(866)

INSUBUY
4678289
8AM9PMCST.MonFri
8AM5PMCST.SatSun

PatriotAmericaPlus
MedicalinsuranceandtravelprotectionfornonU.S.citizens

InstantQuotes&Purchase:
IndividualGroup
WhyConsiderInternationalTravelMedicalInsurance?
Travelingabroadcanbeanexcitingexperience,butwhatwouldhappenifyoubecameillorinjuredwhileawayfrom
home?Yourexperiencecanquicklyturnfrighteningifyou'renotpreparedforamedicalemergency.
Whetheryourtriptakesyouabroadforafewweeksorayear,yourtripshouldbeanenjoyableone.Youhaveenoughto
worryaboutwhenyou'retraveling.Don'tletyourmedicalcoveragebeanuncertainty.PatriotAmericaPlusprovidesyou,
your group, and your dependents traveling with you Coverage Without Boundaries . The plan offers a complete
packageofinternationaltravelinsurancebenefitsavailable24hoursaday.

PatriotAmericaPlus
Patriot America Plus provides coverage for nonU.S. citizens traveling outside their home country. The plan offers a
completepackageofinternationalbenefitsavailable24hoursadaytoindividuals,families,andgroupsoffiveormore
travelers. The plan provides a wide range of plan maximum limits and deductible options, and it is available for a
minimumof5daysuptoamaximumoftwoyears,inaccordancewiththetermsoftheinsurancecontract.
Additionally, the plan offers excellent benefits and services to meet your global travel needs. You have access to
international,multilingualcustomerservicecenters,claimsadministratorswhoprocessclaimsfromallovertheworld,
handling virtually every language and currency, and 24 hour access to highly qualified coordinators of emergency
medicalservicesandinternationaltreatment.

AUnique,FullServiceApproach
Weknowthatthereasonstotravelabroadaremanyandvariedthat'swhyourservicesaredesignedtoprovideyou
withtheassistanceyouneednomatterwhereyouare.OurgoalistoprovideyouwithCoverageWithoutBoundaries.By
providingglobal products and services to vacationers, those working or living abroad for short or extended periods,
people traveling frequently between countries, and those who maintain multiple countries of residence, we are the
singleresourceforallyourinternationaltravelmedicalinsuranceneeds.
Ourserviceandsupportsetsusapart.Since1990,we'veservedmorethanamillionpeoplearoundtheglobealways
focused on the specific needs of each individual. We've set the benchmark for industry service levels by integrating
independentcredentialingserviceswithinhouse,fullyownedandoperatedservicedivisions.Wearetherewithyou,
wherever you go bringing support for all your insurance needs around the globe providing you Global Peace of
Mind .

PLANINFORMATION&HIGHLIGHTS

MaximumLimits

$50,000,$100,000,$500,000

IndividualDeductible

$0,$100,$250,$500,$1,000,$2,500

CoinsurancefortreatmentreceivedoutsidetheU.S.&Canada

NoCoinsurance

CoinsurancefortreatmentreceivedwithintheU.S.&Canada

InthePPONetworkTheplanpays90%ofeligiblemedical
expensesupto$5,000,then100%
OutofthePPONetworkTheplanpays80%ofeligiblemedical
expensesupto$5,000,then100%

ContinuationofTreatmentPeriod

Earlierof6monthsperInjuryorIllnessoruponreturntoHome
Country

MyIMG SM

24hoursecureaccessfromanywhereintheworldtomanage
youraccountatanytime

WorldclassMedicalBenefits

Coverageavailableforeligibleinpatientandoutpatientmedical
expenses

InternationalEmergencyCare

Awiderangeofinternationalemergencybenefitsavailable
includingemergencyevacuation,emergencyreunion,returnof
mortalremains,returnofminorchildrenandmore

INPATIENT/OUTPATIENTBENEFITS
SubjecttothecoinsuranceanddeductiblewhenapplicableandUsual,Reasonable,andCustomary(URC)
HospitalRoomandBoard

URCaveragesemiprivateroomrate

IntensiveCareUnit

URC

EligibleMedicalExpenses

URC

AcuteOnsetofPreexistingConditionpriortoage70Medical
Expenses

URC

LocalAmbulance

URC

PrescriptionMedication

URC

EmergencyRoomAccident

URC

EmergencyRoomIllnesswithInpatientAdmission

URC

EmergencyRoomIllnesswithoutInpatientAdmission

URCwithadditional$250deductible

DentalTreatmentrelatedtoanAccident

URC

DentalEmergency

$100maximum

HospitalDailyIndemnity

$100perovernight,uptoamaximumof10overnights

Terrorism

$50,000lifetimemaximum

RecreationalSports&Activities

URCfornonorganized,noncontact,andnoncollisionactivities

EVACUATIONBENEFITS
Notsubjecttoadeductibleorcoinsurance.
EmergencyMedicalEvacuation

