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Patriot Exchange Program


Plan Summary


Patriot Exchange Program SM is specifically designed for International Educational or Cultural Exchange market. There are numerous organizations that focus on international educational or cultural exchange programs and now you have the perfect product for those groups. Exchange Program Group offers three different plans to provide a wide range of benefits to group members and their dependants traveling with them. Patriot Exchange Insurance satisfies J Visa insurance.

Policy Maximum Patriot Exchange Program plan offers benefit maximums of US$50,000, US$250,000 or US$500,000 per illness or injury with lifetime maximum of US$500,000.
Deductible US$100 deductible per illness or injury.
Co-insurance Plan will pay 100% of the covered amount.
Eligibility - The member must be actively engaged or participating in an educational or cultural exchange program in the country of assignment through a sponsoring organization or school. - The member and his/her travelling dependents must have legally departed the Home Country and must not be a citizen of the Host Country.
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 Sirius International Insurance Corporation, Sirius International is a White Mountains Insurance Group company.
Buy - Online Apply & purchase online Patriot Exchange Program
Brochure Complete, mail/fax the Patriot Exchange Program Brochure along with payment


Patriot Exchange ProgramSM


Plan Benefits


The short term plans are purchased for a minimum of 3 months, coverage may be renewed (without break in coverage) for a total of up to two years. You can also include coverage for the student or participant, his or her spouse and unmarried dependent children travelling with them.

Schedule of Benefits Benefit Description
Plan Maximum Choice of US$50,000, US$250,000 or US$500,000 per illness or injury with a lifetime maximum of US$500,000
Deductible $100 per illness or injury
Coinsurance 100%
Accidental Death & Dismemberment (AD&D) $25,000
Emergency Medical Evacuation $50,000
Repatriation of Remains $25,000
Sudden Recurrence of a Pre-existing Condition (U.S. citizens)
Medical
Emergency Medical Evacuation

Up to US$5,000 of eligible expenses
Up to US$25,000 of eligible costs and expenses
Dental
Injury due to accident
Sudden & unexpected pain

$500
$350
Emergency Reunion $15,000
Terrorism Coverage Up to US$50,000 lifetime maximum
Optional Add-on Benefits
Personal liability
Injury to third party
Damage to third person property
$2,000 limit after US$100 deductible
$500 limit after US$100 deductible. Secondary to any other insurance in force
Baggage
Loss / theft of Baggage
Loss / theft of Valuables
Loss / theft of Personal Papers

$250
$250
$250
Legal Assistance
Binder Fee
$500 when served with summons

Plan Exclusions


Charges for the following services, treatments and/or conditions, among others, are excluded from coverage under the Patriot Exchange Program.

  1. A pre-existing condition is defined as any injury, illness, sickness, disease, or other physical, medical, mental or nervous condition, disorder or ailment that, with reasonable medical certainty, existed at the time of application or at any time during the three years prior to the effective date of the insurance, whether or not previously manifested or symptomatic, diagnosed, treated, or disclosed prior to the effective date, including any subsequent, chronic or recurring complications or consequences related thereto or arising therefrom.
  2. Treatment or surgeries which are elective, investigational, experimental or for research purposes.
  3. War, military action, terrorism, political insurrection, protest, or any act thereof. The Company will not pay for a Political Evacuation if there is a travel advisory in effect on or within six (6) months prior to the Insured Person's date of arrival in the Host Country.
  4. Immunizations and routine physical exams.
  5. Treatment of Temporomandibular Joint or dental treatment, except as expressly provided for in the certificate of insurance.
  6. Venereal disease, AIDS virus, AIDS related illness, ARC Syndrome, or AIDS, and the cost of testing for these conditions, and charges for treatment or surgeries which are incurred by any Insured who was HIV+ at time of enrollment into this insurance.
  7. Pregnancy, childbirth, birth control, artificial insemination, treatment for infertility or impotency, sterilization or reversal thereof, or abortion.
  8. Injury sustained while participating in amateur or professional sports or other athletic activity which is organized and/or sanctioned, or which involves regular or scheduled practices, games or competition. The following hazardous activities are excluded: racing of any kind, aviation (except when traveling as a passenger in a commercial aircraft), BMX, BASE jumping, bobsleigh, bungee jumping, canyoning, caving, high diving, hang gliding, heli-skiing, hot air ballooning, inline skating, jet skiing, kayaking, luge, motocross (moto-x), mountain biking, mountaineering, parachuting, rappelling, rock climbing, rodeo, scuba diving, ski jumping, sky diving, snow skiing, snowboarding, snowmobiling, spelunking, snorkeling, surfing, wakeboarding, water skiing, wind-surfing and whitewater rafting.
  9. Vision or ear tests and the provision of visual or hearing aids.
  10. Vocational, recreational, speech or music therapy.
  11. Treatment while confined primarily to receive custodial care, educational or rehabilitative care, or nursing services.
  12. Charges, injuries and/or illnesses resulting or arising from or occurring during the commission or continuing perpetration of a violation of law by the insured, including without limitation, the engaging in an illegal occupation or act, but excluding minor traffic violations.
  13. Treatment for, and injuries and/or illnesses resulting or arising from, substance abuse or drug addiction.
  14. Injury and/or illness resulting or arising from being under the influence of alcohol or drugs; and injury or illness resulting from operating any type of vehicle after consuming any alcohol or drugs.
  15. Willful self-inflicted injury or illness.
  16. Treatment required as a result of or arising from complications from a treatment or condition not covered under the certificate.
  17. Any services or supplies performed or provided by a relative of the Insured or provided at no cost to Insured.
  18. Treatment for mental and nervous disorders.
  19. Organ or tissue transplants or related services.
  20. Illness or injury where the trip to the host country is undertaken for treatment or advice for such Illness or injury, except as expressly provided for in the certificate of insurance.
  21. Treatment incurred as a result of or arising from exposure to nuclear radiation, and/or radioactive material(s).
  22. Charges for Treatment of a Chronic Illness incurred beyond sixty (60) days from the date of initial Treatment thereof.


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