Diplomat Long Term plan details
Plan A - $50,000
Who is eligible?
Diplomat Long Term (LT) provides Accident and Sickness medical coverage, Accidental Death and Dismemberment benefits and Travel Assistance to Non-US citizens while visiting the United States or for those traveling internationally outside their home country. 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 Iran.
- Coverage is NOT available for citizens of Australia or Iran or residents of New York, Maryland and South Dakot
Traveling to the United States: After you pay the selected deductible, the plan pays 80% up to $5,000 of eligible costs, then 100% to the Medical Maximum. There will be an additional $250 deductible for each emergency room visit as a result of an Illness. The ER deductible will be waived if hospital admittance is within 12 hours of the incident.
Traveling Outside the United States: After you pay your selected deductible this plan will pay100% of Covered Expenses outside the USA up to the selected plan maximum.
Pre-Existing Condition Exclusion: 18 Months prior to the start date of coverage
Unexpected 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 Medical Evacuation Benefits are paid for Covered Expense incurred up to $500,000 for any covered Injury or Illness that requires immediate transportation from the place where You are located (due to inadequate medical facilities).
Repatriation If it is determined by the Assistance Company and your Physician that it is Medically Necessary for You to return to Your primary place of residence because of an unforeseen Sickness or Injury which is acute or life-threatening, the Transportation Expense incurred within 90 days from the date of the Covered Loss will be paid for Your return to Your Home Country or to a medical facility closest to Your primary place of residence.
Return of Mortal Remains If death occurs, Benefits will be paid for Reasonable and Customary Covered Expenses 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 if the Insured requires emergency evacuation due to situations which place him/her in Imminent Bodily Harm or due to a Natural Disaster.
Emergency Dental Treatment (Accident) Benefits are paid for Reasonable and Customary Expense for emergency Dental Treatment to natural teeth.
Emergency Dental Treatment (Palliative) Benefits are paid up to $100 for emergency Treatment for the relief of pain to natural teeth.