All amounts listed are in U.S. dollars. Click the gray titles to see further information.
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| MEDICAL BENEFITS |
Usual reasonable and customary charges, subject to deductible and coinsurance |
| Coverage Area |
Worldwide, 24 hours per day |
| Policy Maximum |
$1,000,000 per insured per certificate period |
| Hospitalization |
Average semi-private room rate |
| Supplemental Accident Benefit |
$300 per covered accident, before application of deductible and coinsurance |
| Mental and Nervous Care |
$20,000 lifetime maximum after 12 months of continuous coverage |
| Maternity and Newborn Care |
Up to the policy maximum after 10 months of continuous coverage |
| Transplants |
Up to a lifetime maximum of $1,000,000 |
 |
Subject to special transplant pre-notification requirements, and only when treatment is provided within the Managed Transplant System Network
| Emergency Medical Evacuation |
Up to a lifetime maximum of $1,000,000-must be approved and coordinated in advance by IMG |
| Emergency Medical Evacuation |
Up to a lifetime maximum of $1,000,000-must be approved and coordinated in advance by IMG |
| Repatriation of Mortal Remains |
Up to $25,000 - must be approved and coordinated in advance by IMG |
| Chiropractic Care |
URC |
|
With a physician's referral URC Without a physician's referral.
$25 per visit, up to 20 visits per year, not subject to deductible or coinsurance
| Wellness Care |
Up to $250 per calendar, not subject to deductible or coinsurance |
|
Routine physical examinations, including pap smear and mammogram after 12 months of continuous coverage
| SCUBA Coverage |
URC |
|
Please contact your agent or representative for details
| Physical Therapy |
Up to $50 per visit, per charge |
| Amateur Sailboat Racing Coverage |
$10,000 per policy period, $50,000 lifetime maximum with a benefit specific deductible of $2,500 per calendar year |
* This Web page contains only a consolidated and summary description of all current benefits, conditions, limitations and exclusions. A certificate containing the complete Certificate Wording with all terms, conditions and exclusions will be included in the fulfillment kit. IMG reserves the right to issue the most current Certificate Wording for this insurance plan in the event this Web page, application, and/or brochure has expired, is modified, or is replaced with a newer version. Current Certificate Wordings are available upon request.