HEALTH INSURANCE

FOR ADVENTUROUS

TRAVELERS

APPLY NOW

HEALTH INSURANCE FOR ADVENTUROUS TRAVELERS

Gateway Patriot Adventure Travel

The thought of adventure travel gives a tremendous sense of anticipation. Getting away from home or even your home country is exhilarating. While away, the last thing anyone wants to think about is the potential for a medical emergency, yet being prepared for such an event can be one of the most crucial and simple measures to be taken. Adventure travel insurance offers specialized protection for every contingency in a way that personalizes care when you most need it.

COVERAGE OVERVIEW

The possibility of an accident or injury exists regardless of travel plans, but may advance to a probability when adding adventure travel to the mix. Is anyone prepared for that emergency that may require medical evacuation for treatment back home? What about family and being able to be together in such time of need? Insurance for your adventure is designed with this in mind and much more. The knowledge that there is an adventure travel insurance plan in place when venturing out is all at once calming. Customer service representative and claims administrators are at the ready to provide 24 hour assistance in your native language with access to over 17,000 treatment providers abroad through the International Provider Access (IPA). In addition to Emergency Evacuation, Emergency Reunion and Repatriation in the event of death, coverage is also included for additional contingencies, such as:
• Political Evacuations
• Extended Benefits
• Common Carrier Accidental Death
• Trip Cancellation
• Lost Luggage

The sports and activities covered under adventure travel insurance are those that would be typically anticipated, such as skiing, snowboarding, kayaking, mountaineering, snorkeling, scuba diving and so much more. Note that only non-contracted amateur athletic activities are covered, excluding professional sports. The coverage has been designed to satisfy the period of time that equates to travel. Gateway Patriot Adventure Travel has been tailored to provide the traveler with everything they would need in the event of a medical emergency while away from home.

PLAN HIGHLIGHTS

Designed for adventurous international travelers who intend to participate in the thrill of adventure sports and realize that their current medical plan does not cover certain hazardous sports and activities.
Highlights:
• Short-term travel medical insurance
• Coverage for individuals and dependents
• Two plan designs – one for U.S. citizens and one for non-U.S. citizens
• Maximum Limit of $50,000
• Coverage for several adventure sport activities
• Coverage for a minimum of 30 days up to a maximum of six months
• Option to purchase in 15 day increments after one month is purchased • Universal Rx pharmacy discount savings
• 24 hour secure access from anywhere in the world to manage your account at any time

PLAN INFORMATION
Maximum Limits | $ 50,000
Deductible | $250 per Period of Coverage

COINSURANCE
For treatment received outside the U.S. & Canada | No Coinsurance
For treatment received within the U.S. & Canada:
In the PPO Network  |   The plan pays 90% of eligible expenses up to $5,000, then 100% up to the Maximum Limit
Outside the PPO Network  |  The plan pays 80% of eligible expenses up to $5,000, then 100% up to the Maximum Limit

MEDICAL BENEFITS

USUAL, REASONABLE, AND CUSTOMARY CHARGES
Subject to deductible and coinsurance
Hospital Room and Board | Up to the Maximum Limit for average semi-private room rate
Intensive Care | Up to the Maximum Limit Medical Expenses | Up to the Maximum Limit
Out-patient Medical Expenses | Up to the Maximum Limit
Local Ambulance | Up to the Maximum Limit

Emergency Room Accident | Up to the Maximum Limit
Emergency Room Illness with In-patient Admission | Up to the Maximum Limit
Emergency Room Illness without In-patient Admission | Up to the Maximum Limit with additional $250 deductible Charges incurred for the use of the Emergency Room for treatment of an illness are subject to an additional (extra) $250 deductible if treatment does not require admittance to the hospital.

Dental – Injury due to an accident Each Patriot Adventure plan covers the cost of emergency dental treatment and dental procedures necessary to restore sound natural teeth lost or damaged in an accident up to the Maximum Limit.
Dental – Sudden dental pain Each plan will pay up to $100 for the necessary treatment of sudden, unexpected pain to sound natural teeth.

INTERNATIONAL EMERGENCY CARE (when coordinated through the Plan administrator)
Emergency Evacuation | Up to the Maximum Limit
Patriot Adventure includes coverage for Emergency Medical Evacuations from a medical facility to the nearest qualified medical facility; expenses for reasonable travel and accommodations resulting from the evacuation; and the cost of returning to either the home country or the country where the evacuation occurred up to the Maximum Limit. Emergency Reunion | Up to $10,000 Patriot Adventure also provides emergency reunion coverage, up to $10,000 for a maximum of 15 days, for the reasonable travel and lodging expenses of a relative or friend during an emergency medical evacuation of the insured person: either the cost of accompanying the insured during the evacuation or traveling from the home country to be reunited with the insured.

