Global Citizen Insurance

Global Citizen Plan Summary

Global Citizen Insurance is an ideal worldwide long term major medical health insurance policy. Global Citizen Insurance works very well for international citizens living in the United States who want to retain their insurance coverage when they move around the globe. Global Citizen Insurance is an annual, renewable policy that includes comprehensive, major medical coverage inside and outside the U.S.

Policy Maximum	Global Citizen Insurance plan has a US$5,000,000 lifetime maximum and a $100,000 maximum benefit for medical evacuation.
Deductible	Deductibles range between US$0 and US$25,000.
Co-insurance	Plan will pay 100% of the covered amount.
Eligibility	- All U.S. citizen living aboard who are 74 or younger at the time of application are eligible to apply for the coverage. - All U.S. residents (citizens and foreign nationals) residing in an approved state 74 years or younger at the time of application.
Pre-Existing Condition Coverage	- Benefits are not available for any services received: (1) on or within 6 months after the eligibility date of an insured person who is not a late enrollee; or (2) on or within 6 months after the effective date of coverage for a late enrollee.
Pre-Existing Condition Definition	- Pre-existing condition means a medical condition for which medical advice, diagnosis, care, or treatment was recommended or received during the 6 months immediately preceding the eligibilty date.
Coverage	- Hospital Room and Board - Hospital intensive care unit charges - Physician visits, surgeon, Private duty nurse fee	- Pre-admission tests - Diagnostics: X-Rays - Hospital emergency room - Prescription Drugs
Underwriter	Underwritten by HM Life Insurance Company.
Buy - Online	Apply & purchase online Global Citizen Insurance
Brochure	Complete, mail/fax the Global Citizen Insurance Brochure along with payment

Global Citizen Health Plan Benefits

Features

Outside U.S.

U.S.(In Network)

U.S.(Outside Network)

Lifetime Maximum per Insured Person

$5,000,000

Preventive and Office Visits

Insurer Waives Deductible

Physician Office Visits (Adult)

All except a $10 copay per visit¹

All except a $30 copay per visit

60% to Out-of-Pocket Maximum then 100%

Physician Office Visits (Children 0-18)

100%

80% to Out-of-Pocket Maximum then 100%

60% to Out-of-Pocket Maximum then 100%

Immunizations, Lab work & X-rays

100%

80% to Out-of-Pocket Maximum then 100%

60% to Out-of-Pocket Maximum then 100%

Women: (25 and Older)
Routine Pap Smears, annual mammogram

100%

80% to Out-of-Pocket Maximum then 100%

60% to Out-of-Pocket Maximum then 100%

PSA for Men

100%

80% to Out-of-Pocket Maximum then 100%

60% to Out-of-Pocket Maximum then 100%

Professional Services

Insurer Pays After Deductible is Met

Surgery, anesthesia, radiation therapy, in-hospital doctor visits, diagnostic X-ray and lab work.

100%

80% to Out-of-Pocket Maximum then 100%

60% to Out-of-Pocket Maximum then 100%

Maternity

100%

80% to Out-of-Pocket Maximum then 100%

60% to Out-of-Pocket Maximum then 100%

Inpatient Hospital Services

Insurer Pays After Deductible is Met

Surgery, X-rays, in-hospital doctor visits, Organ/Tissue Transplant

100%

80% to Out-of-Pocket Maximum then 100%

60% to Out-of-Pocket Maximum then 100%

In-patient medical emergency⁶

100%

80% to Out-of-Pocket Maximum then 100%

60% to Out-of-Pocket Maximum then 100%

Ambulatory and Therapeutic Services

Insurer Pays After Deductible is Met

Ambulatory Surgical Center

100%

80% to Out-of-Pocket Maximum then 100%

60% to Out-of-Pocket Maximum then 100%

Ambulance Service

100%

80% to Out-of-Pocket Maximum then 100%

60% to Out-of-Pocket Maximum then 100%

Accidental Dental

$1,000 per year, $200 per tooth

Acupuncture and Chiropractic Services

100% up to $2000

Durable Medical Equipment

100%

80% to Out-of-Pocket Maximum then 100%

60% to Out-of-Pocket Maximum then 100%

Infusion Therapy

100%

80% to Out-of-Pocket Maximum then 100%

60% to Out-of-Pocket Maximum then 100%

Physical/Occupational Therapy

$30/visit, 12 visits per year

Basic Prescription Drug Benefit

50% of actual charges up to $500

Optional Prescription Drug Benefit

Insurer Waives Deductible

Subject to $5,000 Maximum Benefit per Insured Person per Policy Period.

100% of actual charges

Generics: 100% after $10 copay
Brandname: 100% after $25 copay
Injectables: 70%

Global Travel Benefits

Insurer Pays Without a Deductible

Medical Evacuation

Up to $100,000

n/a

Repatriation of Remains

Up to $25,000

n/a

Accidental Death and Dismemberment

$50,000

Global Citizen Plan ^1,2,3,4,5	Deductible			Out-of-Pocket Maximum
Global Citizen Plan ^1,2,3,4,5	Outside U.S.	U.S.in Network	U.S.out of Network	Out-of-Pocket Maximum
Elite	$0	$0	$1,000	$2,000
500	$250	$500	$1,000	$3,000
1,000	$500	$1,000	$2,000	$4,000
2,000	$1,000	$2,000	$4,000	$8,000
5,000	$2,500	$5,000	$10,000	$10,000
1. Copay waived when visiting an HTH Worldwide contracted provider. 2. Deductibles are Per Person per Policy Period. 3. Out of Pocket Maximums exclude the Deductible. 4. Amounts paid to satisfy a deductible are credited to all other deductibles, both inside and outside the U.S. For example, if you satisfy your Outside U.S. deductible, this amount is credited to the U.S. (In Network) and U.S. (Outside Network) deductible requirement. 5. An Insured Person only has to satisfy his/her Out of Pocket Maximum once a Year for all services received outside of the U.S. and in the U.S. 6. Emergency room visits that do not result in inpatient admissions will be subject to a $50 penalty
Participating and Non-Participating Providers			Inpatient Benefit	Outpatient Benefit
Mental Health			100% up to 20 days per year	80% up to 30 visits per year
Substance Abuse			100% up to 12 days of detox	80% up to 30 visits per year

Services provided in addition to the benefits above

Ready access to quality care

Access to HTH Worldwide's global community of carefully selected, contracted hospitals, physicians, dentists and behavioral health professionals in over 160 countries.
Detailed provider profiles including medical training.
Personalized appointment scheduling and recruitment.
Direct payment to providers.
Fully profiled international treatment options.
Competitive U.S. PPO network and centers of excellence.
Emergency evacuation.

HTH Global Health and Safety Resources

Online assistance tools with full telephone support.
Daily email of health and security alerts
Detailed descriptions of health facilities and security issues by destination
Translation databases for brand name drugs and medical terms/phrases.
Web pages capturing key personalized HTH Resources by destination.

Ten Day Money Back Guarantee

YOUR SATISFACTION IS GUARANTEED. We are so confident in our products that we offer the best guarantee in the business! If you are not completely satisfied with our Global Citizen Product, simply return your Certificate of Insurance and your ID Card to HTH within 10 days of receipt and include a letter indicating your desire to cancel. If you have not already used your insurance benefits, you will receive a full refund.