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Diplomat International - Optional High Risk plan benefits

All coverage, benefits and premiums are in U.S. Dollar amounts. If an Injury or Illness occurs during the Period of Coverage and the Insured Person requires medical or surgical treatment, this plan will pay the following Covered Expenses, up to the selected policy maximum.  (Subject to the selected deductible and applicable co-insurance, and exclusions)

Covered Expenses - Expenses that are incurred for medical care and supplies which are: (a) necessary and customary; (b) prescribed by a Physician for the therapeutic treatment of a disablement; (c) are not excluded under the policy; (d) are not more than the Reasonable and Customary charges (as determined by the Company); and (e) are incurred within 365 days for US Citizens or 180 days for Non US Citizens from the date of the disablement will be considered.

1. Expenses made by a Hospital for room and board, floor nursing and other services, including Expenses for professional services, except personal services of a non-medical nature, provided, however, that Expenses do not exceed the Hospital's average charge for semi-private room and board accommodation.
2. Charges made for Intensive Care or Coronary Care charges and nursing services;
3. Expenses made for diagnosis, Treatment and surgery by a Physician.
4. Charges made for an operating room.
5. Charges made for Outpatient Treatment, same as any other Treatment covered on an  Inpatient basis. This includes ambulatory Surgical centers, Physician's Outpatient visits/examinations, clinic care, and Surgical opinion consultations.
6. Expenses made for administration of anesthetics.
7. Expenses for medication, x-ray services, laboratory tests and services, the use of radium and radio-active isotopes, oxygen, blood transfusions, iron lungs, and medical Treatment.
8. Expenses for physiotherapy, if recommended by a Physician, for the Treatment of a specific Disablement and administered by a licensed physiotherapist; With regards to chiropractic care, eligible charges up to $50.00 per visit, with a maximum of 10 visits.
9. Dressings, drugs, and medicines that are prescribed by a Physician.
10. Hotel room charge, when the insured, otherwise necessarily confined in a Hospital, shall be under the care of a duly qualified  Physician in a hotel room owing to the unavailability of a  Hospital room.

Policy Medical Maximum Choices

Plan A - $50,000

Plan B - $100,000

Plan C - $250,000

Plan D - $500,000

Plan E - $1,000,000

 

Persons up to age 69 are eligible for all plans;

Persons age 70-79 are eligible for plans A and B;

Persons age 80+ are eligible for plan A only.

 

Deductible Choices

$0, $50, $100, $250, $500, $1,000, $2,500, $5000 per person per policy period.

Sudden Recurrence of a Pre-Existing Condition (US Citizens Only) - Limited coverage under Your Medical Expense Benefit is provided for Medical Expenses that result from a sudden and unforeseen recurrence of a Pre-existing Condition.

Emergency Dental Treatment (Palliative) - Benefits are paid for Reasonable and Customary Expense up to $100 for the emergency Treatment for the relief of pain to natural teeth.

Emergency Medical Evacuation - Benefits are paid for Covered Expense incurred up to $100,000 for any covered Injury or Illness that requires immediate transportation from the place where You are located (due to inadequate medical facilities).

Repatriation of Remains - If death occurs, Benefits will be paid for Reasonable and Customary Covered Expense incurred up to $50,000, to return Your remains to Your Home Country.

Emergency Medical Reunion - If it is determined by the Assistance Company and your Physician that it is necessary for You to have an Emergency Medical Evacuation, this Plan will arrange to bring an individual of Your choice, from Your current Home Country, to be at Your side while You are hospitalized and then accompany You during Your return home.

Return of Minor Child(ren) - Should the Insured Person be traveling alone with a Minor Child(ren) and be hospitalized because of a covered Illness or Injury and Your Minor Child(ren) is left unattended, the Assistance Company will arrange for a one way economy fare(s) to Your current Home Country.

In Hospital Indemnity (US Citizens only) - If You are confined to a Hospital as a registered Inpatient as the result of an Illness or Injury which first occurs during Your Period of Coverage and that Illness or Injury is covered under this Plan, this plan will pay benefits up to $100 per day of confinement up to a maximum of 10 days.

Interruption of Trip - If Your trip is interrupted due to the Death of an Immediate Family Member or serious damage to your residence, benefits will be paid up to $5,000 for the Expense of economy travel less the value of applied credit from an unused return travel ticket to return You home to Your area of principal residence.

Loss of Baggage - This plan will reimburse You for loss, theft, or damage to Your baggage or personal effects checked with a Common Carrier, after coverage provided by a Common Carrier.

Political and Natural Disaster Evacuation - Coverage is provided up to $50,000 ($100,000 if the Enhanced PND Benefit is purchased) if the Insured requires emergency evacuation due to situations which place him/her in Imminent Bodily Harm or due to a Natural Disaster.

*Some Exclusions Apply*

Eligibility information about this plan

Diplomat International provides Accident and Sickness medical coverage, Accidental Death and Dismemberment benefits and Travel Assistance to individuals while traveling outside their Home Country, but not to the United States. Coverage is available for 2 adults, any unmarried dependent children ages 14 days until their 18th birthday, or children traveling alone.

• Coverage is NOT available for travel in Afghanistan, Cuba, Iran, Israel, Nepal, or Palestinian Territories

• Coverage is NOT available for citizens of Australia or Iran or residents of New York, Maryland and South Dakota.

Medical Maximums: 50k, 100k, 250k, 500k, 1 Million

• (Age 70-79 = 50k or 100k only)
• (Age 80+ = 20k only)