Why Outreach
You have enough to worry about when you're traveling. Don't let your medical coverage be an uncertainty. The Outreach Travel Medical Insurance plan offers a complete package of international benefits available 24 hours a day. Outreach America provides coverage for non-U.S. residents traveling outside their home country. This plan is available for a minimum of five days up to a maximum of two years, in accordance with the terms of the Certificate of Insurance.
You can choose from a wide range of deductibles, several maximum limits, and you have access to more than 45,000 providers through our International Provider AccessSM when seeking treatment outside the U.S. You can reduce your out-of-pocket costs when seeking treatment in the U.S. by locating providers through the independent Preferred Provider Organization.
Inside the U.S.
Outreach America - If you're visiting the United States
- Maximum limits:
Individual: $50,000 to $1,000,000
Group: $100,000, $250,000, $1,000,000 - Deductible:
Individual: $0 to $2,500 - Extensions:
Up to 24 continuous months - Coinsurance (In-Network):
In-network: The administrator pays 90%
Out-of-network: The administrator pays 80% up to $5,000, then 100% - Coinsurance (Out-of-Network):
80% up to $5,000, then 100% - Sudden and unexpected recurrence of pre-existing conditions:
Up to the maximum limit - Incidental Trip:
Up to 2 weeks
The Administrator Advantage
Our focus on Service, Strength, and Safety Solutions provides you with the ultimate advantage: Global Peace of Mind.
Service - Help when and where you need it.
Nobody wants to experience an emergency while traveling the world, but if you do, you’ll want a team you can trust to have your back. The administrator's expert staff is here for you 24/7. We’re accustomed to working in multiple time zones, languages, and currencies, so rest assured we have the training to assist you—even in remote and hazardous locations. Our international and U.S. provider networks include more than one million physicians and facilities across the globe, giving you access to quality care while away from your primary care team. Our innovative technology allows you to manage your claims, your account, and search for providers through our online portal and mobile app around the clock.
Strength - A market leader you can trust.
You can feel confident with the administrator knowing our industry expertise has led us to serve millions of customers worldwide since 1990. Owned by SiriusPoint, a multi-billion-dollar insurance industry leader and rated “A-” by A.M. Best, an independent analyst of the insurance industry, the administrator has a strong financial backing and vision to become the preeminent provider of travel and health safety solutions. With loyal customers ranging from Fortune 500 companies, universities, to individuals and other insurance companies, our personalized offerings allow us to meet the needs of nearly anyone traveling internationally.
Safety Solutions - Products and services designed with your safety in mind
Physical Health
You can’t plan when you get sick, and unfortunately, it can happen anytime and anywhere. Medical bills can be expensive, and this plan provides the cross-border medical coverage you need for unexpected medical care.
Financial Protection
Costs can add up while seeking medical treatment. However, access to physician and provider networks and pharmacy discount programs can help you save on out-of-pocket medical expenses and prescription medications.
Crisis Support
Navigating an emergency in a foreign country is never easy. That’s why the administrator offers a multilingual staff of nurses, doctors, and case managers that provide 24/7 assistance services to facilitate a response to urgent and emergency situations, such as evacuations.
Personal Property
There are some belongings you know you can’t live without. The administrator has you covered and can help assist you with lost or stolen travel documents like passport or visa, and can reimburse costs if your essential items like luggage are lost, stolen, or damaged during your travels abroad.
