IPatriot Group Exchange Insurance

Patriot Group Exchange insurance Benefits

• COVID-19/SARS-CoV-2 Coverage	Patriot Exchange insurance Offers coverage for COVID-19/SARS-CoV-2 as any other Illness or Injury.
  Coinsurance	In-Network: Plan pays 90%, insured pays 10% Out-Network: Plan pays 80%, insured pays 20% International: Plan pays 100%, insured pays 0%
  Out of Pocket Maximum	In-Network: $1k Out-Network: Up to the Maximum Limit International: $0
  Eligible medical expenses	In-Network: 90% up to policy maximum Out-Network: 80% up to policy maximum International: 100% up to policy maximum
  Hospital room and board	Average semi-private room rate, including nursing services In-Network: 90% up to policy maximum Out-Network: 80% up to policy maximum International: 100% up to policy maximum
  Surgery	In-Network: 90% up to policy maximum Out-Network: 80% up to policy maximum International: 100% up to policy maximum
  Intensive care unit	In-Network: 90% up to policy maximum Out-Network: 80% up to policy maximum International: 100% up to policy maximum
  Bedside visit	$1,500 maximum limit. Not subject to deductible In-Network: 90% up to policy maximum Out-Network: 80% up to policy maximum International: 100% up to policy maximum
  Student Health Center	$5 co-pay per visit. Not subject to deductible.
  Mental/Nervous	Not covered if incurred in student health center; Inpatient: $10,000 maximum limit; Outpatient: $50 maximum limit per day. $500 maximum limit In-Network: 90% up to policy maximum Out-Network: 80% up to policy maximum International: 100% up to policy maximum

• Pre-Certification	50% reduction of eligible medical expenses if pre-certification provisions are not met
  Physician visits	In-Network: 90% up to policy maximum Out-Network: 80% up to policy maximum International: 100% up to policy maximum
  Teladoc Consultation	Company pays 100% within the U.S.; mental and nervous disorders not covered (Group plans only)
  Urgent Care Clinic	$50 copay. Copay is not applicable when the $0 deductible is selected. Not subject to deductible In-Network: 90% up to policy maximum Out-Network: 80% up to policy maximum International: 100% up to policy maximum
  Walk-In Clinic	$20 copay. Copay is not applicable when the $0 deductible is selected. Not subject to deductible In-Network: 90% up to policy maximum Out-Network: 80% up to policy maximum International: 100% up to policy maximum
  Physical Therapy	In-Network: 90% up to policy maximum Out-Network: 80% up to policy maximum International: 100% up to policy maximum
  Prescription Drugs and Medications	Period of Coverage limit: $250k per person Obtained through Retail Pharmacy, Inpatient and Outpatient Surgery, Emergency Room and Outpatient Office Visits.Dispensing maximum for Retail Pharmacy: 90 days per prescription In-Network: Not Covered Out-Network: 80% up to policy maximum International: 100% up to policy maximum

• Emergency local ambulance	Company pays 100%
  Hospital emergency room	Injury: Not subject to Emergency Room Deductible Illness: Subject to a $500 Deductible for each Emergency Room visit for Treatment that does not result in a direct Hospital admission. In-Network: 90% up to policy maximum Out-Network: 80% up to policy maximum International: 100% up to policy maximum
  Interfacility ambulance transfer	Company pays 100%

• Emergency dental treatment	Injury due to covered accident - $500 maximum; Sudden & unexpected pain to natural teeth - $350 maximum b>In-Network: Not Covered Out-Network: 90% up to policy maximum International: 100% up to policy maximum
  Traumatic Dental Injury	In-Network: 90% up to policy maximum Out-Network: 80% up to policy maximum International: 100% up to policy maximum

• Emergency medical evacuation	$50k maximum limit
  Emergency reunion	$100k maximum limit. Not subject to deductibley
  Repatriation for Medical Treatment	$100k maximum limit. Not subject to deductibley
  Return of mortal remains or cremation/burial	$25k maximum limit for Return of Mortal Remains or $5,000 maximum limit for Cremation/Burial
  Political evacuation and repatriation	$10k lifetime maximum

• Terrorism	$50k maximum limit. Not subject to deductible
  Lost Personal Property	$250 per period of coverage limit

• Pre-Existing Condition

  After 12 months of continous coverage $500 per period of coverage; $1,500 lifetime maximum. Charges resulting directly or indirectly from or relating to any Pre-existing Condition that existed within 36 months prior to the Effective Date are excluded until the Insured Person has maintained 12 months of continuous coverage under this insurance.

• Accidental death & dismemberment	$25k principal sum, Not subject to deductible
  Incidental Emergency in the U.S.	Up to a cumulative 14 days (available for non-U.S. residents only) In-Network: 90% up to policy maximum Out-Network: 80% up to policy maximum International: 100% up to policy maximum

• Legal Assistance	$500 per period of coverage limit
  Limited High School and College Sports	Company pays 100% after deductible is met
  Lost Personal Property	$250 per period of cover age limit
  Personal liability	$Personal Liability: $2k per period of coverage limit after $100 deductible. Damage to third party’s property: $500 per period of coverage limit after $100 deductible