Global Medical Insurance^®

Individual & family (1 year or longer)

Global Medical Insurance offers worldwide coverage to a wide variety of international clientele, including expatriates, international executives, diplomats, students, entertainers and other international travelers.

Global Medical Insurance is a long-term, annually renewable, U.S.-style major medical insurance plan. There are three plan options available: Silver, Gold and Platinum. The Silver and Gold plans provide US$5,000,000 of lifetime coverage, while the Platinum plan provides US$8,000,000 of lifetime coverage. Global Medical Insurance offers two areas of coverage to non-U.S. citizens and to U.S. expatriates who want a quality medical insurance plan that will respond to their medical needs anywhere in the world. The two areas of coverage are for people needing coverage worldwide or worldwide excluding U.S./Canada.

Global Medical Insurance offers you the choice of three plan options: Silver, Gold and Platinum. You also have the opportunity to select a coverage area: worldwide or worldwide excluding the U.S. and Canada. Simply choose the plan option and coverage area that best fits your needs. Each one offers a full range of benefits suited for individuals and families, provides coverage 24 hours a day, and you have the freedom to choose any doctor or hospital for treatment.

As part of the eligibility requirements for Global Medical Insurance, U.S. citizens must reside abroad or plan to leave the U.S. on their effective date and plan to reside abroad for at least six of the next 12 months. Non-U.S. citizens may reside anywhere, including their country of citizenship, although certain eligibility restrictions may apply to non-U.S. citizens residing in the U.S.

You also have the option of adding Global Term Life Insurance^SM and Global Daily Indemnity^SM to your Global Medical Insurance coverage.

Global Term Life Insurance

Global Term Life Insurance provides protection for your family at the time of a traumatic loss and is available with no additional underwriting. This coverage is available for a standard annual premium of US$240 and includes an Accidental Death and Dismemberment benefit.

Global Daily Indemnity

Global Daily Indemnity pays you US$100 for each covered overnight hospital stay other than those related to maternity.

Lifetime Eligibility

Lifetime medical coverage is available if you are enrolled in the Global Medical Insurance plan by your 65th birthday and maintain continuous coverage to age 75. Prior to your 75th birthday you will receive a summary of benefits of a new plan, Global Senior Plan^?, and an enrollment form for coverage. There is no additional medical underwriting. You simply need to review the benefits, and complete and return the enrollment form with your premium.

