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Patriot Exchange - Benefits

The Patriot Exchange plan provides coverage on two plan levels:

 

BASIC SHORT-TERM TRAVEL PLAN
Schedule of Benefits Benefit Description
Plan Maximum $10,000 per illness or injury
Coinsurance 100%
Deductible $100 per illness or injury
Treatment Period 60 days per chronic illness
Hospital Room & Board Up to semi-private room rate
Hospital Intensive Care URC*
Physical Therapy URC*, 1 visit per day
Physician Visit URC*
Student Health Center $5 co-pay per visit
Eligible Medical Expenses URC*
Emergency Room URC*
Emergency Illness-with in-patient admission URC*
Emergency Illness-without in-patient admission Additional $250 deductible
Emergency Medical Evacuation $25,000 lifetime maximum
Emergency Reunion $5,000 lifetime maximum
Return of Mortal Remains $7,500
Political Evacuation Up to $10,000
Accidental Death $5,000
Dismemberment $5,000 two limbs; $2,500 one limb
Terrorism Coverage Up to $50,000 lifetime maximum
Sudden Recurrence of a Pre-existing Condition( U.S. citizens)
- Medical Up to $5,000 of eligible expenses
- Emergency Medical Evacuation Up to $25,000 of eligible costs and expenses

 

Optional Add-on Plan
Schedule of Benefits Benefit Description
Baggage
- Loss/theft of Baggage $250
- Loss/theft of Valuables $250
- Loss/theft of Personal Papers $250
Legal Assistance
- Binder Fee $500 when served with summons
Personal liability
- Injury to third party $2,000 limit after $100 deductible
- Damage to third person property $500 limit after $100 deductible. Secondary to any other insurance in force
Limited high school sports coverage

 

 
Standard Short-Term Travel Plan
Schedule of Benefits Benefit Description
Plan Maximum Choice of $50,000, $250,000 or $500,000 per illness or injury
Coinsurance 100%
Deductible $100 per illness or injury
Treatment Period 60 days per chronic illness
Hospital Room & Board Up to semi-private room rate
Hospital Intensive Care URC*
Physical Therapy URC*, 1 visit per day
Physician Visit URC*
Student Health Center $5 co-pay per visit
Eligible Medical Expenses URC*
Dental
- Injury due to accident $500
- Sudden & unexpected pain $350
Emergency Room URC*
Emergency Illness-with in-patient admission URC*
Emergency Illness-without in-patient admission Additional $250 deductible
Emergency Medical Evacuation $50,000
Emergency Reunion $15,000
Return of Mortal Remains $25,000
Political Evacuation Up to $10,000
Accidental Death $25,000
Dismemberment $25,000 two limbs; $12,500 one limb
Terrorism Coverage Up to $50,000 lifetime maximum
Sudden Recurrence of a Pre-existing Condition (U.S. citizens)
- Medical Up to $5,000 of eligible expenses
- Emergency Medical Evacuation Up to $25,000 of eligible costs and expenses

 

Optional Add-on Plan
Schedule of Benefits Benefit Description
Baggage
- Loss/theft of Baggage $250
- Loss/theft of Valuables $250
- Loss/theft of Personal Papers $250
Legal Assistance
- Binder Fee $500 when served with summons
Personal liability
- Injury to third party $2,000 limit after $100 deductible
- Damage to third person property $500 limit after $100 deductible. Secondary to any other insurance in force
Limited high school sports coverage

*Usual, Reasonable and Customary (URC) charges for eligible expenses in the area where you receive treatment.

All amounts listed are in U.S. dollars


This web page contains only a consolidated and summary description of all current Patriot Exchange Program Insurance benefits, conditions, limitations and exclusions. A certificate containing the complete Certificate Wording with all terms, conditions and exclusions will be included in the fulfillment kit. IMG reserves the right to issue the most current Certificate Wording for this insurance plan in the event this application and/or brochure has expired, is modified, or is replaced with a newer version. Current Certificate Wordings are available upon request.

To learn more about the Patriot Exchange plan, please see below:

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