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CoverAmerica-Gold®
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Comprehensive Coverage

Patriot Plus

Comprehensive Coverage

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Overview Medical Coverage Pre-existing Conditions Out-Patient In-Patient Emergency Services Dental Travel COVID-19 Benefits Other
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Overview

Overview

Overview

Medical Coverage

Medical Coverage

Medical coverage details.

Eligible Medical Expenses
Eligible Medical Expenses
Not covered
Eligible Medical Expenses
Not covered
Eligible Medical Expenses
In-Network
In-Network
100% up to policy maximum
100%
In-Network
100% up to policy maximum
100%
Out-Network
Out-Network
80% of first $5,000, 100% thereafter
80% $5,000 100%
Out-Network
90% of first $5,000, 100% thereafter
90% $5,000 100%
Pre-existing Conditions

Pre-existing Conditions

Medical coverage for Pre-existing and Acute Onset of Pre-existing Conditions.

Pre-Existing Conditions
Pre-Existing Conditions

Pre-existing conditions are typically not covered under Travel Medical plans unless classified as an acute onset of pre-existing condition by a physician and the insurer. Here are some common pre-existing conditions:

  • Pre-Existing Diabetes: Not Covered
  • Pre-Existing Hypertension: Not Covered
  • Pre-Existing Heart Conditions: Not Covered

    Please review your policy document for any other limits or exclusions.

  • Pre-Existing Conditions

    Pre-existing conditions are not covered under Travel Medical plans unless classified as an acute onset of pre-existing condition by a physician and the insurer. Here are some common pre-existing conditions:

  • Pre-Existing Diabetes: Not Covered
  • Pre-Existing Hypertension: Not Covered
  • Pre-Existing Heart Conditions: Not Covered

    Please review your policy document for any other limits or exclusions.

  • Acute onset Pre-Existing Condition
    Acute onset Pre-Existing Condition
    • Up to policy maximum: Age 69 and below
    • Up to $30,000: Age 70 and above
    Acute onset Pre-Existing Condition
    Up to policy maximum: Age 69 and below
    Out-Patient

    Out-Patient

    Medical treatment that does not include an overnight stay at a hospital.

    Dr. / Physician Visit
    Dr. / Physician Visit
    Not covered
    Dr. / Physician Visit
    Not covered
    Urgent Care
    Urgent Care
    Not covered
    Urgent Care
    Not covered
    Surgical Treatment
    Surgical Treatment
    Not covered
    Surgical Treatment
    Not covered
    Prescription Drugs / Medicines
    Prescription Drugs / Medicines
    100% up to Policy Maximum
    100%
    Prescription Drugs / Medicines
    90% of first $5,000, 100% thereafter
    90% $5,000 100%
    Lab & X-rays
    Lab & X-rays
    Not covered
    Lab & X-rays
    Not covered
    Dr. / Physician Visit
    In-Network
    In-Network
    100% up to policy maximum
    100%
    In-Network
    100% up to policy maximum
    100%
    Out-Network
    Out-Network
    80% of first $5,000, 100% thereafter
    80% $5,000 100%
    Out-Network
    90% of first $5,000, 100% thereafter
    90% $5,000 100%
    Urgent Care
    In-Network
    In-Network
    $15 copay, 100% up to Policy Maximum. Copay waived if $0 deductible is selected.
    $15 100%
    In-Network
    $25 copay, 100% up to Policy Maximum
    $25 100%
    Out-Network
    Out-Network
    $15 copay, 80% of the first $5,000, 100% thereafter. Copay waived if $0 deductible is selected.
    $15 80% of first $5,000 100%
    Out-Network
    $25 copay, 90% of the first $5,000, 100% thereafter
    $25 90% of first $5,000 100%
    Surgical Treatment
    In-Network
    In-Network
    100% up to policy maximum
    100%
    In-Network
    100% up to policy maximum
    100%
    Out-Network
    Out-Network
    80% of first $5,000, 100% thereafter
    80% $5,000 100%
    Out-Network
    90% of first $5,000, 100% thereafter
    90% $5,000 100%
    Lab & X-rays
    In-Network
    In-Network
    100% up to policy maximum
    100%
    In-Network
    100% up to policy maximum
    100%
    Out-Network
    Out-Network
    80% of first $5,000, 100% thereafter
    80% $5,000 100%
    Out-Network
    90% of first $5,000, 100% thereafter
    90% $5,000 100%
    In-Patient

    In-Patient

    Medical treatment that includes an overnight stay at a hospital.

    Hospital Room and Board
    Hospital Room and Board
    Not covered
    Hospital Room and Board
    Not covered
    Dr. / Physician Visit
    Dr. / Physician Visit
    Not covered
    Dr. / Physician Visit
    Not covered
    Surgical Treatment
    Surgical Treatment
    Not covered
    Surgical Treatment
    Not covered
    Hospital Room and Board
    In-Network
    In-Network
    100% up to policy maximum
    100%
    In-Network
    100% up to Policy Maximum
    100%
    Out-Network
    Out-Network
    80% of first $5,000, 100% thereafter
    80% $5,000 100%
    Out-Network
    Average semi-private room and rate
    Dr. / Physician Visit
    In-Network
    In-Network
    100% up to policy maximum
    100%
    In-Network
    100% up to policy maximum
    100%
    Out-Network
    Out-Network
    80% of first $5,000, 100% thereafter
    80% $5,000 100%
    Out-Network
    90% of first $5,000, 100% thereafter
    90% $5,000 100%
    Surgical Treatment
    In-Network
    In-Network
    100% up to policy maximum
    100%
    In-Network
    100% up to policy maximum
    100%
    Out-Network
    Out-Network
    80% of first $5,000, 100% thereafter
    80% $5,000 100%
    Out-Network
    90% of first $5,000, 100% thereafter
    90% $5,000 100%
    Emergency Services

    Emergency Services

    Hospital emergency services (certain limits may apply).