Benefit

Benefit Description Subject to deductible and coinsurance unless otherwise noted	Silver	Gold	Platinum
Coverage Area	Two options: worldwide or worldwide excluding the U.S. and Canada	Two options: worldwide or worldwide excluding the U.S. and Canada	Two options: worldwide or worldwide excluding the U.S. and Canada
Policy Maximum	$5,000,000 lifetime per individual	$5,000,000 lifetime per individual	$8,000,000 lifetime per individual
Deductible	Ranges from $250 to $10,000 per period of coverage, 50% reduction within PPO	Ranges from $250 to $10,000 per period of coverage, 50% reduction within PPO, Carry forward deductible - last 30 days of certificate year	Ranges from $100 to $10,000 per period of coverage, 50% reduction within PPO, Carry forward deductible - last 30 days of certificate year
Family Deductible	3x the single	3x the single	2x the single
Coinsurance within the U.S. and Canada	80% of the next $5,000 of eligible expenses after the deductible, then 100% to the overall maximum per period of coverage	80% of the next $5,000 of eligible expenses after the deductible, then 100% to the overall maximum per period of coverage	90% of the next $5,000 of eligible expenses after the deductible, then 100% to the overall maximum per period of coverage
Coinsurance within the PPO network and outside the U.S. and Canada	100%	100%	100%
Hospitalization / Room & Board	$600 per day (maximum of 240 consecutive days per covered event)	Average semi-private room rate	Private room rate
Intensive Care Unit	$1,500 per day (maximum of 180 consecutive days per covered event)	Usual, Reasonable and Customary (URC)	Usual, Reasonable and Customary (URC)
Surgery	URC	URC	URC
Anesthetist's Charges Associated with Surgery	20% of surgery benefit	URC	URC
Transplants	$250,000 per transplant	$1,000,000 lifetime maximum	$2,000,000 lifetime maximum
Outpatient	Visits/Exams - 25 visits per insured person per period of coverage to the maximum limit as outlined: physician $70; specialist $70; psychiatrist $60; chiropractor $50; surgical intervention consultation $500; X-rays - $250 per exam maximum limit; Lab Tests - $300 per exam maximum limit	URC	URC
Rx Coverage	URC	URC	URC
Emergency Room Illness	URC - subject to an additional $250 deductible if not admitted	URC - subject to an additional $250 deductible if not admitted	URC - subject to an additional $250 deductible if not admitted
Emergency Room Accident	URC	URC	URC
Local Ambulance	$1,500 per covered event - not subject to deductible or coinsurance	URC	URC
Emergency Evacuation	$50,000 per period of coverage - not subject to deductible or coinsurance	Limited to policy maximum - not subject to deductible or coinsurance	Limited to policy maximum - not subject to deductible or coinsurance
Emergency Reunion	NA (Not Applicable)	$10,000 lifetime maximum	$10,000 lifetime maximum
Return of Mortal Remains	$25,000 lifetime maximum per insured - not subject to deductible or coinsurance	$25,000 lifetime maximum per insured -not subject to deductible or coinsurance	$50,000 lifetime maximum per insured -not subject to deductible or coinsurance
Maternity	Optional Rider - $50,000 lifetime maximum, maximum of $5,000 for normal delivery, $7,500 for C-section, $200 child wellness benefit for first 12 months - not subject to deductible or coinsurance. Available after 10 months of coverage benefits reduced by 50% for births that occur in11th or 12th month of continuous coverage	Optional Rider - $50,000 lifetime maximum, maximum of $5,000 for normal delivery, $7,500 for C-section, $200 child wellness benefit for first 12 months - not subject to deductible or coinsurance. Available after 10 months of coverage benefits reduced by 50% for births that occur in11th or 12th month of continuous coverage	Same As Any Illness (SAAI) $1,000 additional deductible, $50,000 lifetime maximum, $200 child wellness benefit for first 12 months. Available after 10 months of coverage
Supplemental Accident	NA	$300 per occurrence - not subject to deductible or coinsurance	$500 per occurrence - not subject to deductible or coinsurance
Mental/Nervous	Outpatient only - (see Outpatient) Available after 12 months of continuous coverage	$10,000 per period of coverage up to a $50,000 lifetime maximum. Available after 12 months of continuous coverage	SAAI $50,000 lifetime maximum. Available after 12 months of continuous coverage
Adult Wellness	NA	$250 per period of coverage - not subject to deductible or coinsurance Available for those 30 years of age and over after 12 months of continuous coverage	$500 per period of coverage - not subject to deductible or coinsurance Available for those 18 years of age and over after 12 months of continuous coverage
Child Wellness	Three visits per period of coverage -maximum $70 per visit. Available for children under 18 years of age after 12 months of continuous coverage	$200 maximum per period of coverage -not subject to deductible or coinsurance Available for children under 18 years of age after 12 months of continuous coverage	$400 maximum per period of coverage - not subject to deductible or coinsurance Available for children under 18 years of age after 12 months of continuous coverage
Other Services	Extended Care - limited to first 30 days of confinement Radiation Treatment - URC Home Nursing Care - limited 30 days per covered event Hospice Care - limited 30 days per covered event Prosthetic Devices - all URC	URC	URC
Physical Therapy	Maximum $40 per visit 30 visit maximum per period of coverage	Maximum $50 per visit	Maximum $50 per visit
High School Sports Injury	NA	NA	Up to $5,000 maximum
Recreational SCUBA	NA	URC	URC
Remote Transportation	NA	NA	Limited to $5,000 per certificate period up to a $20,000 lifetime maximum
Political Evacuation and Repatriation	NA	NA	Limited to $10,000 lifetime maximum
Complementary Medicine	NA	Acupuncture $150 Aroma Therapy $50 Herbal Therapy $50 Magnetic Therapy $75 Massage Therapy $150 Vitamin Therapy $100 Each per period of coverage	Acupuncture $150 Aroma Therapy $50 Herbal Therapy $50 Magnetic Therapy $75 Massage Therapy $150 Vitamin Therapy $100 Each per period of coverage
Non-emergency Dental	NA	NA	Calendar year maximum - $750 Individual deductible - $50 Schedule of benefits - Class I: 90% Class II: 70% Class III: 50% Ortho 0% (6 month waiting period)
Emergency Dental due to Accident	$1,000 per period of coverage	URC	URC
Emergency Dental due to Sudden Unexpected Pain	NA	$100 per period of coverage	See non-emergency dental benefits
Vision	NA	NA	Exams - up to $100 per 24 months Materials - up to $150 per 24 months
Global Concierge & Assistance Services	NA	NA	Included
Pre-existing Conditions	$5,000 per period of coverage up to a $50,000 lifetime maximum. Available after 24 months of continuous coverage	$5,000 per period of coverage up to a $50,000 lifetime maximum. Available after 24 months of continuous coverage	SAAI
NA (Not Applicable) / URC (Usual, Reasonable and Customary) / SAAI (Same As Any Illness)

This website contains only a consolidated and summary description of some of the current Global Medical Insurance benefits,conditions, limitations and exclusions. A certificate containing the complete Certificate Wording with all terms, conditions and exclusions will be included in the fulfillment kit. IMG reserves the right to issue the most current Certificate Wording for this insurance plan in the event this application and/or brochure has expired, is modified, or is replaced with a newer version. Current Certificate Wordings are available upon request.