Summary of Benefits
| Inpatient or Outpatient Services | |
| Eligible Medical Expenses | Up to the maximum limit |
| COVID-19/SARS-CoV-2 Coverage | COVID-19/SARS-CoV-2 shall be considered by the Company the same as any other Illness or Injury, subject to all other Terms and conditions of this insurance. |
| Physician Visits/Services | Up to the maximum limit |
| Hospital Emergency Room: Inside the U.S. | Up to the maximum limit. Injury: not subject to additional deductible Illness: additional $250 deductible if not admitted |
| Hospital Emergency Room: Outside the U.S. | Up to the maximum limit. |
| Hospitalization/Room & Board | Average semi-private room rate up to the maximum limit. Includes nursing service. |
| Intensive Care | Up to the maximum limit |
| Outpatient Surgical/Hospital Facility | Up to the maximum limit |
| Laboratory | Up to the maximum limit |
| Radiology/X-ray | Up to the maximum limit |
| Chemotherapy/Radiation Therapy | Up to the maximum limit |
| Pre-Admission Testing | Up to the maximum limit |
| Surgery | Up to the maximum limit |
| Reconstructive Surgery Surgery is incidental to and follows surgery that was covered under the plan | Up to the maximum limit |
| Assistant Surgeon | 20% of the primary surgeon's eligible fee |
| Anesthesia | Up to the maximum limit |
| Durable Medical Equipment | Up to the maximum limit |
| Chiropractic Care Medical order or treatment plan required | Up to the maximum limit |
| Physical Therapy Treatment Medical order or treatment plan required | Up to the maximum limit |
| Extended Care Facility Upon direct transfer from an acute facility | Up to the maximum limit |
| Home Nursing Care Upon direct transfer from an acute facility Provided by a home health care agency | Up to the maximum limit |
| Prescription Drugs and Medications | |
| Prescription Drugs and Medications Obtained through Retail Pharmacy, Inpatient and Outpatient Surgery, Emergency Room and Outpatient Office Visits Dispensing maximum for Retail Pharmacy: 90 days per prescription | Up to the maximum limit |
| Emergency Services Not subject to deductible and coinsurance unless otherwise noted. | |
| Emergency Local Ambulance Injury or illness reulting in an inpatient hospital admission | Up to the maximum limit |
| Emergency Medical Evacuation Must be approved in advance and coordinated by the company. | $500,000 maximum limit |
| Emergency Reunion Must be approved in advance by the company. | $50,000 maximum limit |
| Interfacility Ambulance Transfer Transfer must be a result of an inpatient hospital admission | Up to the maximum limit |
| Political Evacuation & Repatriation Must be approved in advance by the company. | Up to $10,000 |
| Return of Minor Children Must be approved in advance by the company. | Up to $50,000 |
| Return of Mortal Remains or Cremation/Burial Must be approved in advance by the company | Up to $50,000 for return of mortal remains or $5,000 for cremation/burial |
| Other Services | |
| Accidental Death & Dismemberment (AD&D) Death must occur within 90 days of the accident | $25,000 principal sum. Not subject to deductible. |
| Common Carrier Accidental Death | $50,000 per adult and $250,000 per family. |
| Identity Theft Assistance | Up to $500. Not subject to deductible. |
| Incidental Trip | 14 days maximum |
| Trip Interruption | Up to $5,000. Not subject to deductible. |
| Dental Treatment - Accident | $100 limit Treatment due to an Accidental Injury and obtained at a Dental Provider's office |
| Traumatic Dental Injury Treatment at a hospital due to an accident | Up to the maximum limit. Additional treatment for the same injury rendered by a dental provider will be paid at 100%. |
| Hospital Indemnity | $100 per overnight inpatient hospitalization, maximum limit of 10 overnights. Not subject to deductible. |
| Emergency Hospital Admission Direct Transfer from Emergency Medical Evacuation (Group Plans Only) | Emergency Admission upon direct transfer via a Company approved Emergency Medical Evacuation where the underlying medical condition is not provided for under this Insurance. Maximum limit: $20,000 The maximum limit is not in addition to the Sudden and Unexpected Recurrence of a Pre-existing Maximum limit. |
| Lost Luggage | Limit $250, $50 maximum per item |
| Natural Disaster | $100 per day and maximum limit of 5 days for accommodations. Not subject to deductible. |
| Terrorism | $50,000 maximum limit. Not subject to deductible. |
All coverage and benefits in the plan are in United States (U.S.) dollars. Benefits are subject to the exclusions and limitations and are payable only at Usual, Reasonable and Customary charges. This is a summary of a selection of plan benefits offered only as an illustration and does not supersede in anyway the Certificate of Insurance and governing policy documents (together the "Insurance Contract"). The Insurance Contract is the only source of the actual benefits provided.
Expand Your Coverage
It's easy to customize your coverage to best meet your needs while away from home. When submitting your application, simply add the riders you need to the plan you've selected.
