DLT

Diplomat Long Term International

Comprehensive Coverage,  Rated By: Global,  UW: Allied World Assurance Company
AM Best Rating
Administrator/Underwriter
Global Underwriters
Allied World Assurance Company
80%
In Network

After deductible, the plan pays 80% up to the policy maximum.

COVID-19 Excluded
ppo
urgent-care
Urgent Care
Comprehensive Coverage Plan
Coverage from 90 days to 12 months
BUY

Diplomat Long-term International Insurance provides travel and medical coverage for the US and Non-US citizens, travelling outside of the United States.

Please review Diplomat Long Term Insurance Brochure brochure or policy document for complete and accurate coverage information.

Dr. / Physician Visit
In the USA: After the deductible, plan pays 80% for the first $5,000 and then 100% up to policy max
Outside USA: After the deductible, plan pays 100% up to the chosen policy max
Surgical Treatment
In the USA: After the deductible, plan pays 80% for the first $5,000 and then 100% up to policy max
Outside USA: After the deductible, plan pays 100% up to the chosen policy max
Prescription Drugs / Medicines
In the USA: After the deductible, plan pays 80% for the first $5,000 and then 100% up to policy max
Outside USA: After the deductible, plan pays 100% up to the chosen policy max
Lab & X-rays
In the USA: After the deductible, plan pays 80% for the first $5,000 and then 100% up to policy max
Outside USA: After the deductible, plan pays 100% up to the chosen policy max
Hospital Room
In the USA: After the deductible, plan pays 80% for the first $5,000 and then 100% up to policy max
Outside USA: After the deductible, plan pays 100% up to the chosen policy max
Surgical Treatment
In the USA: After the deductible, plan pays 80% for the first $5,000 and then 100% up to policy max
Outside USA: After the deductible, plan pays 100% up to the chosen policy max
Hospital Intensive Care Unit
In the USA: After the deductible, plan pays 80% for the first $5,000 and then 100% up to policy max
Outside USA: After the deductible, plan pays 100% up to the chosen policy max
Drug/Alcohol Abuse
Not Covered
Ambulance Expenses
In the USA: After the deductible, plan pays 80% for the first $5,000 and then 100% up to policy max
Outside USA: After the deductible, plan pays 100% up to the chosen policy max
Emergency Room(ER)
In the USA: After the deductible, plan pays 80% for the first $5,000 and then 100% up to policy max
Outside USA: After the deductible, plan pays 100% up to the chosen policy max
Acute, spontaneous and unexpected pain
Up to $100
Accidental emergency
In the USA: After the deductible, plan pays 80% for the first $5,000 and then 100% up to policy max
Outside USA: After the deductible, plan pays 100% up to the chosen policy max
Emergency Medical Evacuation / Repatriation
Up to $500,000
Return of Remains
Up to $50,000
Emergency Reunion
Up to $50,000
Return of minor Child(ren)
Up to $50,000
Trip Interruption
Up to $5,000
Loss of checked Baggage
$50 per item, up to $250
AD&D
$250,000 maximum benefit for any one family or group

Members under age 18:
Lifetime maximum: $5,000
Death: $5,000
Loss of 2 limbs: $5,000
Loss of 1 limb: $2,500

Members age 18—69:
Lifetime maximum: $100,000
Death: $100,000
Loss of 2 limbs: $100,000
Loss of 1 limb: $50,000

Members age 70—74:
Lifetime maximum: $12,500
Death: $12,500
Loss of 2 limbs: $12,500
Loss of 1 limb: $6,250

Members age 75 and older:
Lifetime maximum: $6,250
Death: $6,250
Loss of 2 limbs: $6,250
Loss of 1 limb: $3,125

Not subject to deductible, coinsurance, or overall maximum limit.
Common Carrier Accidental Death
Members under age 18: $25,000
Members age 18—69: $50,000
Members age 70—74: $12,500
Members age 75 and older: $6,250

Subject to a maximum of $250,000 any one family or group. Not subject to deductible, coinsurance, or overall maximum limit.
Cataract Surgery
Not Covered
Cancer
Not Covered
Cardiac
Not Covered
Mental Illness
Not Covered
Alzheimer's Desease
Not Covered
Hazardous Sports Coverage
Not Covered
Pre-Existing Conditions
For US Citizens Only: Covers up to $20,000 for unexpected recurrence of a pre-existing condition. For people 65+ up to $2,500.
Maternity
Not Covered
24-Hrs Emergency Assistance
Yes. Contact Number and details can be found on the ID card.

Plan Administrator Company

Global Underwriters

Carrier / Underwriter

Allied World Assurance Company

AM Best Rating

Eligibility

Can be purchased by US & non-United States citizens, travelling outside of their home country, excluding the USA

Plan Type

Comprehensive Coverage Plan

Coverage in U.S.A.

Percentage-based coverage

Coverage outside U.S.A.

Not Covered

Co-Pay

No Co-pay

Co-Insurance

After deductible no co-insurance.

How the Benefits are Paid

After deductible plan pays 100% up to selected maximum

Plan Effective Date

Coverage can begin as the following:
1. The depature date of your home country or after.
2. The day you request on the application.

Plan End Date

Coverage can terminate as the following:
1. The date of your permanent return to your Home Country; or
2. The termination date shown on the enrollment form, for which premium has been paid; or
3. 36 months after your coverage effective date.

Coverage Type

Lifetime of the policy

Deductible Type

Per policy period

Renewability

Extendable with a $10 fee.
For age 0-69: Up to 3 years.
For age 70-79: Up to 24 months
For age 80+: Up to 12 months

Cancellation

Not CancelableOnly before policy start date. Full refund available if cancelled before start date. A $25 cancellation fee applies. After effective date NO REFUND

PPO Network

No PPO network

Coverage Length

Minimum 3 Months to 1 Year.
Extendable for total of 3 years

Available Deductibles

Choose From: $0, $50, $100, $250, $500, $1,000, $2,500 or $5,000 per Policy Period or Annual.

Available Coverage

Choose From:
Plan A - $500,000
Plan B - $100,000
Ages 70 to 79: $100,000
Ages 80+: Limited to $20,000

Provider Directory

No PPO Network

Plan Brochure

Diplomat Long Term Insurance Brochure brochure

Home Country Definition

The country where the covered person has his/her true, fixed, permanent home and principal establishment. For US citizens, the USA is considered your home country.

US States Restrictions

New York, Maryland and South Dakota- Plan cannot be purchased with these state addresses

Country Restrictions

Citizens and Residents of Australia and Canada are not eligible for this plan.
Plan will not cover for travel to Iran or Australia

Disclaimer

Plan features listed here are high level, provided for your convenience and information purpose only. Please review the Evidence of Coverage and Plan Contract (Policy) for a detailed description of Coverage Benefits, Limitations and Exclusions. Must read the Policy Brochure and Plan Details for complete and accurate details. Only the Terms and Conditions of Coverage Benefits listed in the policy are binding.