Co-Insurance
(Inside
USA/Canada)
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After you pay the deductible,
underwriters will pay 80% of the
next $5,000 of Eligible Expenses,
then 100% to the Overall
Maximum Limit. Coinsurance will
be waived if expenses are
incurred within the PPO and
expenses are submitted to
Underwriters for review and
payment directly to the provider.
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Plan A: After deductible, you pay
20% of the first $5,000 in
covered expenses, rest covered
at 100% up to policy maximum.
Plan B: After deductible, you pay
25% up to policy maximum.
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After you pay the deductible,
the program pays 90% of the
next $5,000 of eligible
expenses, then 100% to the
selected Medical Maximum.
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After you pay the deductible,
the program pays 100% to
the selected Medical Maximum.
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Pre-Existing
Condition Coverage
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Age under 70: You are covered
for an Acute Onset of a
Pre-existing Condition. Coverage
is available up to $15,000
Maximum for Eligible Medical
Expenses and up to $25,000 for
Emergency Medical Evacuation.
Ages 70 & above: No
Pre-existing coverage.
An Acute Onset of a Pre-existing
Condition is a sudden and
unexpected outbreak or recurrence
of a Pre-existing Condition which
occurs spontaneously and without
advance warning either in the form
of Physician recommendations or
symptoms. Treatment must be
obtained within 24 hours of the
sudden and unexpected outbreak
or recurrence.
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Age under 70: You are covered
for an Acute Onset of a Pre-
existing Condition as defined
below. Coverage is available up
to $15,000 Lifetime Maximum
for Eligible Medical Expenses and
up to $25,000 Lifetime
Maximum for Emergency Medical
Evacuation.
Age 70 & above: No Pre-
existing coverage.
Acute Onset of a Pre-existing
Condition” is a sudden and
unexpected outbreak or
recurrence of a Pre-existing
Condition(s) which
occursspontaneously and without
advance warning either in the
form of Physician
recommendations or symptoms,
is of short duration, is rapidly
progressive, and requires urgent
care.
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For US Citizens: Up to
$20,000 for U.S. citizens
traveling outside the United
States.
For Non-US Citizens: For
foreign nationals visiting the
United States, up to $200
per day for each night spent
in the hospital after being
admitted for either a heart
attack or stroke. Max. Benefit
of $3,000.
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Age under 65 (Non US
Citizens): This plan will pay
up to a $20,000 lifetime
maximum for eligible medical
expenses and up to $20,000
lifetime maximum for
emergency medical evacuation.
Age under 65 (US citizens):
Plan will pay the Usual
Reasonable and Customary
charges of a sudden and
unexpected recurrence of a
Pre-existing Condition
(defined on the Exclusions
page) up to the plan
maximum. For those without a
primary health plan, Patriot
Platinum International will pay
up to a $20,000 lifetime
maximum.
Age 65 and older (US
Citizens), with or without a
primary health plan, Patriot
Platinum International will pay
up to a $2,500 lifetime
maximum. The primary health
plan must have existed prior
to the effective date and
during coverage of the Patriot
Platinum plan, and the
Pre-existing Condition must
be covered under the primary
health plan.
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