Return of Mortal Remains | Up to $15,000
If a covered illness/injury results in death, expenses for Repatriation of bodily remains or ashes to the home country will be covered up to a maximum of $15,000. Political Evacuation | Up to $10,000 If the United States Department of State, Bureau of Consular Affairs issues a travel advisory that becomes effective on or after the Insured Person’s date of arrival in the Host Country, the Company will pay up to $10,000 for transportation to the nearest place of safety or for repatriation to the Insured Person’s home country or country of residence provided that:
• The Insured Person contacts the Company within 10 days of the United States Department of State, Bureau of Consular affairs issues the travel advisory
• Political Evacuation and Repatriation is approved and coordinated by the Company. To be eligible for the Evacuation, Reunion and Return benefits, these must be recommended by the attending physician in critical medical situations, and approved in advance and coordinated by IMG.

ADDITIONAL BENEFITS
Benefit Period | Three months
If a covered injury or illness has continuing treatment after the certificate expires, the three-Month Benefit Period may provide continued coverage. When the certificate expires, the Company will review the date of initial treatment for the covered injury or illness. If treatment began less than three months before the certificate expired, benefits for the covered injury or illness will continue subject to the Maximum Limits until there has been three months of coverage for the covered injury or illness.

Common Carrier Accidental Death | $50,000 to Beneficiary; maximum of $250,000 per family
If accidental death should occur while traveling on a commercial Common Carrier, $50,000 will be paid to the beneficiary to a maximum of $250,000 per family

Sports & Activities | Up to the Maximum Limit for basic and Adventure sports as described below Subject to the complete Certificate Terms and Conditions, Patriot Adventure covers injuries incurred during non-contact amateur athletic activities and the following activities: abseiling, BMX, bungee jumping, canyoning, caving, cave tubing, flying (private plane), hang gliding,heli-skiing, high diving, horseback riding, hot air ballooning, jet skiing, jungle zip lining, kayaking, inline skating, motorcycle/motorscooter riding, mountain biking, mountaineering (ropes and guides to 4500m from ground level), paragliding, parascending, rappelling, rock climbing (ropes and guides to 4500m from ground level), scuba diving (to 50m), skydiving, snorkeling, snow skiing, snowboarding, snowmobiling, spelunking, surfing, trekking, wakeboarding, water skiing, whitewater rafting (to Class V), wildlife safaris, and windsurfing. These advenutre activities must be engaged in solely for leisure, recreation or entertainment purposes. Activities may be organized and include scheduled practices, games, and/or competitions. Activities not covered include contact sports, professional sports and any athletic activities that are organized and/or sanctioned by the National Collegiate Athletic Association (or any other collegiate sanctioning body) or the International Olympic Committee.

Trip Cancellation | Up to $5,000 If, during a covered trip, there is a death of an immediate family member (spouse, child, parent or sibling) or the substantial destruction of the insured’s principal residence, the plan will pay to return the insured to the area of principal residence. The plan will pay for a one way air or ground transportation ticket of the same class as the unused travel ticket, less the value of the unused return ticket.

Lost Luggage | Up to $50 per item; maximum of $250

ADDITIONAL INFORMATION

CONDITIONS OF COVERAGE
• Coverage and benefits are subject to the deductible and coinsurance, and all terms of the certificate of coverage and Master Policy.
• Coverage under this plan is secondary to any other coverage.
• Coverage and benefits are for medically necessary, usual, reasonable and customary charges only.
• Charges must be administered or ordered by a physician.
• Charges must be incurred during the Period of Coverage or the Benefit Period.
• Claims must be presented to IMG for payment within the Period of Coverage, Benefit Period or during the three months immediately following the Period of Coverage.

ELIGIBILITY
The following conditions apply to all persons applying for and/or enrolling in Patriot Adventure.
• For coverage while participating in any of the covered adventure sports activities, you must be medically and physically fit to engage in such activity and hold the necessary qualifications as approved by the applicable Governing Body or Authority.
• Patriot Adventure is travel insurance for U.S. citizens traveling outside the United States and for non-U.S. citizens traveling outside their home country.

