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Global Medical

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The table below shows the plan benefits for the Global Medical insurance plan across all plans:

Benefits Silver Gold
(1st 36 months of continuous coverage)
Gold
(Beginning the 1st day of the 37th month)
Gold Plus Platinum
Lifetime Maximum Limit $5 million per individual $8 million per individual
Deductible
Per Period of Coverage
$250 to $10,000 $100 to $10,000
Family Deductible 3 times the individual deductible 2 times the individual deductible
Provider Network PPO Network
Treatment outside the U.S. and Canada Subject to deductible
No coinsurance
Treatment inside the U.S.
Out-patient/ In-patient Emergency
PPO Network - deductible 50% waived
(to a $2,500 maximum). No coinsurance.
Treatment inside the U.S.
In-patient Non-emergency
Medical Concierge - deductible 50% waived (to a $2,500 maximum).
No coinsurance. PPO Network - subject to deductible.
Treatment inside the U.S.-
Non-PPO Network and Canada
Subject to deductible — Plan pays 80% of the next $5,000 of eligible expenses, then 100% to the overall maximum per period of coverage Subject to deductible — Plan pays 90% of the next $5,000 of eligible expenses, then 100% to the overall maximum per period of coverage
Hospitalization/ Room & Board
In U.S. / Canada
URC of average semi-private room rate. All subject to $600 per day - 240 day max. URC of average semi-private room rate. Up to a limit of $2,250 per day - semi-private room rate URC of average semi-private room rate. Private room rate
Hospitalization/ Room & Board
Outside of U.S. / Canada
URC of private room rate (not to exceed 150% of semi-private room rate) All subject to $600 per day - 240 day max. URC of private room rate (not to exceed 150% of semi-private room rate) Up to a limit of $2,250 per day - semi-private room rate URC of private room rate (not to exceed 150% of semi-private room rate) Private room rate
Intensive Care Unit $1,500 per day - 180 day per event URC Up to a limit of $4,500 per day URC URC
Surgery URC URC URC URC URC
Anesthetist's Charges Associated with Surgery 20% of surgery benefit URC 20% of surgery benefit URC URC
Transplants $250k per transplant $1 million lifetime max. $500k lifetime max. $1 million lifetime max. $2 million lifetime max.
Out-patient 25 visits: $70 Dr. / specialist; $60 Psych.; $50 Chiro.; $250 X-ray per exam max. limit; $500 surgery intervention consultation; $300 lab tests per exam max. limit URC Physician Charges - limit of $150 per visit; Hospital Charge - $100 co-pay unless admitted; Urgent Care Facility - $25 co-pay; Diagnostic Lab and X-Rays limited to $5,000 per certificate period URC URC
Emergency Room Illness
(Additional $250 deductible if not admitted)
URC URC URC URC URC
Emergency Room Accident URC URC URC URC URC
Supplemental Accident NA $300 per occurrence $500 per occurrence
Local Ambulance $1,500 per event - not subject to deductible or coinsurance URC $100 per event - not subject to deductible or coinsurance URC URC
Mental/ Nervous Out-patient only after 12 months of continuous coverage $10k per period - $50k max. - Available after 12 months of continuous coverage $2,500 max. per certificate period; In-patient limited to 25 days per certificate period; Out-patient limited to max of 20 visits per certificate period at 70% eligible expenses, up to $75 max. per visit; Lifetime max. of $30,000 $10k per period - $50k max. - Available after 12 months of continuous coverage SAAI - $50k lifetime max. - Available after 12 months of continuous coverage
Emergency Evacuation $50,000 per period of coverage - not subject to deductible or coinsurance Up to max. limit - not subject to deductible or coinsurance $250k limit per person per certificate period Up to max. limit - not subject to deductible or coinsurance Up to max. limit - not subject to deductible or coinsurance
Emergency Reunion NA $10,000 lifetime max.
Return of Mortal Remains
Lifetime maximum per insured - not subject to deductible or coinsurance
$25,000 $25,000 $15,000 $25,000 $50,000
Remote Transportation NA NA NA NA Limited to $5,000 per certificate period up to $20,000 lifetime max.
Political Evacuation and Repatriation NA NA NA NA Limited to $10,000 lifetime max.
Child Wellness
(Under 18 years of age)
3 visits per period of coverage - $70 max. per period - Available after 12 months of continuous coverage $200 max. per period of coverage - not subject to deductible or coinsurance. Available after 12 months of continuous coverage $400 max. per period of coverage - not subject to deductible or coinsurance. Available after 6 months of continuous coverage
Adult Wellness NA $250 per period of coverage - not subject to deductible or coinsurance - Available for those 30 years of age and over after 12 months of continuous coverage $500 per period of coverage - not subject to deductible or coinsurance - Available for those 18 years of age and over after 6 months of continuous coverage
Rx Coverage URC URC $5,000 per certificate period for each insured person, out-patient only URC Outside U.S. - URC. Inside U.S. - Rx drug card co-pay: $20 for generic / $40 for brand name where generic is not available (Certain monthly per prescription amount limits may apply and require pre-approval by the Company.)
Other Services Extended care: first 30 days; Radiation: URC; Home nursing: 30 days per covered event; Hospice: 30 days; Prosthetic Devices: all URC URC URC - Radiation & Chemotherapy treatments (in and out-patient) limited to $10,000 per year; $50,000 lifetime max. URC URC
Physical Therapy Max. $40 per visit - 30 visit max. Max. $50 per visit Max. $50 per visit - $1,000 max per certificate period. $10,000 lifetime max. Max. $50 per visit Max. $50 per visit
Complementary Medicine NA Acupuncture $150; Aroma Therapy $50; Herbal Therapy $50; Magnetic Therapy $75; Massage Therapy $150; Vitamin Therapy $100. Each per period of coverage
Recreational Scuba NA URC URC URC URC
Emergency Dental due to Accident $1,000 per period of coverage URC $500 per period of coverage URC URC
Emergency Dental due to Sudden Unexpected Pain NA $100 per period of coverage See Non-emergency Dental benefits
High School Sports Injury NA NA NA NA Up to $20,000 per certificate period
Dental Care (after 6 months of coverage)

