Visitors Health Insurance

Patriot International Insurance

Patriot International Insurance - Buy Online

Patriot International Insurance provides comprehensive accidental health and medical sickness coverage for U.S. citizens traveling abroad (outside the United States) for a minimum of 5 days up to a maximum of two years. Patriot International Insurance is an excellent international travel insurance plan and if the plan is purchased for a minimum of three months, coverage may be renewed (without break in coverage) for a total of up to two years.

Patriot International Insurance - Plan Highlights

Patriot International Insurance provides coverage for US citizens traveling abroad for a minimum of 10 days up to a maximum of one year. Patriot International Insurance is an excellent international travel insurance plan.

Policy Maximum	Patriot International Insurance plan offers benefit maximums of US$50,000, US$100,000, US$500,000, US$1,000,000 or US$2,000,000 for the life of the plan.
Deductible	US$0, US$100, US$250, US$500, US$500, US$1000 or US$2500 deductible per period of coverage.
Co-insurance	No co-insurance outside US and Canada. For treatment within US and Canada, plan pays 90% within PPO network and 80% out of PPO network up to $5000 expense and 100% afterwards up to policy maximum.
Eligibility	Available for US citizens traveling outside the United States
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
Plan Life	Minimum of 5 days to a maximum of 2 years
Underwriter	Underwritten by Sirius International Insurance Corporation, a White Mountains Insurance Group company.
Quote - Online	Get instant online quote for Patriot International Insurance
Buy - Online	Apply & purchase online Patriot International Insurance
Application Form	Complete, mail/fax the Patriot International Insurance Paper Application along with payment
Claims Form	Download Patriot International Insurance Claims form.
Renewability	Online Renewal (without break in coverage) for a total of up to two years is available when plan is purchased for at least 3 months initially

Patriot International Insurance - Plan Details

Patriot International^SM provides coverage for US citizens traveling abroad for a minimum of 10 days up to a maximum of one year.

Although the Patriot International Plan is not renewable, it can be rewritten for succeeding or subsequent coverage periods. New Deductible, Coinsurance, Eligibility, Conditions of Coverage and Pre-Existing Condition Exclusions apply to any succeeding or subsequent Period of Coverage. A new application also must be completed.

If you are a US citizen traveling for three (3) months or more and under age 70, please review the ExPatriot Plus® plan, which offers a 10% discount on rates and is renewable for up to two years.

ONE MONTH RATES (five Policy Maximum options)
	Option 5	Option 6	Option 7	Option 8	Option 9
	$50,000	$100,000	$500,000	$1,000,000	$2,000,000
AGE	One Month	One Month	One Month	One Month	One Month
18-29	$36	$42	$48	$54	$60
30-39	$42	$48	$64	$70	$80
40-49	$66	$74	$82	$90	$110
50-59	$106	$122	$136	$152	$170
60-64	$122	$144	$170	$200	$224
65-69	$144	$154	$176	$210	$270
70-79	$210	N/A	N/A	N/A	N/A
80+*	$420	N/A	N/A	N/A	N/A
DEP. CHILD	$20	$26	$30	$32	$38
CHILD ALONE	$36	$40	$46	$50	$58
*US$10,000 limit

DAILY RATES (MINIMUM COVERAGE IS 10 DAYS)
	Option 5	Option 6	Option 7	Option 8	Option 9
	$50,000	$100,000	$500,000	$1,000,000	$2,000,000
AGE	Daily	Daily	Daily	Daily	Daily
18-29	$1.20	$1.40	$1.60	$1.80	$2.00
30-39	$1.40	$1.60	$2.15	$2.35	$2.70
40-49	$2.20	$2.50	$2.75	$3.00	$3.70
50-59	$3.55	$4.10	$4.55	$5.10	$5.70
60-64	$4.10	$4.80	$5.70	$6.70	$7.50
65-69	$4.80	$5.15	$5.90	$7.00	$9.00
70-79	$7.00	N/A	N/A	N/A	N/A
80+*	$14.00	N/A	N/A	N/A	N/A
DEP. CHILD	$0.70	$0.90	$1.00	$1.10	$1.30
CHILD ALONE	$1.20	$1.35	$1.55	$1.70	$1.95
*US$10,000 limit

All premium rates are in US dollars and are effective through 12/31/2004. Rates include 2.5% surplus lines tax. A dependent child is your child shown on the Application Form over 14 days and under 18 years of age, traveling with you, and for whom premium has been paid.

Refund of Premium

IMG will refund premium only if a written request is received prior to the certificate's effective date. The premium is non-refundable after that date.

Precertification, Emergency Evacuation and Repatriation

For precertification, emergency evacuation and repatriation please call IMG in the U.S. 1-800-628-4664 (toll free) or 1-317-655-4500. Call IMG outside the US: 001-317-655-4500 (collect if necessary). This information will also be provided on your ID card.

IMG must be notified prior to treatment or within 48 hours of an emergency.

To Report Claims

Please mail completed claim forms to International Medical Group, 407 Fulton Street, Indianapolis, IN 46202 USA. All IMG contact numbers, claim forms and Policy Wordings will be included in the fulfillment kit. IMG may also be contacted by fax: 317-655-4505 or email: insurance@imglobal.com.

This web page contains only a consolidated and summary description of all current Patriot Travel Medical Insurance benefits, conditions, limitations and exclusions. A certificate containing the complete Policy Wording with all terms, conditions and exclusions will be included with the fulfillment kit. IMG reserves the right to issue the most current Policy Wording for this insurance plan in the event this application and/or brochure has expired, is modified, or is replaced with a newer version. Current Policy Wordings are available upon request.

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