$500,000lifetimemaximum(independentoftheMaximumLimit)

AcuteOnsetofPreexistingConditionpriortoage70Emergency
$25,000lifetimemaximum
MedicalEvacuation
EmergencyReunion

$50,000lifetimemaximum

ReturnofMortalRemainsorCremation/Burial

$50,000forReturnofMortalRemainsor$5,000for
Cremation/Burial

ReturnofMinorChildren

$50,000lifetimemaximum

PoliticalEvacuation

$10,000lifetimemaximum

ADDITIONALBENEFITS
Notsubjecttoadeductibleorcoinsurance.
IncidentalTrips

Uptoacumulativetwoweeks

EndofTripHomeCountryCoverage

Onemonthforeverysixmonthsofcontinuouscoverage,upto
twomonthsmaximum

TripInterruption

$5,000maximum

CommonCarrierAccidentalDeath

$50,000tobeneficiarymaximumof$250,000perfamily

AccidentalDeath&Dismemberment

$25,000principalsum

LostLuggage

$50peritemmaximumof$250

NaturalDisaster

$100perdayforfivedaysmaximum

IdentityTheft

$500maximum

OPTIONALRIDERS
OtherthantheEnhancedAD&DRider,optionalriderscanberequestedandapplytoalleligibleindividualslistedonthe
Application.

AdventureSportsRider
(availabletoinsuredsuptoage65)

Age

LifetimeMaximum

049

$50,000

5059

$30,000

6064

$15,000

EnhancedAD&DRider
(availabletotheprimaryinsuredonly)

Uptoanadditional$400,000

CitizenshipReturnRider

UptotheMaximumLimit

EvacuationPlusRider
(availabletoinsuredsuptoage65)

NonLifethreateningMedicalEvacuation:Uptoamaximumof
$25,000.NaturalDisasterEvacuation:Uptoamaximumof$5,000

PatriotAmericaPlusIndividualPremiumRates
OneMonthRates
Age

MaximumLimitOptions
$50,000

$100,000

$500,000

1829

$42

$52

$66

3039

$55

$70

$88

4049

$82

$101

$135

5059

$120

$155

$190

6064

$152

$196

$233

6569

$173

$234

$254

7079

$235

N/A

N/A

80+*

$407*

N/A

N/A

Dep.Child

$38

$46

$60

ChildAlone

$42

$52

$66

DailyRates
Age

MaximumLimitOptions
$50,000

$100,000

$500,000

1829

$1.35

$1.70

$2.15

3039

$1.80

$2.25

$2.85

4049

$2.65

$3.25

$4.35

5059

$3.90

$5.00

$6.15

6064

$4.90

$6.30

$7.50

6569

$5.60

$7.55

$8.20

7079

$7.60

N/A

N/A

80+*

$13.15

N/A

N/A

Dep.Child

$1.25

$1.50

$1.95

ChildAlone

$1.35

$1.70

$2.15

80+*individualsarelimitedtoa$10,000MaximumLimit

EnhancedAD&DRider*
AdditionalAD&DCoverage

MonthlyRate

$100,000

$8

$200,000

$16

$300,000

$24

$400,000

$32

*Availabletotheprimaryinsuredonly.Availabletoinsuredsthatareapplyingfor3monthsofPatriotAmericaPluscoverage.Premium
ischargedinwholemonthincrements.

NewpremiumratesperInsuredPersoneffectiveMay12,2015foreligibleindividualswhoseapplicationsareapproved
byIMG.IMGreservestherighttoassessthemostcurrentratesatthetimeoftheeffectivedateintheeventtheserates
expire,aremodified,orarereplaced.Ratesincludepremiumtaxwhereapplicable.

