Plan Administrator: Trawick International | AM Best Rating: A | Underwriter: Crum and Forster, SPC
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Age and Policy Maximum |
Age(0-69):$25,000,$50,000,$75,000,$100,000 Age(70-89):$50,000,$100,000 |
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Doctor Visit |
Pays upto $ 125 one visit per person per policy. |
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Urgent Care |
Limited to $50 to $130 one visit per day and 30 visits per policy period. |
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Hospital Room and Board |
Limited to $1400 to $3000 per day to a maximum of 30 days. |
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Ambulance |
Limited to $500 to $750 per incident. |
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Prescription |
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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 conditions, which will be limited to $25,000 up to and including age 69 and $15,000 for ages 70 and above. Upon attaining ages 70-79 Acute Onset benefits will be reduced to a Maximum of $35,000, upon attaining age 80 Acute Onset benefits will be reduced to a Maximum of $15,000 with a $25,000 Maximum Lifetime Limit for Emergency Medical Evacuation. Provides coverage for an Acute Onset of a Pre-Existing Condition. Any repeat/reoccurrence within the same policy period will no longer be considered Acute Onset of a Pre-Existing Condition and will not be eligible for additional coverage. A Pre-Existing Condition which is a chronic or congenital condition or that gradually becomes worse over time and/or known, scheduled, required, or expected medical care, drugs or treatments existing or necessary prior to the Effective Date are not considered to be an Acute Onset. This benefit covers only ONE (1) Acute Onset episode of a Pre-Existing condition. Sudden and Acute Onset of a Pre-Existing Condition Coverage expires upon medical advice that the condition and Onset is no longer acute, or you are discharged from a medical facility.
The Company maintains a Preferred Provider Network both within and outside the United States. Within the United States, the Company recommends the use of the Preferred Provider Network for maximum benefit payment. Outside the U.S., the Company retains the right to require the use of a Network Provider, where available Or be subject to a 20% copayment on all claims. Utilizing these providers may result in payments directly to the provider as well as referrals to licensed medical providers you can trust. You can find the link to the provider directory at https://www.trawickinternational.com/resources/healthcare-provider-search
In the United States, provider choices and reimbursement assessment will be based as follows:
In-Network Preferred Provider: This tier consists of all In-Network Providers as well as other preferred providers designated by the Company and listed on the website. In-Network Providers have agreed to accept a negotiated discount for services. This results in lower out-of-pocket costs.
Out-Of-Network Provider: Utilizing providers that are Out-of-Network is a more costly financial option for the Insured. The Company reimburses such providers up to a Reasonable and Customary amount as determined by the Company. The provider may bill the Insured the difference between the amounts reimbursed by the Company and the Provider’s billed charge. Additionally, you will pay a Coinsurance amount that is higher than ifan In-Network Provider were used. Amounts in excess of the Reasonable and Customary charges will not count toward theOut-of-Pocket Maximum, Deductibles or Plan Co-payments.
An extension notice will be sent to the Covered Person before the Policy Period ends and includes links to extend prior to the termination date. The Covered Person is subject to the following rules at extension: If it is initially purchased for a minimum of 5 days.
Full cancellation and refund will only be considered if We receive a 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 a) 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 $25 will be charged; and (ii) only unused days b) premiums will be considered as refundable; and c) If after a refund is made, it is determined that a claim was presented to Us on aCovered Person’s behalf, the Covered Person will be fully responsible for that claim in its entirety.
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.