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Offers 100% coverage across most benefits. All plan options have an Unlimited Lifetime Maximum and a $250,000 maximum benefit for emergency medical evacuation.
| Features | Benefits | ||
|---|---|---|---|
| Lifetime Maximum per Insured Person | Unlimited | ||
| Annual Maximum per Insured Person | Unlimited | ||
| Preventative and Primary Care | Insurer waives deductible | ||
Preventative Care For Babies/Children: (Birth to Age 18)
|
100% | ||
Preventative Care For Adults: (Age 19 and Older)
|
100% | ||
| Primary Care Office Visits | All except a $10 copay per visit 1 | ||
| 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 emergency 2 | 100% | ||
| In-patient drugs | 100% | ||
| Ambulatory and Therapeutic Services | Insurer Pays After Deductible is Met; Unless Noted | ||
| 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 deductible is waived |
$50 limit per visit, 12 visits per year | ||
| Rehabilitation and Therapy | Insurer Pays After Deductible is Met | ||
| a. Inpatient Mental Health | 100% up to 60 days | ||
| b. Outpatient Mental Health | 75% up to 40 visits/60% thereafter | ||
| c. Inpatient Substance Abuse | 100% up to 60 days detox | ||
| d. Outpatient Substance Abuse | 75% up to 40 visits/60% thereafter | ||
| Optional Xplorer Essential with Basic U.S. Benefits | Insurer Pays After Deductible is Met | ||
| Emergency Medical Care, Illness and Accidental Injury Services while temporarily visiting the United States | |||
| Physician's Office Visit Services |
U.S. Participating Provider - 100%, No Deductible, $50 Copay U.S. Non- Participating Provider - 60% |
||
| Hospital Emergency Room |
U.S. Participating Provider - 80% Additional $250 Copay per visit - waived if admitted U.S. Non-Participating Provider - 60% Additional $250 Copay per visit - waived if admitted |
||
| Outpatient Professional Services (radiology, pathology and ER Physician) |
U.S. Participating Provider - 80% U.S. Non-Participating Provider - 60% |
||
| Urgent Care Facility |
U.S. Participating Provider - 100%, No Deductible, $75 Copay U.S. Non- Participating Provider - 60% |
||
| X-ray and/or Lab performed at the Emergency Room or Urgent Care Facility (billed as part of the visit) |
U.S. Participating Provider - 80% U.S. Non-Participating Provider - 60% |
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| X-ray and/or Lab performed at the Independent facility in conjunction with the Emergency Room visit |
U.S. Participating Provider - 80% U.S. Non-Participating Provider - 60% |
||
| Ambulance |
U.S. Participating Provider - 80% U.S. Non- Participating Provider - 60% |
||
| Inpatient Hospital - Facility/Professional Charges | Admissions limited to Emergency Medical Care, Illness and Accidental Injury Services while temporarily visiting the United States | ||
| Bed and Board Charges |
U.S. Participating Provider - 80% U.S. Non-Participating Provider - 60% |
||
| Physician's Visits/Consultations |
U.S. Participating Provider - 80% U.S. Non-Participating Provider - 60% |
||
|
Professional Services (Surgeon, Radiologist, Pathologist, Anesthesiologist) |
U.S. Participating Provider - 80% U.S. Non-Participating Provider - 60% |
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| Prescription Drugs Purchased inside the United States |
Limited to Emergency Medical Care, Illness and Accidental Injury Conditions covered under this package.
Pre-existing Condition Limitation Apply(es) 100% of the Actual Cost, Deductible does not apply Maximum benefit of $1,000 per Calendar Year and the maximum supply of 30 days per covered prescription |
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| Optional Enhanced Prescription Benefits | Insurer Waives Deductible | ||
| Basic Prescription Drug Benefit (Pay and claim benefit only) | 100% of actual charges up to $1,000 | ||
| Optional Prescription Drug Benefit, Subject to $25,000 Maximum per Insured Person per Policy Period | 100% of actual charges | ||
| Optional Dental Benefits |
Annual Max - $1,500 Preventative Dental - 100% Primary Dental - 80% Major Dental - 50% Orthodontic Dental - 50% up to $1000 Lifetime Max |
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| Optional Vision Benefits |
Annual Max - $250 Vision Examination - 70% Frames or Lenses - 70% |
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| Global Travel Benefits | Insurer Waives Deductible | ||
| Medical Evacuation | Up to $250,000 | ||
| Repatriation of Remains | Up to $25,000 | ||
| Accidental Death and Dismemberment | $50,000 | ||
| Plan Options Essential1,2 | Deductible 3 |
|---|---|
| Elite | $0 |
| 250 | $250 |
| 500 | $500 |
| 1,000 | $1,000 |
| 2,500 | $2,500 |
| 5,000 | $5,000 |
| Plan Options Select1,2 | Deductible 3 |
|---|---|
| Elite | $0 |
| 2,500 | $2,500 |
| 5,000 | $5,000 |
1. Copay waived when visiting a contracted provider.
2. Emergency room visits that do not result in inpatient admissions will be subject to a $50 penalty.
3. Deductibles are Per Person per Calendar Year. A family is charged a maximum of 2.5 deductibles.
Additional services provided
- Access to our global community of carefully selected, contracted hospitals, physicians, dentists and behavioral health professionals in over 190 countries
- Detailed provider profiles
- Appointment scheduling
- Direct Pay to providers
- Emergency evacuation services
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mPassport and Global Health and Safety Resources
- Convenient mobile app makes it easy to identify, access and pay for quality healthcare around the world
- Request appointments and arrange Direct Pay
- Find local equivalency and availability for your medication
- Translate medical terms and phrases in thirteen languages
- Country and city-level health and security profiles
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Ten Day Money Back Guarantee
YOUR SATISFACTION IS GUARANTEED. We are so confident in our products that we offer the best guarantee in the business! If you are not completely satisfied with our product, simply return your Certificate or Policy of Insurance and Description of Emergency Medical Evacuation and Other Services within 10 days of receipt and include a letter indicating your desire to cancel.