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Overseas Travel Medical Plan


                                                          
 

                                                                                                         

Short Term Medical Protection Benefits
for Individuals Traveling Outside of Their Home Country
               

Comprehensive protection for:

  • U.S. citizens traveling abroad
  • Non U.S. citizens traveling to the U.S.
  • Hospital & Medical Expenses
  • Emergency Dental
  • 24-Hour Medical Emergency Services
  • Emergency Evacuation
  • Return of Minor Children
  • Trip Interruption
  • Lost Luggage
  • Accidental Death & Dismemberment

Benefits provided by:
American Consumer Insurance Trust

Administered By:

HPA, Inc., Rockford IL

Overseas Travel Medical Plan

Comprehensive Short Term Medical Protection Benefits for Individuals Traveling Outside of Their Home Country

Why do you need the Overseas Travel Medical Plan?

Today, more and more people are traveling outside of their home country, either for business, recreation or personal reasons.  Frequently, domestic health insurance does not provide coverage for overseas medical emergencies, and international travelers are unable to obtain this type of protection after they are outside of their home country.

Furthermore, most traditional health insurance does not provide coverage for expenses for an emergency medical evacuation, medical reunion, return of mortal remains, trip interruption or loss of checked luggage.  

Who should apply for the Overseas Travel Medical Plan?

Anyone traveling outside of their home country needs the type of comprehensive protection the Overseas Travel Medical Plan provides.

If You are a citizen or resident of the United States (U.S.), You can purchase the Overseas Travel Medical Plan to travel anywhere outside of the U.S. 

At this time, this program is not available to residents of: NY, OR and KS. If You are a U.S. citizen residing outside of the U.S., You can purchase this protection as long as You hold a current and valid U.S. passport.

If You are a foreign visitor traveling to the United States (U.S.), You can purchase the Overseas Travel Medical Plan as long as You provide us with your current and valid passport I.D. number. 

What is 24-Hour Medical Emergency Protection?

The Overseas Travel Medical Plan includes a unique added benefit for You and Your family, 24 Hour Medical Emergency Protection.  Our emergency assistance services are superior and include:
 

  • Medical referrals and medical care location
  • Communication arrangements between family and doctors
  • International hospital bill translation / interpretation services
  • Medical case management and catastrophic case notification
  • Coordinating emergency medical evacuation or repatriations
  • Arrangements for medical transportation
  • Assisting in the replacement of lost passports
  • Locating legal assistance and local interpreters

ELIGIBLE PERSONS

Eligible Persons:
A person who has applied for benefits, is named on the application and for whom HPA has received the appropriate plan cost, is considered eligible for benefits under this Plan.

Eligible Dependents:

Are considered a spouse who is legally married to You or Your unmarried Child from 14 days old until his / her 19th birthday.

SCHEDULE OF BENEFITS
Accident & Sickness Medical Benefits Maximum Choices:*
$50,000, $100,000, $250,000 or $1,000,000

Deductible Choices: 
$125, $250, $500, $1,000, $2,500


The Coinsurance
(after satisfaction of the Deductible) for U.S. citizens or residents outside of the U.S. is 100% of Eligible Expenses; and for non U.S. citizens inside of the U.S. it is 80% of the first $5,000 of Eligible Expenses, and then 100% of the remaining Eligible Expenses.

*The Maximum for Accident & Sickness Medical Benefits is limited to $10,000 for Eligible Persons ages 80 and above.
*The Maximum for Accident & Sickness Medical Benefits is limited to $10,000 for the Hazardous Sports Rider.

Additional Benefits:

  • Emergency Medical Evacuation: $100,000
  • Return of Mortal Remains:  $20,000 
  • Emergency Medical Reunion:  $10,000
  • Return of Minor Children:  $5,000 
  • Interruption of Trip:  $5,000
  • Loss of Checked Luggage:  $250
  • Emergency Dental for Accidents:  $500
  • Accidental Death and Dismemberment:  $25,000 for Eligible Person; and $5,000 for each Eligible Dependent(s)

TERM OF PROTECTION

The minimum Term of Protection is 15 days; the maximum is 12 months.  Benefits can be purchased in a combination of monthly and 15-day periods by paying the appropriate Plan Cost.

