How the Medical Insurance Works

For Covered Medical Expenses during a Term of Insurance, the Gateway USA plan works like this:

• Each Insured Person must meet the $150 Deductible. The Deductible is applied once during each new Term of Insurance. For Term of Insurance that is extended by renewal, the Deductible is applied once during every 12-month period from the original Effective Date of insurance.
  
  
• After the Deductible, the Plan pays 80% of the reasonable and customary charges for Covered Medical Expenses up to $5,000. Thereafter, the Plan pays 100% of the reasonable and customary charges for remaining Covered Medical Expenses up to the Medical Expense Maximum or the Maximum Coverage Period, whichever occurs first.
  
  
• Each Insured Person is responsible for 20% of the first $5,000 of Covered Medical Expenses during each Term of Insurance.
  
  
• The Maximum Coverage Period is 52 weeks from the date of covered injury or onset of covered illness.
  
  
• The Medical Expense Maximum and the Maximum Coverage Period apply to each separate, distinct, and unrelated condition.
  
  

The Description of Coverage section provides details about Covered Medical Expenses, Exclusions, and Limitations.

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