| Benefit | Bronze | Silver | Gold(1st 36 months of continuous coverage) | Gold(Beginning the 1st day of the 37th month) | Gold Plus | Platinum |
| Doctor Visit(OPT) | Specialists/consultants (pre-inpatient) - up to $500 prior to inpatient treatment | 25 visits: $70 doctor/specialist maximum limit;$60 psychiatrist maximum limit; $50 chiropractor maximum limit; | 100%Up to policy max | Physician Charges - limit of $150 per visit; Hospital Charge - $100 co-pay unless admitted; Urgent Care Facility - $25 co-pay | 100%Up to policy max | 100%Up to policy max |
| X-ray and Labs(OPT) | Lab tests - up to $300 per visit; Diagnostic X-Rays limited to $250 per visit. | $250 X-Ray per exam maximum limit; $300 lab tests per exam maximum limit. | 100%Up to policy max | Diagnostic Lab and X-Rays limited to $5,000 per period of coverage. | 100%Up to policy max | 100%Up to policy max |
| Hospital Room &Board (IPT) | In U.S. – 100% of average semi-private room rate. Outside of U.S. - 100% of private room rate (not to exceed 150% of semi-private room rate). | In U.S. – 100% of average semi-private room rate. Outside of U.S. - 100% of private room rate (not to exceed 150% of semi-private room rate). | In U.S. – 100% of average semi-private room rate. Outside of U.S. - 100% of private room rate (not to exceed 150% of semi-private room rate). | Up to a limit of $2,250 per day | In U.S. – 100% of average semi-private room rate. Outside of U.S. - 100% of private room rate (not to exceed 150% of semi-private room rate). | Private room rate |
| Crew Member Return | $2,500 per period of coverage. | $2,500 per period of coverage. | $2,500 per period of coverage. | $2,500 per period of coverage. | $2,500 per period of coverage. | $2,500 per period of coverage. |
| Pre-Existing Conditions Limitation | Excluded | $50,000 lifetime maxium; $5,000 per period of coverage after 24 months | $50,000 lifetime maxium; $5,000 per period of coverage after 24 months | $50,000 lifetime maxium; $5,000 per period of coverage | $50,000 lifetime maxium; $5,000 per period of coverage after 24 months | Same as any illness |
Complete details are given in certificate of insurance.
| Bronze | Silver | Gold(1st 36 months of continuous coverage) | Gold(Beginning the 1st day of the 37th month) | Gold Plus | Platinum | |
| Pre-Existing Conditions Limitation | Excluded | $50,000 lifetime maximum; $5,000 per period of coverage after 24 months | $50,000 lifetime maximum; $5,000 per period of coverage after 24 months | $50,000 lifetime maximum; $5,000 per period of coverage | $50,000 lifetime maximum; $5,000 per period of coverage after 24 months | Same as any illness |
Acute Onset of Pre-existing Condition sudden and unexpected outbreak or recurrence of a Pre-existing Condition(s) which occurs spontaneously and without advance warning either in the form of Physician recommendations or symptoms, is of short duration, is rapidly progressive, and requires urgent care. The Acute Onset of a Pre-existing Condition(s) must occur after the effective date of the policy. Treatment must be obtained within 24 hours of the sudden and unexpected outbreak or recurrence. A Pre-existing Condition that is a chronic or congenital condition or that gradually becomes worse over time will not be considered Acute Onset.
Subject to the terms of the plan, Global Crew Medical Insurance is annually renewable and coverage is continuous when renewed. Prior to the end of each period of coverage (12 months) you will receive a renewal form. You must continue to meet the eligibility requirements in order to renew. There are no additional medical questions at renewal, and we can work with you to provide flexible renewable options. Please select your deductible carefully, as you will be unable to select a lower deductible when you renew your coverage. Note: If you have reached part of your deductible during the last 30 days of your certificate year, we will carry over that portion you have met of your deductible to the next certificate year.
We are confident that you will be pleased with the full terms of coverage. To ensure your satisfaction, once you are accepted in the plan we provide a 15 day period to review the fulfillment kit contents. If during that 15 day period you find that you are not satisfied with the plan for any reason, you may submit a written request for cancellation and full refund of your premium. See the Certificate of Insurance for full details.
Cancellation requests received after this 15 day period will be granted at the sole discretion of IMG as the plan administrator. Any refund you may receive will be based on an established refund schedule, not a pro-rated basis. See the Certificate of Insurance for full details.
Log on to the secure, 24-hour online portal, MyIMGSM, to submit and view your claims, manage your account, search for providers, Live Chat with representatives and more.
If Treatment or supplies eligible for coverage under this insurance are received directly from the Company’s approved list of independent PPO providers while the Insured Person is in the United States: (1) the Company will reduce by fifty percent (50%) any part of the Deductible applicable to such claims, and (2) the Company will waive any and all Coinsurance applicable to such claims. However, all claims for Treatment or supplies received in the United States from a non-PPO provider will remain subject to the applicable Deductible and Coinsurance, whether or not the Insured Person may be eligible for the foregoing special benefit relating to Treatment or supplies received from PPO providers.