| BENEFIT | LIMIT |
|---|---|
| Medical Maximums | $60,000; $125,000; $600,000; $1,000,000 Medical Maximum is per person per Period of Coverage. Insureds age 65 to 79 traveling inside the United States are limited to a $60,000 medical maximum. Insureds age 80 years and older traveling inside the United States are limited to a $20,000 medical maximum. Insureds age 70 to 79 traveling outside the United States are limited to a $125,000 medical maximum. Insureds age 80 years and older traveling outside the United States are limited to a $20,000 medical maximum. |
| Deductible | $0, $100, $250, $500, $1,000, $2,500. Deductible is per person per Period of Coverage. Maximum of 3 Policy Period Deductibles per family. |
| Coinsurance | Individuals traveling outside the U.S. & Canada: After You pay the Deductible, the Policy pays 100% to the selected Medical Maximum. Individuals traveling inside the U.S. & Canada: After You pay the Deductible, the Policy pays 80% of the next $5,000 of eligible expenses, then 100% to the selected Medical Maximum. |
| Hospital Indemnity | $150 per night, up to a maximum of 30 days (Applicable to Individuals traveling outside the U.S. and Canada only). |
| Dental (Sudden Relief of Pain) | To a maximum of $100 (Only available to programs purchased for 1 month or more.) |
| Dental (Accident Coverage) | To a maximum of $500 (Only available to programs purchased for 1 month or more.) |
| Emergency Medical Evacuation/Repatriation | $300,000 (in addition to the Medical Maximum) |
| Return of Mortal Remains | $50,000 |
| Political Evacuation: | $50,000 |
| Felonious Assault | $10,000 |
| Coma Benefit | $50,000 |
| Terrorism | Usual, reasonable and customary to $50,000 Lifetime Maximum |
| Return of Minor Child(ren) | $50,000 |
| Emergency Reunion | $50,000 |
| Local Ambulance Benefit | $5,000 |
| Accidental Death & Dismemberment (AD&D) Note: In the event of a Common Carrier Accidental Death, this benefit will not be paid. | $25,000 principal sum for Insured or Insured Spouse $5,000 principal sum for Dependent Child(ren) Aggregate limit of $250,000 per family |
| Common Carrier Accidental Death | $50,000 principal sum for Insured or Insured Spouse, $12,500 principal sum for Dependent Child(ren) Aggregate limit of $250,000 per family |
| Loss of Baggage | $250 |
| Interruption of Trip | $5,000 |
| Home Country Coverage | Incidental Trips to The Home Country: Up to $50,000 Extension of Benefits (Follow Me Home Coverage): Up to $5,000 |
| Hospital Room & Board | Usual, reasonable and customary to the selected Medical Maximum |
| Intensive Care | Usual, reasonable and customary to the selected Medical Maximum |
| Outpatient Medical Expenses | Usual, reasonable and customary to the selected Medical Maximum |
| Waiver of Pre-existing Conditions | Available only for U.S. citizens traveling outside the United States and Canada. If the insured has a Primary Health Plan as defined herein, the benefit covers to the medical maximum (for persons age 65 and over, the amount is limited to $2,500). If the insured does not have a Primary Health Plan, the benefit covers the first $20,000 in eligible medical expenses (for persons age 65 and over, the amount is limited to $2,500). |
| Heart Attack and Stroke | Up to $200 per day for each night spent in the hospital after being admitted for either a heart attack or stroke. (For foreign nationals visiting the United States only) |
| Benefit Period | 180 Days |
| Hazardous Sport Coverage | Optional, provided only if required premium is paid. |