Adventure Sports Rider
If you're a thrill-seeking traveler who enjoys life's more adventurous activities, you may want to consider adding supplemental coverage to your plan. The Adventure Sports Rider provides coverage for injuries sustained during certain extreme sports that would otherwise be excluded from your insurance policy.
Lifetime Maximum
Age 0-49: $50,000
Age 50-59: $30,000
Age 60-64: $15,000
Chaperone/Faculty Leader Replacement Rider*
If you are the designated chaperone/faculty leader and experience an unexpected death of a relative, a medical emergency, or the destruction of your residence that causes you to cancel or interrupt travel, this rider covers reimbursement for a round trip economy airline ticket up to $3,000 for a replacement chaperone/faculty leader.
Evacuation Plus Rider**
While Outreach provides emergency medical evacuation coverage for life-threatening injuries and illness, the Evacuation Plus Rider provides coverage up to $25,000 for medical evacuations if you experience a sudden, non-life-threatening medical condition that requires hospitalization. The administrator will arrange and cover ground and air transportation to the nearest hospital capable of providing treatment.Note: Must be purchased for a minimum of three months regardless of the minimum number of days being traveled. Premium is charged in whole-month increments.
Enhanced Accidental Death & Dismemberment Rider (AD&D)**
Accidents can happen - wouldn't you rather be prepared, especially when you're away from home? The AD&D rider will pay you or your beneficiaries up to $400,000 if your death or dismemberment is the direct result of an accident.
Note: Available to the primary insured only. Available with a minimum purchase of three months of medical and AD&D rider coverage. Premium is charged in whole-month increments.
*Rider option is available on group plans only.
**Rider option is available on individual plans only.
Innovative Technology & Member Services
- Over 18,550 physicians and facilities
- Direct billing arrangements that minimize time and upfront expense
MyAccount
MyAccount provides service at your fingertips, giving you the information and tools to manage your plans anytime, anywhere, through easy-to-use technology. You’ll have immediate access to important resources online, including our service center team, plan document access, claim forms and much more.
Pharmacy Discount Savings
Universal Rx is a discount savings program that allows you to purchase prescriptions from one of 35,000 participating pharmacies in the U.S. and receive the lower of 1) Universal Rx contract price or 2) the pharmacy regular retail price. This network offers a simplified claims process with minimal paperwork for the member if they visit an in-network provider.
This program is not insurance coverage; it is purely a discount program.
International Provider AccessSM
Travelers outside of the U.S. can also enjoy access to quality healthcare worldwide with proprietary IPA network that includes:
How To Get Covered
Step 1:
Get a quote in the online application.
Step 2:
Complete your application: If applying as a family, you may include yourself, your spouse, and dependents on one application. Please complete a group application if you have two or more primary insureds.
Step 3:
Receive a fulfillment kit that includes an identification card, declaration of insurance, and a Certificate of Insurance outlining the details of the plan. Welcome to the family!
How To Extend Your Coverage
To meet the needs of our customers, Outreach plans can be extended for up to a 365-day period until reaching a maximum of 24 continuous months. Each insured person must only satisfy one deductible and coinsurance within each 12-month period of coverage. To renew your coverage, please visit here.
Protect Your Investment
We also offer trip cancellation plans to help protect your travel investment. There are different plan options specifically designed for your needs. For more information, please visit Trip Insurance.
IMPORTANT NOTICE REGARDING PATIENT PROTECTION AND AFFORDABLE CARE ACT (PPACA): This insurance is not subject to and does not provide benefits required by PPACA. Since January 1, 2014, PPACA requires U.S. citizens, U.S. nationals and certain U.S. residents to obtain PPACA-compliant insurance coverage unless they are exempt from PPACA. Penalties may be imposed on persons who are required to maintain PPACA compliant coverage but do not do so. Eligibility to purchase, extend or renew this product, or its terms and conditions, may be modified or amended based upon changes to applicable law, including PPACA. Please note that it is an insured person's sole and exclusive responsibility to determine the insurance requirements applicable to them, and the Company and the administrator shall have no liability whatsoever, including for any penalties a person may incur, for failure to obtain coverage required by any applicable law including, without limitation, PPACA. For information on whether PPACA applies to you or whether you are eligible to purchase Outreach Travel Medical Insurance, please contact your attorney or CPA.