Global Concierge and Assistance Services^SM

DEDICATED SERVICE LINE
An international toll-free number accessible worldwide 24/7.

DEDICATED CLAIMS TEAM
Provides members with expedited claims processing.

BAG TRACKING
Assistance in locating lost checked baggage and arranging the delivery of it to you anywhere in the world.

DRUG TRANSLATION SERVICES
24/7 online access that provides country specific brand names of common prescription and over-the-counter medications.

EMBASSY & CONSULATE REFERRALS
Provides the location and contact information of the nearest U.S. Embassy or Consulate.

EMERGENCY CASH TRANSFERS
Assists in arranging and obtaining cash transfers anywhere in the world.

EMERGENCY MESSAGE RELAY
Relay messages to your family, friends and co-workers, helping you maintain contact during an emergency.

EMERGENCY TRAVEL ARRANGEMENTS
Assists in making the appropriate travel arrangements in the event you must interrupt your travel and return home.

LEGAL REFERRALS
Provides the contact information for an attorney located in your country of travel.

LOST PASSPORT/TRAVEL DOCUMENTS ASSISTANCE
Assists in reporting, retrieval or replacement of lost or stolen travel documents.

PRESCRIPTION DRUG REPLACEMENT ASSISTANCE
Assists in the replacement and shipment of lost or damaged medication.

PRE-TRIP HEALTH AND SAFETY ADVISORIES
24/7 online access to information concerning current passport and visa requirements; information regarding inoculations and vaccinations; and up-to-date travel safety advisories.

SECURITY UPDATES AND COUNTRY PROFILES
24/7 online access to the latest advisories and travel warnings.

Global Concierge and Assistance Services are additional services offered under the Platinum plan option. They are not insurance benefits.

Pre-existing conditions and exclusions

Silver and Gold:

After coverage has been in effect for 24 continuous months, the Silver and Gold plan options provide a US$50,000 lifetime benefit for eligible pre-existing conditions that existed at or prior to the effective date, subject to a maximum of US$5,000 per period of coverage. This benefit is payable whether or not you have received consultation or treatment for the condition(s) during the 24-month period. The Silver and Gold plan options do not rider or charge additional premium for pre-existing conditions. If you properly disclose a pre-existing condition at the time of application and are accepted into the plan, you will be covered for eligible medical expenses after 24 months of continuous coverage, subject to the foregoing limits and the other terms of the plan.*

The following illnesses which exist, manifest themselves or are treated or have treatment recommended prior to or during the first 180 days of coverage from the initial effective date are considered pre-existing conditions and are subject to the waiting period and other limitations of coverage described above: asthma, allergies, tonsillectomy, back conditions,
adenoidectomy, hemorrhoids or hemorrhoidectomy, disorders of the reproductive system, hysterectomy, hernia, gall stones or kidney stones, any condition of the breast, and any condition of the prostate.

Platinum:

On the Platinum plan option, conditions that are fully disclosed on the application and have not been excluded or restricted by a rider will be covered the same as any illness. Conditions, including any complications therefrom, that are not fully disclosed on the application will not be covered.

OTHER EXCLUSIONS & LIMITATIONS*

Treatment not ordered or received by a physician
Treatment or supplies not medically necessary
Investigational, experimental or research procedures
Custodial care
Weight modification
Elective cosmetic or plastic surgery
Treatment of impotency
Contraceptive medication or treatment
Drug and alcohol abuse treatment
Organ transplants not specifically listed
Routine foot care
Treatment by a relative or family member
Treatment as a result of war or riot
Treatment resulting from illegal activities
Speech therapy
Persons HIV+ at effective date
Organized amateur or professional sports
Maternity and newborn care (unless the maternity rider or Platinum plan option is purchased - see Summary Schedule of Benefits)
Services and treatment eligible for payment by any government or other insurance
Adult routine physical examinations are excluded under the Silver plan option and for the first 12 months for the Gold and Platinum plan options
Devices to correct sight or hearing are excluded under the Silver and Gold plan options
Inpatient mental and nervous is excluded under the Silver plan option and for the first 12 months for the Gold and Platinum plan options
Outpatient mental and nervous for the first 12 months on all plan options

*This website contains only a consolidated and summary description of some of the current Global Medical Insurance benefits, conditions, limitations and exclusions. A certificate containing the complete Certificate Wording with all terms, conditions and exclusions will be included in the fulfillment kit. IMG reserves the right to issue the most current Certificate Wording for this insurance plan in the event this application and/or brochure has expired, is modified, or is replaced with a newer version. Current Certificate Wordings are available upon request.

Global Medical Insurance®

Individual & family (1 year or longer)

Global Concierge and Assistance ServicesSM

Global Medical Insurance^®

Global Concierge and Assistance Services^SM