International Health Insurance : Coverage Detail
You may access information about the program, by clicking the links below:
Health & Benefit Summary
Deductible Options
Optional Dental Coverage
Optional Accidental Death Coverage
Optional War & Terrorism
Exclusions
Additional Policy Information
Maximum Lifetime Benefit |
$5,000,000 per individual |
|
Co-insurance (after deductible) |
100% Outside U.S. & Canada |
|
|
100% inside U.S. PPN |
|
|
80% outside U.S. PPN |
|
Maximum Out-of-Pocket |
$1,000 per individual / year |
|
(after deductible) |
$3,000 per family / year |
Summary of Benefits
- Hospitalization, physician, surgeon and specialist fees.
- Annual Physical Examination up to $150. per person.
- Out-patient prescription drugs.
- Medical Emergency Transportation, Local Emergency Transportation, Emergency Family Reunion are covered expenses under GlobalCare. All emergency transportation must be pre-approved by the Assistance Company.
- Basic benefit coverage subject to a 20% co-payment. Maximum out-of-pocket co-payment expense of $1,000 of eligible expenses.
- Hospital charges (semi-private room), including drugs, medical supplies and dressings.
- Coverage for sexually transmitted diseases, including HIV or AIDS, are included up to $50,000 maximum lifetime, subject to pre-existing condition limitations.
- Comprehensive diagnostic and evaluation services.
- Emergency dental treatment and dental procedures necessary to restore natural teeth lost or damaged in an accident.
- Pregnancies are covered at 75% only after ten months of continuous coverage, same as any other illness.
- Chiropractor and physical therapy benefits (limited).
- Psychiatric care and substance abuse (limited).
- Incidental home country coverage for medical emergency situations first manifested while visiting your home country. This coverage is limited to 30 days per any six-month period of coverage and commences after six months of continuous coverage.
Deductible Options
Deductibles are stated on a calendar year basis. All plans carry a $250 deductible per hospital admission outside of the PPN.
Per Individual |
Family Maximum / Per Year |
|
$250 |
$750 |
|
$500 |
$1500 |
|
$750 |
$2250 |
|
$1000 |
$3000 |
|
$2500 |
$7500 |
|
$5000 |
$15000 |
Optional Dental Coverage
In addition to medical coverage, GlobalCare offers an optional annual policy to cover dental expenses. If dental insurance is selected, coverage for all family members is required.
Policy Term Deductible |
$100 |
|
Maximum Benefit |
$1000 |
|
Preventative |
100% (no deductible) |
|
Basic Restorative |
80% (after deductible) |
|
Major Restorative |
50% (after deductible)* |
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*Covered after 18 months of continuous coverage. |
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Age |
Monthly Premium |
|
0 - 4 |
no charge |
|
5 - 14 |
$13.50 |
|
15 - 65 |
$29.25 |
|
Optional Accidental Death & Dismemberment (AD&D) Coverage
Our program offers enrollees with an optional extension of coverage that provides a financial sum should an accident or serious injury occur. AD&D coverage is available on an individual basis for those age 19 and older.
Ages |
Insured Sum |
Annual Premium |
>19 - 65 |
$100,000 |
$100 |
66 - 69 |
$50,000 |
$50 |
Rates may be subject to change. Coverage for dependents residing in home country may be rated separately.
Optional War & Terrorism Coverage
This unique policy enhancement extends your policy to provide medical coverage for illness or injury that is caused by an act of war and terrorism. This coverage is available in most countries throughout the world. If War & Terrorism is selected, coverage for all family members is required. Due to underwriting restrictions, there are some countries where war and terrorism extension is not available
Annual Premium
Additional 15% of Total Medical Premium
Exclusions
GlobalCare does not cover losses connected with any of the following conditions or events:
- All costs incurred in home country, Canada or in the U.S. unless covered under Incidental Home Country coverage, GlobalCare America, or GlobalCare Plus;
- Bodily injury sustained while engaged in a hazardous occupation such as flying, ballooning, hang-gliding, parachuting, mountain climbing, sky diving, racing, piloting an aircraft;
- Bodily injury sustained while under the influence of intoxicating liquor or drugs and due directly or indirectly to the state of intoxication;
- Self-inflicted injury, illness or attempted suicide;
- War, civil war, riots, civil unrest or voluntary participation in committing or attempting to commit a crime;
- The first $250 of eligible expenses per policy term; maximum of $750 per family, per policy term. Optional deductible applies if taken;
- Any pre-existing condition until the insured person has maintained coverage continuously for at least 18 months;
- Routine medical examinations or treatment including eye and ear examinations, vaccinations, inoculations, medical certificates, or any elective treatment or surgery, except as provided herein;
- Any maternity-related expenses in the first 10 months of coverage;
- Prescription drugs, unless following an accident or
sudden illness covered under this policy.
Additional Policy Information
This page provides a brief description of the GlobalCare programs. Therefore, the international health insurance coverages and the principal exclusions listed herein must be regarded only as an outline. A complete description of this program is contained in the policy which is the legal document and as such defines the insurance in precise terms.
To obtain a copy of the policy or for any additional information on the program, please contact Clements International at info@clements.com or 1.202.872.0060.
NOTE: The information above pertains to all GlobalCare policies with an effective date of March 1, 2007 or later. For information on all other polices, please contact Clements International at 1.800.872.0067 or 1.202.872.0060.