| Global Citizen EXP: | Benefits| Quote & Apply| FAQs| Eligibility| Why Buy| Claims| Plan Description | ||
| Features | Benefits | |||||||||||||||||||
| Preventative and Primary Care – Deductible is not applicable | ||||||||||||||||||||
Preventative Care For Babies/Children: (Birth to Age 18)
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100% | |||||||||||||||||||
Preventative Care For Adults: (Age 19 and Older)
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100% | |||||||||||||||||||
| Primary Care Office Visits | All except a $10 copay per visit1 | |||||||||||||||||||
| Professional Services | Insurer Pays After Deductible is Met | |||||||||||||||||||
| Surgery, anesthesia, radiation therapy, in-hospital doctor visits, diagnostic X-ray and lab work. | 100% | |||||||||||||||||||
| Inpatient Hospital Services | Insurer Pays After Deductible is Met | |||||||||||||||||||
| Surgery, X-rays, in-hospital doctor visits, Organ/Tissue Transplant | 100% | |||||||||||||||||||
| In-patient medical emergency2 | 100% | |||||||||||||||||||
| In-patient drugs | 100% | |||||||||||||||||||
| Ambulatory and Therapeutic Services | Insurer Pays After Deductible is Met | |||||||||||||||||||
| Ambulatory Surgical Center | 100% | |||||||||||||||||||
| Ambulance Service | 100% | |||||||||||||||||||
| Accidental Dental | $1,000 per year, $200 per tooth | |||||||||||||||||||
| Acupuncture and Chiropractic Services | 100% up to $2,000 | |||||||||||||||||||
| Durable Medical Equipment | 100% | |||||||||||||||||||
| Infusion Therapy | 100% | |||||||||||||||||||
| Physical/Occupational Therapy | $30/visit, 12 visits per year | |||||||||||||||||||
| Basic Prescription Drug Benefit | 50% of actual charges up to $500 | |||||||||||||||||||
| Optional Prescription Drug Benefit | Insurer Waives Deductible | |||||||||||||||||||
| Subject to $3,000 Maximum Benefit per Insured Person per Policy Period | 80% of actual charges | |||||||||||||||||||
| Global Travel Benefits | Insurer Pays Without a Deductible | |||||||||||||||||||
| Medical Evacuation | Up to $100,000 | |||||||||||||||||||
| Repatriation of Remains | Up to $25,000 | |||||||||||||||||||
| Accidental Death and Dismemberment | $50,000 | |||||||||||||||||||
| Other | Inpatient Benefit | Outpatient Benefit | ||||||||||||||||||
| Mental Health | 100% up to 20 days per year | 80% up to 30 visits per year | ||||||||||||||||||
| Substance Abuse | 100% up to 12 days of detox | 80% up to 30 visits per year | ||||||||||||||||||
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Maternity Benefits After 12 months of continuous coverage, Global Citizen members may renew their coverage or apply for a new plan that covers maternity costs in the same way as all other medical conditions. To be eligible for the maternity benefit, a member must not be pregnant at the time of upgrade. |
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| Services provided in addition to the benefits above | ||||||||||||||||||||
For Exclusions and Limitations, and State to State variation in benefits, see Plan Description.
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