    Ambulance Expenses
    Ambulance Expenses
    Not covered
    Ambulance Expenses
    Not covered
    Emergency Room
    Emergency Room
    Not covered
    Emergency Room
    Not covered
    Ambulance Expenses
    In-Network
    In-Network
    No PPO - Out of network coverage applies
    In-Network
    Up to 100%
    100%
    Out-Network
    Out-Network
    100% of urc, up to Policy Maximum
    100%
    Out-Network
    Up to 100%
    100%
    Emergency Room
    In-Network
    In-Network
    Up to 100% coverage. Additional $250 deductible for illnesses that do not result in a hospital admission
    100%
    In-Network
    100% up to policy maximum
    100%
    Out-Network
    Out-Network
    Up to 80% of the first $5,000, 100% thereafter. Additional $250 deductible for illnesses that do not result in a hospital admission
    80% $5,000 100%
    Out-Network
    90% of first $5,000, 100% thereafter
    90% $5,000 100%
    Dental Coverage

    Dental Coverage

    Treatment for injury to or acute and spontaneous pain in sound natural teeth.

    Dental Emergency
    Dental Emergency
    Up to $300
    Dental Emergency
    Up to $300
    Travel Coverage

    Travel Coverage

    Travel-related coverage

    US Border Entry Protection
    US Border Entry Protection
    One way ticket and/or common carrier change fees up to $750
    US Border Entry Protection
    Not covered
    Emergency Medical Evacuation / Repatriation
    Emergency Medical Evacuation / Repatriation
    Up to $1,000,000
    Emergency Medical Evacuation / Repatriation
    Up to $1,000,000
    Return of Mortal Remains
    Return of Mortal Remains
    Up to $25,000
    Return of Mortal Remains
    100% up to policy maximum
    100%
    Trip Interruption
    Trip Interruption
    Up to $10,000
    Trip Interruption
    Not covered
    Trip Delay
    Trip Delay
    Up to $100 (delay of 12hrs or longer)
    Trip Delay
    Not covered
    Lost Luggage
    Lost Luggage
    Up to $1,000
    Lost Luggage
    Up to $500, $50 per item
    Terrorism
    Terrorism
    Up to 100%
    Terrorism
    Up to $50,000
    Personal Liability
    Personal Liability
    Up to $50,000
    Personal Liability
    Up to $25,000
    Identity Theft
    Identity Theft
    Up to $500
    Identity Theft
    Up to $500
    Legal Fees
    Legal Fees
    Up to $250
    Legal Fees
    Not covered
    Lost or Stolen Passport
    Lost or Stolen Passport
    Up to $200
    Lost or Stolen Passport
    Not covered
    Missed Connection
    Missed Connection
    Up to $400
    Missed Connection
    Not covered
    COVID-19 Benefits

    COVID-19 Benefits

    Covid-19 related benefits and coverage

    COVID-19 Medical Coverage
    COVID-19 Medical Coverage
    This plan covers COVID-19 like any other covered medical condition up to the policy maximum. COVID-19 treatment and services will be covered if the virus was contracted after the policy effective date. Preventative care related to COVID-19, like vaccinations, is not covered under the policy. Please review your policy documents for any limits or exclusions.
    COVID-19 Medical Coverage
    This plan covers COVID-19 like any other covered medical condition up to the policy maximum. COVID-19 treatment and services will be covered if the virus was contracted after the policy effective date. Preventative care related to COVID-19, like vaccinations, is not covered under the policy. Please review your policy documents for any limits or exclusions.
    COVID-19 Testing
    COVID-19 Testing
    One-time benefit to cover the cost of a COVID-19 test up to $150. The policyholder does not need to have symptoms or a physician order to utilize the benefit.
    COVID-19 Testing
    Testing can be covered if ordered by the attending physician for diagnostic purposes if symptoms occur after the policy effective date
    COVID-19 Vaccine/Booster
    COVID-19 Vaccine/Booster
    Not covered
    COVID-19 Vaccine/Booster
    Not covered
    COVID-19 Quarantine Coverage
    COVID-19 Quarantine Coverage
    A quarantine indemnity benefit of up to $50/day for 10 days.
    COVID-19 Quarantine Coverage
    Not covered
    Other

    Other

    Other types of coverage not mentioned above.

    Doctor Wellness Visit
    Doctor Wellness Visit
    Not covered
    Doctor Wellness Visit
    Not covered
    Preferred Rates
    Preferred Rates
    Returning customers will enjoy a preferred rate that is approximately 5% lower. The preferred rate will only apply to the same policyholder(s) who purchase a new CoverAmerica-Gold policy.
    Preferred Rates
    Not covered

    Note: All benefits are paid as per UCR. UCR is an established maximum amount that an insurance company will reimburse for a particular medical service or procedure. These changes are based on the average costs billed by the majority of providers in a given region. Learn more.

    Disclaimer
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