PatriotAmericaPlusGroupPremiumRates
OneMonthRates
MaximumLimitOptions

Age

$50,000

$100,000

$500,000

1829

$38

$47

$59

3039

$50

$63

$79

4049

$74

$91

$122

5059

$108

$140

$171

6064

$137

$176

$210

6569

$156

$211

$229

7079

$212

N/A

N/A

80+*

$366

N/A

N/A

Dep.Child

$34

$41

$54

ChildAlone

$38

$47

$59

DailyRates
MaximumLimitOptions

Age

$50,000

$100,000

$500,000

1829

$1.20

$1.50

$1.90

3039

$1.60

$2.05

$2.55

4049

$2.40

$2.95

$3.90

5059

$3.50

$4.50

$5.50

6064

$4.40

$5.70

$6.75

6569

$5.00

$6.80

$7.40

7079

$6.80

N/A

N/A

80+*

$11.80

N/A

N/A

Dep.Child

$1.10

$1.35

$1.75

ChildAlone

$1.20

$1.50

$1.90

*80+individualsarelimitedtoa$10,000MaximumLimit
EnhancedAD&DRider*
AdditionalCoverage

MonthlyRate

$100,000

$8

$200,000

$16

$300,000

$24

$400,000

$32

*Availabletotheprimaryinsuredonly.Availabletoinsuredsthatareapplyingfor3monthsofPatriotAmericaPluscoverage.Premium
ischargedinwholemonthincrements.
NewpremiumratesperInsuredPersoneffectiveMay12,2015foreligibleindividualswhoseapplicationsareapprovedbyIMG.IMG

reservestherighttoassessthemostcurrentratesatthetimeoftheeffectivedateintheeventtheseratesexpire,aremodified,orare
replaced.Ratesincludepremiumtaxwhereapplicable.

PatriotAmericaPlusServices
LocatingaProvider
Youmayseektreatmentwiththehospitalordoctorofyourchoice.WhenseekingtreatmentintheU.S.,youhaveaccess
tothePreferredProviderOrganizations(PPO),whichareseparatelyorganizednetworksofhundredsofthousandsof
established,highlyqualifiedhealthcarephysiciansandmanywellrecognizedhospitalsintheU.S.Additionally,tohelp
you locate health care providers outside the U.S., online International Provider AccessSM (IPA), a database of over
17,000providershasbeenprovided.
AkesoCareManagement (ACM )
The ability to access quality health care is of paramount importance when a medical emergency arises abroad. To
coordinatecareandprovideU.S.andinternationallybasedmedicalmanagementservices,IMGformedACM,aURAC
accredited,onsitespecializeddivisiondevotedentirelytomedicalmanagement.ACM'sclinicalmembersareexpertsat
assessingtheneedforservicesandensuringthoseservicesaredeliveredinatimely,costeffectivemanner.
Fromroutinemedicalcaretocomplexcasemanagement,fromcheckupstoemergencymedicalevacuations,ACMis
thereforyou.Theyarecommittedtopatientprotectionandempowerment,qualityoperationsandprovidercompliance.
Thistranslatesintobettercareforyouaroundtheworld,aroundtheclock.
UniversalRxPharmacyDiscountSavings
ThisisadiscountsavingsprogramavailabletoeveryinsuredofthePatriotAmericaPlusplan.Thisprogramallowscard
holderstopurchaseprescriptionsatoneofover35,000participatingpharmaciesintheU.S.andreceivethelowerof1)
UniversalRxcontractpriceor2)thepharmacyregularretailprice.
Thisdiscountprogramisnotinsurance.ItispurelyadiscountprogramavailabletoinsuredsinthePatriotAmericaPlus
plans.Useofthediscountcarddoesnotguaranteethatmedicationiscoveredorwillbereimbursedundertheinsurance
plan.

PlanAdministrator
InternationalMedicalGroup ,Inc.
P.O.Box88509
2960NorthMeridianStreet
Indianapolis,IN462080509USA
IMGactsastheauthorizedrepresentativeandplanadministratorforandonbehalfofSiriusInternational.

PlanUnderwriter

CoverageisunderwrittenandissuedbySiriusInternationalInsurance Corporation (publ), rated A (excellent) by A.M.

BestandAbyStandard&Poor's(atthetimeofprinting).SiriusInternationalisaWhiteMountainsRecompany.
Thisinvitationtoinquireallowseligibleapplicantsanopportunitytoinquirefurtherabouttheinsuranceofferedandis
limited to a brief description of any loss for which benefits may be payable. Benefits are offered as described in the
insurance contract. Benefits are subject to all deductibles, coinsurance, provisions, terms, conditions, limitations, and
exclusionsintheinsurancecontract.Thecontractdoescontainapreexistingconditionexclusionanddoesnotcover
lossesorexpensesrelatedtoapreexistingcondition.
This brochure contains many of the valuable trademarks, names, titles, logos, images, designs, copyrights and other
proprietary materials owned and registered and used by of International Medical Group, Inc. and its representatives
throughouttheworld.
052015

ThispageURL:http://www.insubuy.com/patriotamericaplus/visitorinsurance/

Copyright20022016Insubuy ,Inc.Allrightsreserved.