HEALTH

INSURANCE FOR

US VISITORS

INDIVIDUAL APPLYGROUP APPLY

HEALTH INSURANCE FOR US VISITORS

US Visitors Health Insurance from Gateway USA

Millions of people from all over the world visit the United States every year. Many come for business, specialized training, or university study, not to mention thousands of vacationing tourists. For US visitors, an unexpected medical expense can interrupt such plans, crippling a travel budget. Severe medical emergencies requiring hospitalization can drastically affect return travel, leaving visitors stranded. Travel health insurance for USA exchange activities can help alleviate the potential strain of an unexpected medical emergency. Some types of exchange programs even list visitor insurance in USA as a requirement for those wishing to participate.

COVERAGE OVERVIEW

Visitors health insurance functions much like a standard healthcare plan: the policy pays a majority of covered medical expenses incurred during an individual’s stay in the US. Medical treatments, medications, and tests are covered typically after a reasonable deductible is met. Medical evacuations and repatriation expenses are often included, should a covered individual need emergency travel back to his or her home country. For example, if a traveler buys visitor insurance, US doctors provide emergency stabilizing treatment in the US, then arrange to have the traveler flown home for further medical care if needed. Covered travel expenses are most often limited to evacuations due to illness, injury or other health conditions, however, some policies cover non-medical emergency travel expenses.

Whether required for a particular exchange activity, or simply purchased to provide peace of mind, US visitor health insurance protects travelers from costly unexpected medical expenses. Rather than worrying over finding quality healthcare in a foreign country or arranging the payment of unexpected medical costs, visitors can rest assured knowing such expenses and difficulties are handled. Travel safely and with exceptional peace of mind by purchasing US visitor health insurance today, before you travel to the US.

PLAN HIGHLIGHTS

You have enough to worry about when you’re traveling. Don’t let your medical coverage be an uncertainty. As a solution, Gateway USA offers a complete package of international benefits available 24 hours a day. Gateway USA provides coverage for non-U.S. citizens traveling outside their home country for a minimum of 5 days up to a maximum of two years.

ELIGIBILITY
The following conditions apply to all persons applying for and/or enrolling in Gateway USA Medical Insurance.
• Gateway USA is travel health insurance for non-U.S. citizens traveling outside their home country.
• For those under 65 years of age and visiting the U.S., your initial Period of Coverage must begin within six months of arrival in the U.S. For those 65 years of age and older, it must begin within 30 days of arrival. These requirements will be waived with proof of previous valid international travel insurance. Prior U.S. domestic health care coverage does not meet this eligibility requirement. Please provide the name of your international insurance carrier on the Application Form. If you are not in the U.S. at the time of application, please indicate your expected date of arrival on your Application Form.

MEDICAL INSURANCE
Maximum Limits  |  $50,000, $100,000, $500,000, $1,000,000
Deductible  |  $0, $100, $250, $500, $1,000, $2,500

DENTAL
Injury due to an accident | Each Gateway 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.
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 $500,000 lifetime maximum (independent of the Maximum Limit)

OTHER INSURANCE
Emergency Medical Evacuations | Up to $500,000
Emergency Reunion | Up to $50,000
Repatriation | Up to $50,000
Common Carrier Accidental Death | $50,000 to Beneficiary; maximum of $250,000 per family
Accidental Death and Dismemberment occurring during the Period of Coverage | $25,000
Accidental Loss of life | Principal sum
Accidental Loss of two Members | Principal sum
Accidental Loss of one Member | 50% of principal sum (“Member” means hand, foot or eye)
Terrorism Coverage | Up to $50,000 lifetime maximum
Political Evacuation | Up to $10,000
Identity Theft Assistance | Up to $500 per Period of Coverage
Natural Disaster | $100 per day for five days
Trip Interruption | Up to $5,000
Lost Luggage | Up to $50 per item of personal property; maximum of $250 per Period of Coverage

EXCLUSIONS

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, whether or not previously manifested or symptomatic, diagnosed, treated, or disclosed prior to the effective date, including any subsequent, chronic or recurring complications or consequences related thereto or arising therefrom.

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 expressly provided for in the certificate of insurance.

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 amateur or professional sports or other athletic activity which is organized and/or sanctioned, or which involves regular or scheduled practices, games or competition. The following hazardous activities are excluded unless the Adventure Sports Rider is purchased: abseiling, aviation (except when traveling as a passenger in a commercial aircraft), BMX, bobsleigh, bungee jumping, canyoning, caving, high diving, hang gliding, heli-skiing, hot air ballooning, inline skating, jet skiing, kayaking, mountain biking, paragliding, parascending, rappelling, rock climbing, sky diving, snow skiing, snowboarding, snowmobiling, spelunking, surfing, trekking, wind-surfing and whitewater rafting.Racing of any kind, BASE jumping, mountaineering, climbing or trekking above elevation 4500 meters above ground level or without proper ropes or guides; luge, motocross, Moto-X, rodeo activity, ski jumping, whitewater rafting exceeding Class V difficulty, scuba below 10 meters; and/or adventure sports not expressly covered hereunder are excluded regardless of which plan or rider is selected.

Vision or ear 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 being under the influence of alcohol or drugs; and injury or illness resulting from operating any type of vehicle after consuming any alcohol or drugs.

Willful self-inflicted injury or illness.

Treatment required as a result of or arising from complications from a treatment or condition not covered under the certificate.

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 expressly provided for in the certificate of insurance.

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

ADDITIONAL INFORMATION

SERVICES
Worldwide Medical and Travel Assistance: Included

HOW THE MEDICAL INSURANCE WORKS
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.

EVACUATION PLUS RIDER
Provides coverage for emergency medical evacuations for medical conditions that are non-life threatening and evacuations as a result of a natural disaster. Patriot Platinum Non-Life-threatening Medical Evacuation – Up to a maximum of $50,000. Disaster Evacuation – Up to a maximum of $10,000. Requirements: Up to age 65. Available with a minimum of 3 months of coverage regardless of the minimum number of days being traveled.

COVERAGE RENEWAL
If your plan is purchased for a minimum of three months, coverage may be renewed (without break in coverage) for a total of up to two years. Renewals are available in whole month or daily increments and may be completed online or by using a paper application, however, renewals of less than one month are available only online. For each renewal of less than one month completed online, you will be charged an additional $5 processing fee. Each insured person must only satisfy one deductible and coinsurance within each 12 month coverage period. Please note: Renewal rates may differ from initial rates.

COVERAGE EXTENSION
Gateway USA cannot be renewed when initial enrollment in the plan is for less than 3 months. However, a new Term of Insurance may be issued provided a new Application and premium is received, and eligibility requirements continue to be met. Each subsequent Application represents a separate Term of Insurance subject to plan provisions including limitations and exclusions.

REFUND OF PREMIUM
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. If you do not have any claims filed with IMG, you may cancel your plan after your effective date, however, the following conditions will apply: 1) you will be required to pay a $50 cancellation fee and 2) only full month premiums will be considered for refunds (e.g., if you choose to cancel your coverage two months and two weeks prior to the date your coverage ends, IMG will only consider the two full months for a refund). If you have filed claims, your premium is non-refundable.

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 USA 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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ABOUT YOUR PLAN

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ABOUT GATEWAY

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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.

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