Out-Patient |
| Dr. / Physician Visit |
80%covered for first $5,000 100% covered thereafter
|
| Urgent Care |
With $50 copay (Deductible waived) only applicable to claims incurred inside the US.
|
| Surgical Treatment |
80%covered for first $5,000 100% covered thereafter
|
| Prescription Drugs / Medicines |
80%covered for first $5,000 100% covered thereafter (pay first then file claim)
|
| Lab & X-rays |
80%covered for first $5,000 100% covered thereafter
|
| Physical Therapy |
$50 per visit
|
In-Patient |
| Hospital Room |
80%covered for first $5,000 100% covered thereafter
|
| Surgical Treatment |
80%covered for first $5,000 100% covered thereafter
|
| Hospital Intensive Care Unit |
80%covered for first $5,000 100% covered thereafter
|
Emergency Services |
| Ambulance Expenses |
80%covered for first $5,000 100% covered thereafter
|
| Emergency Room(ER) |
80%covered for first $5,000 100% covered thereafter. ($200 co-pay applicable, In addition to the deductible if not admitted as an inpatient. Only applicable to claims incurred inside the US.)
|
Dental |
| Acute, spontaneous and unexpected pain |
Up to $250
|
| Accidental emergency |
80%covered for first $5,000 100% covered thereafter
|
Travel |
| Emergency Medical Evacuation / Repatriation |
Emergency air and/or ground transportation to the nearest hospital that is qualified to provide the Medically Necessary treatment.$500,000 Maximum Lifetime Limit.
|
| Return of mortal Remains |
Air and/or ground transportation of bodily remains or ashes to the area of your Principal Residence, and reasonable costs of preparation of your remains necessary for transportation.
|
| Emergency Reunion |
$15,000
|
| Return of minor Child(ren) |
Benefit upto $50,000. The cost of a one-way economy air and/or ground transportation ticket for each covered child to the terminal serving the area of Principal Residence of each covered child.
|
| Trip Interruption |
The cost of a one-way economy air and/or ground transportation ticket for each covered child to the terminal serving the area of Principal Residence.
|
| Loss of checked Baggage |
$50 per item, $250 max
|
Life |
| AD&D |
Up to $25,000 (Benefit Limits apply for ages 70 & over)
(Dependents: $5,000)
|
| Common Carrier Accidental Death |
Up to $50,000 (Dependents $25,000 each; $250,000 Max for Family)
|
Other |
| Pre-Existing Conditions |
If you are under age 70, you are covered for an Acute Onset of a Pre-existing Condition. Coverage is available $50,000 or $100,000 Maximum for Eligible Medical Expenses and upto $25,000 for Emergency Medical Evacuation. 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.
|
| Local Burial or Cremation |
$5,000 lifetime limit
|
| Maternity |
Not covered
|
| Incidental Home Country Coverage |
Non-US citizen permitted a maximum of 30 days per 3 month. Incidental home country coverage.
|
| General Physical full Checkup |
Not covered
|
| Terrorism Coverage |
Up to $50,000
|
| Brochure |
Atlas America Insurance Brochure
|
Support |
| 24-Hrs Emergency Assistance |
Yes. Contact Number and details can be found on the ID card.
|