GeoBlue – Travel Medical Insurance – Multi Trip

This insurance policy offers various benefits and coverage options. The maximum benefit per insured person during the policy period is $1,000,000, but for individuals aged 70-95, it is limited to $100,000. South Dakota residents may have different benefits and eligibility criteria. The deductible per insured person is $100 but is waived for services provided by GeoBlue contracted providers.

Coverage includes inpatient and outpatient benefits, with the insurer paying 100% of covered expenses after the deductible is met. This includes professional services such as surgery, anesthesia, and diagnostic procedures. Inpatient hospital services, including surgery and medical emergencies, are also covered at 100%. Ambulatory surgical center services and ambulance service for non-medical evacuation are covered up to $1,000.

Prescriptions and dental care outside the U.S. are covered up to $5,000, and dental care for pain relief or injury is covered up to $300 per trip period. Physical and occupational therapy are covered up to 6 visits per insurance period, with a maximum payment of $100 per visit.

Travel assistance benefits include coverage for accidental death and dismemberment ($25,000), repatriation of remains ($25,000), emergency medical transportation ($500,000), and emergency family travel arrangements (up to $2,500 for one economy round trip airfare ticket). Lost baggage and personal effects coverage have a maximum benefit of $500 per trip period, with a $100 limit per bag or personal effect.

Coverage for hazardous activities like downhill skiing and scuba diving (up to 20 meters depth) is available with a maximum benefit of $25,000, provided specific certification or supervision requirements are met.

• Home Country is the U.S.; and
• You must be age 95 and younger*; and
• Enrolled in a Primary Plan**; and
• For children under age 6, must be enrolled with a parent, aunt, uncle or grandparent*; and
• Initial purchase must be made in home country prior to departing on trip

Family Members included in your Plan (if applicable) must be:

• Your spouse; civil union partner or domestic partner age 95 and younger*, and/or your eligible child(ren) or other eligible dependent(s)—see Eligible Dependents.
• Resident(s) of the United States.
• Traveling outside the U.S. and scheduled to spend at least 24 hours away from his/her home.

Primary Plan is a Group Health Benefit Plan, an individual health benefit plan or a governmental health plan designed to be the first payer of claims (such as Medicare) for an Insured Person prior to the responsibility of this Plan. Such plans must have coverage limits in excess of $50,000 per incident or per year to be considered a Primary Plan. PLEASE NOTE: Medicaid and V.A. health plans do not constitute primary health insurance because they are not defined as the first payer of medical claims. The primary plan does not need to be a Blue Cross and/or Blue Shield medical plan in order to be eligible.

This insurance plan provides a maximum benefit of $500,000 per insured person per policy period, with a reduced limit of $100,000 for individuals aged 70-95. South Dakota residents may have different benefits and eligibility criteria. The deductible per insured person per policy period is $200 but is waived for physician and hospital services provided by GeoBlue contracted providers.

Coverage includes inpatient and outpatient benefits, with the insurer paying 100% of covered expenses after the deductible is met. This includes professional services like surgery, anesthesia, and diagnostic procedures, as well as office visits and inpatient hospital services. Ambulatory surgical center services and ambulance service for non-medical evacuation are covered up to $1,000.

Prescription, dental care, and physical therapy coverage include 100% of reasonable charges for outpatient prescription drugs up to $2,500, dental care for pain relief up to $100 per trip period, and dental care required due to injury up to $200 per trip period. Physical and occupational therapy coverage includes up to 6 visits per insurance period, with a maximum payment of $50 per visit.

Travel assistance benefits encompass accidental death and dismemberment ($0 coverage), repatriation of remains ($15,000), emergency medical transportation ($250,000), and emergency family travel arrangements (up to $2,500 for one economy round-trip airfare ticket). Coverage for hazardous activities such as downhill skiing and scuba diving (up to 20 meters depth) has a maximum benefit of $25,000, provided specific certification or supervision requirements are met.

• Home Country is the U.S.; and
• You must be age 95 and younger*; and
• Enrolled in a Primary Plan**; and
• For children under age 6, must be enrolled with a parent, aunt, uncle or grandparent*; and
• Initial purchase must be made in home country prior to departing on trip

Family Members included in your Plan (if applicable) must be:

• Your spouse; civil union partner or domestic partner age 95 and younger*, and/or your eligible child(ren) or other eligible dependent(s)—see Eligible Dependents.
• Resident(s) of the United States.
• Traveling outside the U.S. and scheduled to spend at least 24 hours away from his/her home.

Primary Plan is a Group Health Benefit Plan, an individual health benefit plan or a governmental health plan designed to be the first payer of claims (such as Medicare) for an Insured Person prior to the responsibility of this Plan. Such plans must have coverage limits in excess of $50,000 per incident or per year to be considered a Primary Plan. PLEASE NOTE: Medicaid and V.A. health plans do not constitute primary health insurance because they are not defined as the first payer of medical claims. The primary plan does not need to be a Blue Cross and/or Blue Shield medical plan in order to be eligible.