Plan Administrator: International Medical Group | AM Best Rating: A "Excellent" | Underwriter: Sirius International
Complete details are given in certificate of insurance.
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Age and Policy Maximum |
Through age 65: $50,000, $100,000, $500,000 or $1,000,000 Ages 65 to 69: $50,000 or $100,000 Ages 70 to 79: $50,000 Ages 80 and older: $10,000 |
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Doctor Visit |
In-Network 100%. Out-of-Network 80%. International 100% |
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Urgent Care |
$25 co-pay. Co-pay is not applicable when the $0 deductible is selected. Not subject to deductible In-Network 100%. Out-of-Network 80%. International 100% |
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Hospital Room and Board |
Injury not subject to emergency room deductible, Illness: Subject to a $250 deductible for each emergency room visit for treatment that does not result in direct inpatient hospital admission. In-Network 100%. Out-of-Network 80%. International N/A |
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Ambulance |
In-Network 100%. Out-of-Network 80%. International 100% |
Complete details are given in certificate of insurance.
Complete details are given in certificate of insurance.
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Acute Onset of Pre-existing Conditions Subject to Deductible and Coinsurance unless otherwise noted Eligible Medical Expenses are limited to Usual, Reasonable and Customary Limits per Period of Coverage unless stated as Maximum Limit |
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Acute Onset of Pre-existing Conditions · Insured Person must be under 70 years of age · Refer to the ACUTE ONSET OF PRE- EXISTING CONDITIONS provision for further details and requirements |
Up to the Period of Coverage limit |
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Emergency Medical Evacuation ·Arises or results directly from a covered Acute Onset of a Pre-existing Condition ·Insured Person must be under 70 years of age |
Maximum Limit: $25,000 |
PPO Providers are contracted separately through United States Preferred Provider Organization.
https://providerlocator.firsthealth.com/LocateProvider/SelectNetworkType
Complete details are given in certificate of insurance
Subject to the Terms of the TERMINATION OF MASTER POLICY and TERMINATION OF COVERAGE FOR INSURED PERSONS subparagraphs of the CONDITIONS AND GENERAL PROVISIONS, an Insured Person can request coverage under this insurance plan to be extended a minimum of five (5) days for up to a three hundred sixty-five (365) day period until reaching a maximum of twenty-four (24) continuous months in accordance with and subject to the Terms of the plan then in effect (including the Terms of the then applicable Master Policy) and so long as extension Premium is paid when due and the Insured Person otherwise continues to meet the applicable eligibility requirements of the plan.
Complete details are given in certificate of insurance
The Insured Person shall have three (3) days from the Initial Effective Date of Coverage (the “Review Period”) to review the benefits, conditions, limitations, exclusions and all other Terms of the Master Policy as evidenced and outlined by this Certificate. If not completely satisfied, the Insured Person may request cancellation of this insurance retroactive to the Initial Effective Date of Coverage by sending a written request to the Company by email, mail or fax and received by the Company within the Review Period, thereby qualifying to receive a full refund of Premium paid. Upon effectuation of such cancellation and refund, neither the Company nor the Insured Person shall have any further rights, liabilities or obligations under this insurance. After the Review Period, the Insured person may request cancellation by sending a written request to the Company by email, mail or fax. However, the following conditions apply for Premium refund: (a) If any claims have been filed with the Company, the Premium is fully earned and is non-refundable. (b) If no claims have been filed with the Company: (i) a cancellation fee of fifty dollars ($50.00 USD) will be charged (ii) only Premium covering time periods after cancellation are refundable
Complete details are given in certificate of insurance
Proof of Claim: When the Insured Person receives Treatment or the Company receives notice of a claim for benefits under this insurance, the Insured Person shall submit an International Medical Group (IMG) Claim Form as a necessary component of the Proof of Claim. An IMG Claim Form may be completed online via the MyIMG customer portal atwww.imglobal.com/member or obtained by contacting the Company.
Complete details are given in certificate of insurance