgery or treatment requiring hospitalization
• Outpatient surgery
• CAT scans, MRI's
• Notification within the first 90 days of pregnancy
• Within 48 hours after an emergency admission to the hospital
• Care in an extended care facility
• Home nursing care
• Durable medical equipment including artificial limbs
• Transplants

By the Plan Administrator we will be able to verify benefits, review length of stay and coordinate payment with the hospital or outpatient facility. Pre-certification may be done by you, the doctor, a hospital administrator or relative.

Click here for Tips on How to Apply

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Please read the Benefits & Exclusions of this plan carefully before submitting your application. 

  Click here for Rates for Worldwide Coverage

Click here for Rates for Worldwide Coverage Excluding the USA & Canada

Bon Voyage!
Haben Sie eine sichere Reise! Abbia un viaggio sicuro!
ˇTenga un viaje seguro! Ayez un voyage sűr! Have a safe trip!
 

  If you have any questions, please contact our friendly specialists.

877-211-3654 or 559-294-0316

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