PP

Patriot Platinum

Comprehensive Coverage,  Rated A- (Excellent)By: IMG,  UW: Sirius SpecialitySirius Specialty Insurance Corporation
AM Best Rating
A- (Excellent)
Administrator/Underwriter
IMG
Sirius Specialty Insurance Corporation
100%
In Network

After deductible, the plan pays 100% up to the policy maximum.

90%
Out of Network

Plan pays 90% of the first $5,000, then 100% up to the policy maximum.

COVID-19 Included
acute-onset-pre-existing-condition
Acute onset of Pre-Existing Conditions
extendable-cancelable
Extendable & Cancelable
ppo
urgent-care
Urgent Care
medical-coverage-during-travel
Medical Coverage During Travel
extendable-cancelable
Comprehensive Coverage Plan
Coverage from 5 days to 365 days
BUY

Patriot Platinum insurance is a travel medical insurance plan that provides medical insurance coverage and emergency services to individuals and families traveling outside their home country. After the deductible is satisfied, for treatments within the PPO network, the plan pays 100% up to the policy maximum. Outside the PPO network, the plan pays 90% for the first $5,000 and 100% thereafter. Outside the USA, the plan pays 100% after deductible.

Please review Patriot Platinum Insurance Brochure brochure or Description of Coverage brochure (policy document) for complete and accurate coverage and exclusions.

Out-Patient

Dr. / Physician Visit

In-Network: The plan pays 100% to the selected maximum.
Out-of-Network: The plan pays 90% of eligible expenses up to US $5,000, then 100% up to the policy maximum.

Urgent Care

$25 co-pay applies for Urgent Care.
$15 co-pay applies to walk in clinics.
Co-pay waived if $0 deductible is chosen
In-Network: 100% covered up to policy maximum
Out-of-Network: 90% covered for first $5,000
100% covered thereafter

Surgical Treatment

In-Network: The plan pays 100% to the selected maximum.
Out-of-Network: The plan pays 90% of eligible expenses up to US $5,000, then 100% up to the policy maximum.

Prescription Drugs / Medicines

Up to policy maximum.

Lab & X-rays

In-Network: The plan pays 100% to the selected maximum.
Out-of-Network: The plan pays 90% of eligible expenses up to US $5,000, then 100% up to the policy maximum.

Physical Therapy

In-Network: The plan pays 100% to the selected maximum.
Out-of-Network: The plan pays 90% of eligible expenses up to US $5,000, then 100% up to the policy maximum.

In-Patient

Hospital Room

Average semi-private room rate up to the maximum limit. Includes nursing service.

Surgical Treatment

In-Network: The plan pays 100% to the selected maximum.
Out-of-Network: The plan pays 90% of eligible expenses up to US $5,000, then 100% up to the policy maximum.

Hospital Intensive Care Unit

In-Network: The plan pays 100% to the selected maximum.
Out-of-Network: The plan pays 90% of eligible expenses up to US $5,000, then 100% up to the policy maximum.

Emergency Services

Ambulance Expenses

In-Network: The plan pays 100% to the selected maximum.
Out-of-Network: The plan pays 90% of eligible expenses up to US$5,000, then 100% up to the Policy Maximum.

Emergency Room(ER)

In-Network: 100% covered up to policy maximum
Out-of-Network: 90% covered for first $5,000
100% covered thereafter.

Separate deductible of $250 applies to ER visit for illness that does not result in direct inpatient hospital admission.

This deductible does not apply to injuries, or illness that lead to hospitalization.

Dental

Acute, spontaneous and unexpected pain

Up to $300

Accidental emergency

100% covered

Travel

Emergency Medical Evacuation / Repatriation

100% covered up to the medical maximum

Return of Remains

Coverage up to a maximum of $50,000 for return of mortal remains to the insured's home country or up to $5,000 for the preparation, local burial and cremation of your mortal remains at the place of death.