Outreach America® Individual Rates
Rates below reflect a $250 deductible
Individual Daily Rate
| Maximum Limit | |||||
|---|---|---|---|---|---|
| Age | $50,000 | $100,000 | $500,000 | $1 Million | |
| 18-29 | $1.39 | $1.73 | $2.23 | $2.67 | |
| 30-39 | $1.83 | $2.34 | $2.89 | $3.39 | |
| 40-49 | $2.72 | $3.34 | $4.45 | $4.95 | |
| 50-59 | $4.20 | $5.36 | $6.59 | $7.58 | |
| 60-64 | $5.25 | $6.83 | $8.11 | $9.74 | |
| 65-69 | $6.83 | $9.28 | $10.07 | $11.99 | |
| 70-79 | $9.21 | N/A | N/A | N/A | |
| 80+* | $16.04 | N/A | N/A | N/A | |
| Dep. Child | $1.28 | $1.56 | $2.00 | $2.23 | |
| Child Alone | $1.39 | $1.73 | $2.23 | $2.50 | |
*10,000 Maximum
Additional Deductible Options
| Deductible | $0 | $100 | $250 | $500 | $1,000 | $2,500 |
|---|---|---|---|---|---|---|
| Rate Factor | 1.25 | 1.10 | 1.00 | .90 | .80 | .70 |
Group Rates (Groups of 5 or more)
Group must select one option only and one deductible for the entire group. The maximum benefit for ages 70-79 is always limited to $100,000 regardless of what maximum benefit the group selects, and the premium will be the same for all ages based on the table below.
| Maximum Benefit | Total Daily Rates | ||
|---|---|---|---|
| Deductibles | $0 | $100 | $250 |
| Option 1 - $100,000 Max | $3.36 | $2.96 | $2.69 |
| Option 2 - $250,000 Max | $3.70 | $3.26 | $2.96 |
| Option 3 - $1,000,000 Max | $4.03 | $3.54 | $3.22 |
New premium rates per Insured Person are effective 11/01/2023 for eligible individuals whose applications are approved by the administrator. The administrator reserves the right to assess the most current rates at the time of the effective date in the event these rates expire, are modified or are replaced.
Enhanced AD&D Rider*
| Up to $100,000 additional coverage | $8 per month |
| Up to $200,000 additional coverage | $16 per month |
| Up to $300,000 additional coverage | $24 per month |
| Up to $400,000 additional coverage | $32 per month |
*Available to the primary Insured on individual plans only. Available with a minimum purchase of three months of medical and AD&D rider coverage. Premium is charged in whole-month increments.
Evacuation Plus Rider*
| Premium per covered insured | $45 per month |
*Available to the primary insured on individual plans only. Must be purchased for a minimum of three months regardless of the minimum number of days being traveled. Premium is charged in whole-month increments.
Chaperone/Faculty Leader Replacement Rider (Group Plans Only)
10% Increase of base premium
Adventure Sports Rider (Group and Individual Plans)
20% Increase of base premium
Administrator
IMG9200 Keystone Crossing
Suite 800
Indianapolis, IN 46240
FOR ADDITIONAL INFORMATION
Cyndi Thompson-Belmont2415 W Oak Grove Ct
Visalia, CA 93291
United States
Phone: (888) 636-2454
Website: belmont.brokersnexus.com
This invitation to inquire allows eligible applicants an opportunity to seek information about the insurance offered and is limited to a brief description of any loss for which benefits may be payable.
Benefits are offered as described in the Insurance Contract for a premium and are subject to all deductibles, coinsurance, provisions, terms, conditions, limitations and exclusions in the insurance contract. Certain insurance contracts and services agreements do contain pre-existing condition exclusions and do not cover losses or expenses related to pre-existing conditions. Please review the Insurance Contract and Master Services Agreement for more information regarding benefits, terms, and conditions.
This brochure contains many of the valuable trademarks, names, titles, logos, images, designs, copyrights and other proprietary materials owned and registered and used by International Medical Group, Inc. and its representatives throughout the world. © 2007-2023 International Medical Group, Inc. All rights reserved.
Version:
1123
CM0050A2191231017