Plan Administrator: Trawick International | Underwriter: Zurich Insurance Europe AG Belgian branch | AM Best Rating: A+ ‘Superior’

• Coverage Area: Non-US citizens (age 0-89) who reside outside USA & traveling outside their home country to visit solely USA , or to visit a combination of US & other countries Worldwide (certain countries may be restricted at different times).
• Coverage Length: Min 5 days up to max 364 days.
• Renew Online: Renewable up to max 364 days.
• Acute Onset of Pre-existing Condition: (Age 0-69: Up to medical maximum), (Age 70-79: up to $25,000) & (Age 80-89: $15,000). Coverage related to Cardiac Conditions or Stroke are limited to (Age 0-69: $25,000) & (Age 70-89: $15,000).
  
• PPO Network: Provides First Health PPO Network.
• ID Card: Link comes in email to download.

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• Coverage depends on age and medical maximum selected.
• Physician’s Visits/ Urgent Care: $55 to $130 per visit, one visit per day and 30 visits per Policy Period.
• Diagnostic X-rays and Lab Services: $450 to $1,000 per Incident
• Hospital Room and Board Expenses: $1,400 to $3,000 per day to a maximum of 30 days.
• Prescription drugs and medications: $250 to $350 per Incident
• Ambulance Service Benefits: $500 to $750 per Incident

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•  Economy $25,000: Up to Policy Maximum.
• Basic $50,000: Up to Policy Maximum.
• Silver $75,000: Up to Policy Maximum.
• Gold $100,000: Up to Policy Maximum
• Platinum $175,000: Up to Policy Maximum.
• Diamond $50,000: For ages 70-79, up to $25,000. For ages 80 and above, up to $15,000
• Diamond Plus $100,000: For ages 70-79, up to $25,000. For ages 80 and above, up to $15,000

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Extension period can be purchased

1. at the premium rate in force at the time of the extension;
2. for a minimum of 5 days;
3. for up to a maximum of 364 days, provided the Covered Person’s Policy Period does not exceed 364 days in total.

There are no grace periods for extension. Once the policy has lapsed, reapplication is required.

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Full cancellation and refund will only be considered if We receive written request prior to or on the Effective Date of the coverage. If We receive a written request for cancellation and refund after the Effective Date of coverage, a partial cancellation and refund may be allowed.

The following conditions apply

1. If any claims have been filed with Us, the premium is fully earned and is non-refundable. If no claims have been filed with the Company, then
   (i) a cancellation fee of US $50 will be charged; and
   (ii) only unused days
2. premiums will be considered as refundable; and
3. If after a refund is made, it is determined that a claim was presented to Us on a Covered Person’s behalf, the Covered Person will be fully responsible for that claim in its entirety.

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All claims must be submitted within 90 days of the date of service. All claims MUST BE ON A FULLY COMPLETED claim form including medical history sections. A claim form must be completed and provided for each medical condition. Providers should submit claims using the Universal Billing Form.

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