Global Medical Gold Insurance

Global Medical Silver insurance benefits

• Hospital room and board	Subject to deductible and coinsurance for average private room rate
  Surgery	Subject to deductible and coinsurance
  Intensive care unit	Subject to deductible and coinsurance
  Assistant Surgeon	20% of primary surgeon’s charge
  Hospital Indemnity(Inpatient hospitalization outside the U.S. only)?	Private Hospitals: $400 maximum limit per overnight and $4,000 maximum limit per period of coverage Public Hospitals: $500 maximum limit per overnight and $5,000 maximum limit per period of coverage. Not subject to deductible or coinsurance

• Chemotherapy or Radiation Therapy	Subject to deductible and coinsurance
  Physical therapy	Subject to deductible and coinsurance. $50 maximum per visit
  Treatment Outside the U.S.	50% of deductible waived, up to a maximum of $2.5k. No coinsurance
  Treatment Inside the U.S. (using Medical Concierge)	50% of deductible waived, up to a maximum of $2.5k. No coinsurance
  Treatment Inside the U.S. (PPO Network)	Subject to deductible. No coinsurance
  Treatment Inside the U.S. (Non PPO Network)	Subject to deductible. Plan pays 80% of the next $5,000 of eligible expenses, then 100% to the overall maximum per period of coverage
  Office visits and Diagnostic/X-Ray	Subject to deductible and coinsurance
  CAT Scans, MRI, Echocardiography, Endoscopy, Gastroscopy, Cystoscopy	Subject to deductible and coinsurance
  Transplants	$1M lifetime maximum
  Complementary Medicine	$500 maximum limit per period of coverage
  Podiatry Care	$750 maximum limit

• Emergency local ambulance(Injury or Illness resulting in an inpatient hospital admission)	Subject to deductible and coinsurance.U.S. only
  Emergency Room Accident	Up to the maximum limit
  Emergency room illness	Subject to deductible and coinsurance.Additional $250 deductible if not admitted as an inpatient

• Treatment Due to Unexpected Pain to Sound, Natural Teeth	100%
  Traumatic Dental Injury Treatment at a hospital facility	Up to the lifetime maximum limit
  Non-Emergency Dental	Optional Rider

• Emergency medical evacuation	Up to maximum limit. Not subject to deductible or coinsurance
  Emergency reunion	$10k maximum limit. Not subject to deductible
  Return of mortal remains or cremation/burial	$25k lifetime maximum. Not subject to deductible or coinsurance
  Child Preventative Care( Through age 18)	$200 per period of coverage. Not subject to deductible or coinsurance.
  Adult Preventative Care(Age 19 or older)	$250 per period of coverage. Not subject to deductible or coinsurance.

• Orphan or Biologic Drugs	Inpatient & Outpatient Treatmentmaximum limit: $250,000.
  Healthy Travel Preventative Coverage	$250 lifetime maximum.
  Vision	Optional Rider
  Supplemental Accident	$300 maximum limit per accident. Not subject to deductible and coinsurance

• Pre-Existing Conditions Limitation

  $250 lifetime maximum.

• Mental/Nervous	$10k maximum. Available after 12 months of continuous coverage
  Prescription Coverage	Up to $500
  Complementary Medicine	$500 maximum limit per period of coverage