Emergency Reunion

Up to $100,000

Return of minor Child(ren)

Up to $100,000

Trip Interruption

Up to $10,000

Loss of checked Baggage

$50 per item up to $500 maximum per period of coverage

Life

AD&D

Up to $50,000

Common Carrier Accidental Death

Up to $100,000 per Adult; $25,000 per child , to the maximum of $250,000 per family

Other

Pre-Existing Conditions

Acute onset of a pre-existing condition coverage, with varying limits by age, up to $1,000,000 for those under 70 years old.
For people 70 years & over there is no coverage for acute onset of pre-exiting conditions.
$25,000 maximum limit for emergency medical evacuation

Maternity

Not Covered

General Physical full Checkup

Not Covered

Terrorism Coverage

100% covered

Brochure

Support

24-Hrs Emergency Assistance

Yes. Contact number and details can be found on the ID card.

Plan Administrator Company

IMG

Carrier / Underwriter

Sirius Specialty Insurance Corporation

AM Best Rating

A- (Excellent)

Eligibility

Can be purchased by an non-U.S. citizen traveling outside of their home country on a legal visa status. Non-United States citizens or any visa holders (e.g. L/H/B1, B2, etc.) as well as person on Green Card living outside of the U.S. can also purchase the plan for temporary coverage in the U.S. For someone below 65 years of age, coverage must begin within 6 months of arrival in the U.S. and for someone 65 years of age and older, coverage must begin within 30 days of arrival in the U.S. (restriction waived with proof of previous valid insurance within 30 days of the policy start date).

Plan Type

Comprehensive Coverage Plan
Plan pays up to a certain percentage of medical expenses.

Coverage in U.S.A.

Covered

Coverage outside U.S.A.

Covered

Co-Pay

$25 co-pay for Urgent Care;
$15 Co-pay for Walk in Clinics
Co-pay waived if $0 deductible is selected

Co-Insurance

After the Insured pays the deductible:

Within US and Canada- Inside PPO Network: The plan pays 100% to the selected maximum. Outside the PPO Network: The plan pays 90% of eligible expenses up to US$5,000, then 100% up to the Policy Maximum. Outside the United States and Canada:The plan pays 100% to the selected maximum.

How the Benefits are Paid

After the Insured pays the deductible:

Within US and Canada- Inside PPO Network: The plan pays 100% to the selected maximum. Outside the PPO Network: The plan pays 90% of eligible expenses up to US$5,000, then 100% up to the Policy Maximum. Outside the United States and Canada:The plan pays 100% to the selected maximum.

Coverage Type

Lifetime of the policy

Deductible Type

Once Annually or Per Policy Period.

Renewability

Extendable (Only if initially purchased for 1 month) with $5 fee each time you extend, up to a maximum period of 3 years.

Cancellation

Full refund available if cancelled before the policy start date.
Prorated refund available after start date only if no claims have been made
$50 cancellation fee applicable if cancelled after start date

PPO Network

Coverage Length

Min 5 days to Max 36 months.

Available Deductibles

Choose From: $0, $100, $250, $500, $1,000 , $2,500, $5,000, $10,000, $25,000
Co-pay waived if $0 deductible is selected

Available Coverage

Choose From: $1,000,000,$5,000,000,$8,000,000
Ages 70+: Limited to $100,000
Ages 80+: Limited to $20,000

Provider Directory

By Provider, Phone Nos.: 800-628-4664 or 317-655-4500

Plan Brochure

Patriot Insurance Brochure brochure

Home Country Definition

U.S. Citizens: Home Country is always the United States of America.
Non-U.S. Citizens:
Home Country is the country of which the Insured Person is a citizen or national; including any country where the Insured Person maintains his/her primary residence or usual place of abode and any country of which the Insured Person is the possessor of a validly issued passport. In the event there is more than one home country under the above-listed criteria, the Home Country is the country meeting the above-listed criteria and listed by the Insured as his or her Home Country on the application.

US States Restrictions

Residents of Maryland (MD) state cannot purchase this policy. Applicant with Maryland (MD) state address cannot purchase this policy. Policy still provides coverage for policy holder who is visiting MD State

Country Restrictions

Paper Application is needed for residents of Gambia, Ghana, Nigeria, Sierra leone, Niger, Botswana

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.