Convenient Plan Cost payment options include: (1) Payment in Full by, Visa, MasterCard or Discover credit cards; (2) Monthly Pay as you go, allows you to pay monthly by, Visa, MasterCard or Discover credit cards.

Effective Date
of the Term of Protection begins on the latest of the following:

  1. The Date HPA receives a completed Application and the appropriate Plan Cost for the Period of Protection;  or
  2. The Effective Date requested on the Application; or
  3. The moment You arrive in the country noted on the Application; or
  4. The Date HPA approves the Application.
Expiration Date of the Term of Protection terminates on the earlier of the following:
  1. The moment You return to Your Home Country; or
  2. The expiration of twelve months from the Effective Date; or
  3. The date shown on the Schedule provided by HPA; or
  4. The end of the period for which the Plan Cost has been paid; or
  5. The date You are no longer considered an Eligible Person; or
  6. For foreign visitors, the Date You become a permanent resident of the United States.

DESCRIPTION OF BENEFITS

Medical Benefits:  

Benefits will be paid for Reasonable and Customary Eligible Expenses incurred by You due to an accidental Injury or Illness up to the earlier of the maximum amount You chose after the Deductible and Coinsurance is satisfied, or the Expiration Date of Your Term of Protection. All bodily disorders, or bodily Injuries sustained in any one Accident, existing simultaneously which are due to the same or related causes shall be considered one Disablement.  If a Disablement is due to causes which are the same or related to the cause of a prior Disablement (including complications arising there from), the Disablement shall be considered a continuation of the prior Disablement and not a separate Disablement.

The initial treatment of the Illness or Injury must occur within 30 days of the Accident or onset of the Illness.

Only the following, which are specifically enumerated in the following list of charges and which are not excluded, shall be considered as Eligible Expenses:

  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 semiprivate room and board accommodation.
  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.  This includes ambulatory Surgical centers, Physicians’ outpatient visits and examinations, clinic care, and surgical opinion consultations.
  6. Charges made for the cost and administration of anesthetics.
  7. 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.
  8. Charges for physiotherapy, if recommended by a Physician for the treatment of a specific Disablement and administered by a licensed physiotherapist.
  9. Dressings, drugs, and medicines that can only be obtained upon a written prescription of a Physician or surgeon.
  10. Local transportation to or from the nearest Hospital or to and from the nearest Hospital with facilities for required treatment.  Such transportation shall be by licensed ground ambulance only, within the metropolitan area in which You are located at that time the service is used.  If You are in a rural area, then licensed ground ambulance transportation to the nearest metropolitan area shall be considered an Eligible Expense.
Optional Hazardous Sports Rider:

Benefits will be paid if You are injured while participating in one of the following: Motorcycle or motor scooter riding, mountaineering (4500 meter limit), hang gliding, parachuting,  bungee jumping, water skiing, snow skiing, snowmobiling, and snow boarding.

Emergency Dental Treatment:  

Benefits are paid for Reasonable and Customary expenses up to the maximum shown on the Schedule of Benefits for repair or replacement to sound, natural teeth damaged as a result of an Accident.

Emergency Medical Evacuation and Medically Necessary Repatriation:

Benefits are paid for Eligible Expenses incurred up to the maximum shown in the Schedule of Benefits, if Injury or Illness commences during the Term of Protection results in Your Medically Necessary Emergency Medical Evacuation or Repatriation.  The decision for an Emergency Medical Evacuation or Repatriation must be pre-approved and arranged by the Assistance Company in consultation with Your local attending Physician.

Emergency Medical Evacuation or Repatriation means: a) Your medical condition warrants immediate transportation from the place where You are located (due to inadequate medical facilities) to the nearest adequate medical facility where medical treatment can be obtained; or b) after being treated at a local medical facility as a result of a Medical Evacuation, Your medical condition warrants transportation with a qualified medical attendant to Your Home Country to obtain further medical treatment or to recover; or c) both a) and b) above.

Eligible Expenses are expenses for transportation, medical services and medical supplies necessarily incurred in connection with Your Emergency Medical Evacuation or Repatriation.  All transportation arrangements must be by the most direct and economical route. These Eligible Expenses must be: a) pre-approved and ordered by the Assistance Company and b) required by the standard regulations of the conveyance transporting You.  Transportation means any land, water or air conveyance required to transport You and includes, but is not limited to, licensed ground and air ambulances, commercial airlines, and private motor vehicles.

