| Insurance Providers |
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| Coinsurance |
In-network: The plan pays 100%
Out-of-network: IMG pays 80% up to $5,000, then 100% |
Plan pays 100% of eligible expenses after the deductible up to the overall maximum limit |
The plan pays 100% up to the overall maximum limit |
| Length of Coverage |
5 days up to 12 months - renewable up to 24 months |
Minimum : 5 days
Maximum : 364 days |
5 days to maximum of 1 year, Renewable up to 2 years |
| Renewability |
Yes : Up to 24 months |
Yes : Up to 364 days |
Yes : Up to 24 months |
| Medical Benefits |
| Hospital room and board |
Average semi-private room rate, including nursing services |
Average semi-private room rate, including nursing services. |
The average semi private room rate |
| Intensive care unit |
Up to the overall maximum limit |
Up to the overall maximum limit |
Three times the average semi private room rate |
| Hospital indemnity |
$250 per overnight inpatient confinement, maximum limit of 10 overnights. Not subject to deductible |
$100 per day of inpatient hospitalization (not subject to deductible or coinsurance). |
$50 per night up to a maximum of $500 per Policy Period |
| Urgent Care Clinic |
$30 per Incident, if the $0 out of Network Deductible is chosen, there is no Co-Pay |
Claims incurred in the U.S.
Up to $15 co-payment. (co-payment is waived for members with a $0 deductible)
Claims incurred outside the U.S. - No co-payment. |
$30 per Incident, if the $0 out of Network Deductible is chosen, there is no Co-Pay |
| Emergency Services |
| Emergency local ambulance |
Covered |
Usual, reasonable and customary charges when covered illness or injury results in hospitalization as inpatient. |
Covered |
| Hospital emergency room |
Outside the U.S: Up to the maximum limit
Inside the U.S: Subject to a $250 deductible for each emergency room visit for treatment that does not result in direct inpatient hospital admission. Up to the maximum limit |
Outside the U.S: No co-payment.
Inside the U.S: Up to $200 co-payment for each use of emergency room for an illness unless you are admitted to the hospital. (no co-payment for emergency room treatment of an injury) |
Outside the U.S: No co-payment.
Inside the U.S: Up to $200 co-payment for each use of emergency room for an illness unless you are admitted to the hospital. (no co-payment for emergency room treatment of an injury) |
| Dental |
| Emergency dental treatment |
$300 maximum limit due to accident or unexpected pain to sound natural teeth |
Up to $300 (not subject to deductible or coinsurance). |
$250 per Policy Period |
| Acute Onset of Pre-Existing Condition |
| Acute Onset of Pre-Existing Conditions |
Patriot America Lite: Not Covered
Under 70 years of age,with varying limits by age up to $1,000,000. $25,000 maximum limit for medical evacuation.
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Under 80 years of age,covers up to overall maximum limit. covers up to $25,000 lifetime maximum (excludes chronic and congenital conditions) |
For ages up to and including 69 the limit is up to the Medical Policy Maximum purchased per Period of Coverage except for any coverage related to cardiac disease or cardiac conditions, which will be limited to $25K up to and including age 69, with a $25K Maximum Lifetime Limit for Emergency Medical Evacuation. |
| Life |
| AD&D |
$50,000 principal sum. |
Members under age 18: Up to $5,000 lifetime maximum.
Members age 18-69: Up to $25,000 lifetime maximum.
Members age 70-74: Up to $12,500 lifetime maximum.
Members age 75 and older: Up to $6,250 lifetime maximum.
$250,000 maximum benefit any one family or group.
Accidental death & dismemberment buy up: $25,000 |
$25,000 |
| Common carrier AD&D |
$25,000 per insured child, $100,000 per insured adult, $250,000 maximum limit per family. Not subject to deductible |
Up to $50,000 for ages 18 through 69
Up to $10,000 under age 18
Up to $25,000 for ages 70 through 74
Up to $12,500 for ages 75 and older
Maximum of $250,000 for any one family or group. |
Not Covered |
| Evacuation |
| Emergency medical evacuation |
Up to the Maximum Limit |
$1,000,000 lifetime maximum, except as provided under acute onset of pre-existing condition. |
100% up to $2,000,000 |
| Emergency reunion |
$100,000 maximum limit. Not subject to deductible |
Up to $100,000, maximum of 15 days (not subject to deductible or coinsurance) |
$15,000 |
| Return of mortal remains or cremation/burial |
Up to the maximum limit for return of mortal remains or ashes to country of residence, or $5,000 maximum limit for cremation or local burial at the place of death. Not subject to deductible |
Equal to the elected overall maximum limit - not subject to deductible or coinsurance or subject to the overall maximum limit. |
100% up to $50,000 |
| Return of minor children |
$100,000 maximum limit. Not subject to deductible |
Up to $50,000 (not subject to deductible or coinsurance). |
$5,000 |
| Political evacuation and repatriation |
$100,000 maximum limit. Not subject to deductible |
Up to $100,000 lifetime maximum (not subject to deductible or coinsurance). |
$25,000 |
| Natural disaster evacuation |
$25,000 maximum limit. Not subject to deductible (Must be approved in advance by the company) |
Up to $250 a day for 5 days (not subject to deductible or coinsurance). |
$25,000 maximum limit |
| Trip interruption |
Up to $10,000 (not subject to deductible or coinsurance). |
Up to $10,000 (not subject to deductible or coinsurance). |
$5,000 (Per Policy Period does not cover lost trip cost) |
| Unique Advantages |
- Optional coverage for adventure sports with purchase of the rider.
- It is a comprehensive benefit plan.
- Optional coverage for Enhanced AD&D rider.
- Plan can be renewed up to two years, if plan is purchased for a minimum of 1 month.
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- Atlas America Insurance is designed for travelers on H1B/H4 visa holders or students on OPT status.
- Covers treatment of complications of pregnancy during the first 26 weeks of pregnancy.
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- 80% of the first $5,000 of eligible expenses then 100% up to the policy maximum
- Covers doctor visits, x-rays, prescriptions, hospital, surgery, ambulance
- Emergency medical treatment of pregnancy up to $1,000
- Mental or nervous disorders up to $2,500
- Physiotherapy/Chiropractic $50 per visit per day up to 10 visits
- Dental treatment - for injury or emergency alleviation of pain $250
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| Travel Insurance |
| Underwriter |
Sirius International Insurance |
Lloyds, London. |
Crum and Froster SPC |
| Rating |
"A" (Excellent) |
A++ (Superior)
Standard & Poor’s Rating: AA- |
"A" (Excellent) |
| Brochure and Details |
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