Atlas Travel America Insurance

Comprehensive benefits plan
For non-U.S. citizens traveling outside home country (U.S.A. included)
In USA & Canada:
a) In Network & Directly Billed: After deductible, Plan pays 100% to policy maximum
b) Otherwise: After deductible, Plan pays 80% of $5,000 and then 100% to policy maximum
Outside USA & Canada: After deductible, Plan pays 100% to policy maximum
Cancelable and Renewable
Same as Policy Maximum (up to $1,000,000) coverage for acute onset of pre-existing conditions for age under 70 years
Coverage is provided outside of home country including during travel
Deductible and Policy Maximum is per certificate period per person
Coverage is available from 5 days to 364 days for ages 14 days to 99 years
Coventry Health Care PPO Network
Not available if mailing address and insured is physically located at the time of quote in Maryland(MD), New York(NY) & Washington(WA)
Administrator: HCC Medical Insurance Services
Underwriter: Lloyd’s of London
Only plan where start date can be same day
Extreme/Vacation Sports are covered
$50 copay for urgent care visit. Not subject to deductible
Free insurance for a child under 10 years old per each insured adult
Other Benefits: • 24/7 Worldwide Travel and Medical Assistance •Accidental Death and Dismemberment •Common Carrier Accidental Death •Complications of Pregnancy •Emergency Dental (acute onset of pain) •Emergency Medical Evacuation Emergency Reunion •Hospitalization and Outpatient Treatment •Incidental Home Country Coverage •Lost Checked Luggage •Natural Disaster Benefit •Political Evacuation •Repatriation of Remains •Return of Minor Children •Sports Coverage •Terrorism •Trip Interruption
Optional Riders: • Enhanced Accidental Death & Dismemberment

Benefits

BENEFIT	LIMIT
Deductibles	$0, $100, $250, $500, $1,000 or $2,500 per certiﬁcate period.
Coinsurance - Claims incurred in U.S. or Canada	For the certiﬁcate period, underwriters will pay 80% of the next $5,000 of eligible expenses after the deductible, then 100% to the overall maximum limit. Coinsurance will be waived if expenses are incurred within the PPO and are submitted to underwriters for review and payment directly to the provider.
Coinsurance - Claims incurred out- side U.S. or Canada	For the certiﬁcate period, underwriters will pay 100% of eligible expenses after the deductible up to the overall maximum limit.
Hospital Room and Board	Average semi-private room rate, including nursing services.
Local Ambulance	Usual, reasonable and customary charges, when covered illness or injury results in hospitalization as inpatient.
Intensive Care Unit	Usual, reasonable and customary charges.
Emergency Room Co-payment	In addition to coinsurance, the member shall be responsible for a $200 co-payment for each use of emergency room for an Illness unless the member is admitted to the hospital. There will be no copayment for emergency room treatment of an injury.
Urgent Care Center	For each visit, the member shall be responsible for a $50 co-payment, after which coinsurance will apply. Not subject to deductible.
Hospital Indemnity (in addition to medical expenses)	$100 per day of inpatient hospitalization for member's use to offset miscellaneous expenses (not subject to deductible or coinsurance).
Physical Therapy	$50 maximum per day.
All Other Eligible Medical Expenses	Usual, reasonable and customary charges.
Acute Onset of Pre-existing Condition (only available to members younger than 70)	Limited beneﬁt up to the medical coverage maximum (excludes chronic and congenital conditions). $25,000 lifetime maximum for emergency medical evacuation.
Emergency Dental (acute onset of pain)	$250 limit per certiﬁcate period (not subject to deductible or coinsurance).
Emergency Medical Evacuation	$1,000,000 lifetime maximum, except as provided under acute onset of pre-existing condition (not subject to deductible or coinsurance).
Return of Minor Children	$50,000 per certiﬁcate period (not subject to deductible or coinsurance).
Pet Return	Up to $1,000 to return a traveling pet home if member is hospitalized.
Repatriation of Remains	Overall maximum limit (not subject to deductible or coinsurance).
Emergency Reunion	$50,000 limit per certiﬁcate period, subject to a maximum of 15 days (not subject to deductible or coinsurance).
Natural Disaster	Maximum $100 a day for 5 days (not subject to deductible or coinsurance).
Trip Interruption	$5,000 limit per certiﬁcate period (not subject to deductible or coinsurance).
Trip Delay	$100 for a 12-hour delay requiring an unplanned overnight stay (2 days maximum).
Lost Checked Luggage	$500 limit per certiﬁcate period (not subject to deductible or coinsurance).
Political Evacuation	$10,000 lifetime maximum (not subject to deductible or coinsurance).
Terrorism	$50,000 maximum lifetime limit, eligible medical expenses only.
Accidental Death and Dismemberment (excludes loss due to common carrier accident; $250,000 maximum beneﬁt per one family or group)	Not subject to deductible or coinsurance.
Members up to age 18	Lifetime max. - $5,000; Death - $5,000; Loss of 2 limbs - $5,000; Loss of 1 limb - $2,500.
Members age 18 through 69	Lifetime max. - $50,000; Death - $50,000; Loss of 2 limbs - $50,000; Loss of 1 limb - $25,000.
Members age 70 through 74	Lifetime max. - $12,500; Death - $12,500; Loss of 2 limbs - $12,500; Loss of 1 limb - $6,250.
Members age 75 and older	Lifetime max. - $6,250; Death - $6,250; Loss of 2 limbs - $6,250; Loss of 1 limb - $3,125.
Common Carrier Accidental Death ($250,000 maximum beneﬁt per any one family or group)	Not subject to deductible or coinsurance. Up to age 18 - $25,000 per member; Age 18 to 69 - $50,000 per member; Age 70 to 74 - $12,500 per member; Age 75 and older - $6,250.
Hospital Pre-certiﬁcation Penalty	50% of eligible medical expenses.
Overall Maximum Limit Per Certiﬁcate Period	Age 80 or older - $10,000; Age 70 to 79 - $50,000, $100,000; All others - $50,000, $100,000, $200,000, $500,000 or $1,000,000.
Crisis Response	$10,000 limit per certiﬁcate period; Includes access to Unity Crisis Group services.
Personal Liability	$10,000 lifetime maximum.
Bedside Visit	$1,500 (economy ticket for family member to visit if member admitted to ICU).