Return of Mortal Remains: 

Benefits will be paid for the reasonable Eligible Expenses incurred up to the maximum as stated in the Schedule of Benefits, to return Your remains to Your current Home Country, if You die. Eligible Expenses include, but are not limited to, expenses for embalming, or cremation, a minimally necessary container appropriate  for transportation, shipping costs, and the necessary government authorizations.  All Eligible Expenses in connection with a Return of Mortal Remains or cremation must be pre-approved and arranged by the Assistance Company.

Emergency Medical Reunion: 

When You are eligible for an Emergency Medical Evacuation under this Plan and the Assistance Company and the attending Physician determine that it is necessary and prudent for one individual selected by You from Your current Home Country to be brought to where You are hospitalized and accompany You during Your return to Your current Home Country, benefits will be paid for the round trip economy-class transportation arranged by the Assistance Company.  The benefits payable will include:  All transportation in connection with an Emergency Medical Reunion, which must be pre-approved and arranged by the Assistance Company.

Return of Minor Child(ren):  

Should You be traveling alone and are hospitalized because of an Illness or Injury and Your Minor Child(ren) is left unattended, the Assistance Company will arrange and benefits will be paid for one way economy fares to their current Home Country. Meals and lodging are Your responsibility. If an attendant/escort is necessary to insure the safety and welfare of the Minor Child(ren), the Assistance  Company will arrange and benefits will be paid for these services up to the maximum shown on the Schedule of Benefits. All transportation in connection with a Return of Minor Child(ren) must be pre-approved and arranged by the Assistance Company.

Interruption of Trip: 

If You interrupt Your trip due to one of the following reasons:
  1. Death of Your Family Member; or
  2. Your home made uninhabitable by fire or flood.
Benefits will be paid up to the maximum stated in the Schedule of Benefits, for the cost of reasonable, additional transportation expenses for the cost of economy travel, less the value of applied credit from an unused return travel ticket, needed to reach Your return destination.

Loss of Checked Luggage: 

Benefits will be paid up to the maximum shown in the Schedule of Benefits, for loss, theft or damage to baggage and personal effects, checked with a Common Carrier provided You have taken all reasonable measures to protect, save and/or recover Your property at all times. There will be a per article limit of $50. 

Accidental Death and Dismemberment:

Benefits shall be paid up to the maximum noted on the Schedule of Benefits if You sustain an Accidental Injury.  The Injury must:
  1. Occur during Your Term of Protection; and
  2. Occur within 60 days after the date of Accident causing such Loss.
Benefits payable for any such Loss shall be according to the Table of Losses noted below, as applicable to Your loss and if You incur more than one loss as the result of one Accident, only the largest of the amounts stated in the Schedule of Benefits shall be payable.
Principal Sum     Description of Loss (for Loss of)
100%     Life
100%     Both Hands or Both Feet or Sight of Both Eyes
100%     One Hand and One Foot
100%     Either Hand or Foot and Sight of One Eye
50%     Either Hand or Foot
50%     Sight of One Eye
100%     Quadriplegia
75%     Paraplegia (total paralysis of both lower limbs)
50%     Hemiplegia (total paralysis of upper and lower limbs of one side of the body)
25%     Uniplegia (total paralysis of one limb)

Excess Benefits:  

All benefits, except Accidental Death and Dismemberment, shall be in excess of all other valid and collectible Insurance or other Indemnity and shall apply only when such benefits are exhausted.  Other valid and collectable Insurance or other Indemnity for which benefits  may be payable are Insurance programs provided by:
  1. Individual, group or blanket Insurance or coverage;
  2. Other prepayment coverage provided on a group or individual basis;
  3. Any coverage under labor management trustee plans, union welfare plans, employer organizational plans, employee benefit organization plans, or other arrangement of benefits for individuals of a group;
  4. Any coverage required or provided by any statue, socialized Insurance program;
  5. Any no-fault automobile Insurance;
  6.  Any third party liability Insurance.

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Secure STM is the brand name used for products underwritten and issued by
Standard Security Life Insurance Company of New York
Rated A (Excellent) by A.M. Best Reports


License #'s: for Lewis Fink, agent, CA: OC38446 MT: 29724 F00-0283-LC 

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