EXTENSION OF COVERAGE
Patriot Adventure can be rewritten for succeeding or subsequent periods but is not renewable. New Deductible, Coinsurance, Eligibility, Conditions of Coverage and Pre-Existing Condition Exclusions apply to any succeeding or subsequent Period of Coverage. A new application must also be completed.

QUALITY GUARANTEE Your satisfaction is very important to IMG and the plan underwriter. If you are not pleased with this product for any reason, you may submit a written request, prior to your effective date, for cancellation and refund of your premium.

EXCLUSIONS

Charges for the following services, treatments and/or conditions are excluded from coverage under the Patriot Adventure plans.

A Pre-existing Condition is defined as any injury, illness, sickness, disease, or other physical, medical, mental or nervous condition, disorder or ailment that, with reasonable medical certainty, existed at the time of application or at any time during the three years prior to the effective date of the insurance, including any subsequent, chronic or recurring complications or consequences related thereto or arising therefrom whether or not previously manifested or known, diagnosed, treated, or disclosed.

Treatment or surgeries which are elective, investigational, experimental or for research purposes.

War, military action, terrorism, political insurrection, protest, or any act thereof.

The Company will not pay for a Political Evacuation if there is a travel advisory in effect on or within six (6) months prior to the Insured Person’s date of arrival in the Host Country.

Immunizations and routine physical exams.

Treatment of Temporomandibular Joint or dental treatment, except as provided for herein. Venereal disease, AIDS virus, AIDS related illness, ARC Syndrome, or AIDS, and the cost of testing for these conditions, and charges for treatment or surgeries which are incurred by any Insured who was HIV+ at time of enrollment into this insurance.

Pregnancy, childbirth, birth control, artificial insemination, treatment for infertility or impotency, sterilization or reversal thereof, or abortion.

Injury sustained while participating in professional sports or any athletic activity that is sponsored or sanctioned by the National Collegiate Athletic Association (or any collegiate governing body) or the International Olympic Committee.

Injury sustained while participating in contact sports of any kind as well as the following: mountaineering or climbing above 4500 meters from ground level and without the proper use of ropes and guides; scuba diving below 50 meters; whitewater rafting above Class V; BASE jumping; luge; motocross or Moto-X; racing by horse, motor vehicle of any type, or motorcycle; rodeo; ski jumping; and any Adventure Sport not listed as covered under the Benefits page.

Vision or hearing tests and the provision of visual or hearing aids. Vocational, recreational, speech or music therapy. Treatment while confined primarily to receive custodial care, educational or rehabilitative care, or nursing services.

Charges, injuries and/or illnesses resulting or arising from or occurring during the commission or continuing perpetration of a violation of law by the insured, including without limitation, the engaging in an illegal occupation or act, but excluding minor traffic violations.

Treatment for, and injuries and/or illnesses resulting or arising from, substance abuse or drug addiction. Injury and/or illness resulting or arising from or sustained while under the influence of or disablement of drugs or alcohol.

Willful self-inflicted injury or illness, and injury due to reckless endangerment or needless peril.

Treatment required as a result of or arising from complications from a treatment or condition not covered hereunder.

Any services or supplies performed or provided by a relative of the Insured or provided at no cost to Insured.

Treatment for mental and nervous disorders.

Organ or tissue transplants or related services.

Illness or injury where the trip to the host country is undertaken for treatment or advice for such illness or injury, except as provided for herein.

Treatment incurred as a result of or arising from exposure to nuclear radiation, and/or radioactive material(s).

CONTACT US

If you have any questions regarding IMG or the products located on this website, please contact us. We are available to provide support to our producers and prospective clients. Our contact information is below. Additionally, you may use the online inquiry form. An IMG representative will review your questions or comments, and respond in a timely manner.

International Medical Group
2960 North Meridian Street
Indianapolis, IN 46208-4715

Telephone: 1.317.655.4500 or 1.877.808.7434
Fax: 1.317.655.4505
Email: insurance@imglobal.com

For all claims correspondence, please use the following address:
International Medical Group
Claims Department
PO Box 88500
Indianapolis, IN 46208-0500

To submit applications, underwriting information or premium, please use the following address:
International Medical Group
PO Box 88509
Indianapolis, IN 46208-0509

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QUALITY GUARANTEE

Your satisfaction is very important to IMG and the plan underwriter. If you are not pleased with this product for any reason, you may submit a written request, prior to the effective date, for cancellation and refund of your premium.