Benefits | Coverage |
Emergency Medical & Hospitalization | $50,000 |
Hospitalization/ Room & Board | 100% |
Inpatient Surgery/ Hospital Facility | 100% |
Outpatient Surgery/ Hospital Facility | 100% |
Surgeon | 100% |
Pre-admission Testing | 100% |
Anesthesia/ Anesthesiologist | 100% |
Physician Visits Inpatient or Outpatient | 100% |
Physician Specialists Visits | 100% |
Urgent Care Visits | 100% |
Laboratory, Radiology & X-ray | 100% |
Outpatient Prescription Drugs | 100% |
Emergency Local Ambulance | 100% |
Outpatient Physical Therapy/ Chiropractor | $2,500 |
Emergency Dental | $500 |
Deductible | $0 |
Co-Insurance | 100% |
Emergency Medical Evacuation/ Repatriation | $150,000 (per evacuation) |
Accompaniment | $6,000 ($300/day) |
Continuation | 100% |
Repatriation of Mortal Remains, Cremation or Local Burial | $20,000 |
24/7 Emergency Assistance | Included |