318-573-6186
Jing Liu
318-573-6186
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Global Medical Insurance - Bronze - International Health Insurance
Please use this high level information as a guide only and do not make any decisions solely based on this comparison. If you have any concerns, doubts or questions, please refer to the individual policy details for complete information as it is not possible to accurately represent all the details in concise information such as follows. Please call us for further details. If there is any discrepancy between this comparison and the actual policy details, the policy details will override.
All the amounts are in U.S. dollars.
General
Medical - Outpatient
$500 maximum
Pre-inpatient or post-inpatient treatment
$500 maximum
Pre-inpatient or post-inpatient treatment
$500 maximum
Pre-inpatient or post-inpatient treatment
-
-
To policy maximum
$600, maximum of 90 days per covered event. Orphan Drugs or Biologic Drugs do not apply to the maximum limit per event.
X-ray $250 per exam;
Lab services $300 per test
To policy maximum
To policy maximum
20% of primary surgeon's eligible fee.
Medical - Inpatient
Average semi-private room rate, to policy maximum.
To policy maximum
To policy maximum
To policy maximum
20% of primary surgeon's eligible fee.
To policy maximum
Medical - Other Treatment And Services
-
To policy maximum
$600, maximum of 90 days per covered event.
-
$1,500 per covered event
Illness must result in hospital admission.
-
Inpatient: To policy maximum
Outpatient: $40 per visit, maximum of 10 visits within 90 days per covered event.
Must be ordered in advance by physician.
None
Yes
-
-
100% if requested, reduced to 50% if not obtained when required.
Transplants, Interfacility Ambulance Transfer, Medical Evacuation, Orphan Drugs or Biologic Drugs - no coverage if not pre-certified; otherwise covered at 100%; All other - 50%
180 days
$250,000 lifetime
$600 per covered event
Prior to inpatient treatment.
-
To policy maximum
$150 per day, maximum of 30 days.
-
Included
Maternity Coverage
Dental
Optional
$1,000
Wellness
Travel
$10,000, maximum of 15 days; $25 per day meal maximum.
$50,000
$25,000
$5,000
Life
Included in Optional Term Life Insurance
-
Optional
Alternative Medicine
Other
Private Hospital: $400 per night, maximum of $4,000
Public Hospital: $500 per night, maximum of $5,000
-
Plan Features
Before effective date, full refund.
After effective date, short rate refund.
$0
$0
Health Travel Preventative Coverage: $250 for vaccinations and preventative prescription drugs administered by a Physician 30 days prior to initial effective date and before departure.
$250 Up to 74
$500 Up to 74
$1,000 Up to 74
$2,500 Up to 74
$5,000 Up to 74
$10,000 Up to 74
International Medical Group (IMG)
SiriusPoint Specialty Insurance Corporation
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- URC - Usual, Reasonable and Customary Charges.
- For medical benefits, to policy maximum, refer to the Usual, Reasonable and Customary Charges. Deductible and coinsurance apply, unless otherwise noted.
- Whenever there is a difference in benefits levels within PPO network and outside PPO network, the benefits shown above are applicable when availing treatment within PPO network.
- Coverages shown are per person unless noted otherwise.
- The dash (-) in the fields above means Not Applicable (N/A).