Optional Vision & Dental Rider*

Calendar Year Max. US$750 per Insured Person
Deductible US$50 per Insured Person per Calendar Year
Deductibles per Family per Calendar Year. with a max. of two (2)
Calendar year max.: $750;
Individual deductible - $50 Schedule of Benefits-
Class I 90%; Class II 70%; Class III 50%; 6 month waiting period
Vision

Optional Vision & Dental Rider*

Exam Up to $100 every twenty-four (24) months for a Routine Eye examination.
Corrective Up to $150 every twenty-four (24) months for corrective lenses, Not subject to deductible and coinsurance.
Contacts to correct vision and frames. Not subject to deductible and coinsurance.
Exams: up to $100
Materials: up to $150 per 24 months
Maternity Delivery, wellness, new born care & congenital disorders, Family Matters Maternity Program (*not subject to deductible or coinsurance - available after 10 months of coverage)

Optional Maternity Rider*

$50,000 lifetime max., max. of $5,000 for normal delivery,
$7,500 for C-section, $200 child wellness benefit for the first 12 months, new born care & congenital disorders
max. of $250k for the first 31 days (Benefits reduced by 50% for births that occur
in the 11th or 12th month of continuous coverage)
SAAI - $1,000 additional deductible,
$50,000 lifetime max.,
$200 childwellness benefit for the first 12 months, new born care& congenital disorders max. of $250k for the first 31 days

Pre-existing Conditions

The Silver, Gold and Gold Plus plan options provide a $50,000 lifetime benefit for eligible pre-existing conditions that existed at or prior to the effective date, subject to a maximum of $5,000 per period of coverage after coverage has been in effect for 24 continuous months. This benefit is payable whether or not you have received consultation or treatment for the condition(s) during the 24-month period of continuous coverage.

The following illnesses which exist, manifest themselves, or are treated or have treatment recommended prior to or during the first 180 days of coverage from the initial effective date are considered pre-existing conditions and are subject to the waiting period and other limitations of coverage described above: acne, asthma, allergies, tonsillectomy, back conditions, adenoidectomy, hemorrhoids or hemorrhoidectomy, disorders of the reproductive system, hysterectomy, hernia, gall bladder or gall stones and kidney stones, any condition of the breast, and any condition of the prostate.

On the Platinum plan option, conditions that are fully disclosed on the application and have not been excluded or restricted by a rider will be covered the same as any illness. Conditions, including any complications therefrom, that are not fully disclosed on the application will not be covered.

The above is a summary schedule of benefits. Benefits are subject to the deductible and coinsurance unless otherwise noted. NA (Not Applicable); URC (Usual, Reasonable and Customary); SAAI (Same As Any Illness). For a further description of benefits, please refer to the Global Medical Brochure.

For more information about the Global Medical Insurance plan, or to apply over the phone:
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For more information about the Global Medical Insurance plan, please see below:

Benefits | Exclusions | Free Quote | Apply Online

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