Medical Coverage

• All eligible inpatient and outpatient medical expenses — physician visits, hospital room and board, intensive care, surgery, anesthesia, and assistant surgeon
• Outpatient surgical facility and laboratory charges
• Radiology, X-ray, chemotherapy, and radiation therapy
• Pre-admission testing
• Reconstructive surgery (incidental to and following a covered surgery)
• Durable medical equipment
• Chiropractic care (medical order or treatment plan required)
• Physical therapy (medical order or treatment plan required)
• Extended care facility and home nursing care (upon direct transfer from an acute care facility)
• Prescription drugs and medications — 90-day dispensing maximum per retail pharmacy prescription; up to $250,000 per period of coverage on plans with $1M+ maximum
• Teladoc Telehealth — 24/7 access to board-certified doctors via phone or video for non-emergency medical issues; not subject to deductible or coinsurance; embedded in all Patriot Platinum plans
• Urgent Care Clinic — $25 copay (not subject to deductible; copay waived with $0 deductible)
• Walk-in Clinic — $15 copay (not subject to deductible; copay waived with $0 deductible)
• Hospital Emergency Room — covered at 100%; inside the U.S., illness visits are subject to a $250 ER deductible if not resulting in direct inpatient admission; injury is not subject to the ER deductible
• Supplemental Accident Benefit — $300 per covered accident, not subject to deductible

Emergency Services

• Emergency Medical Evacuation — up to the policy maximum; must be approved in advance and coordinated by IMG
• Non-Emergency Medical Evacuation (Evacuation Plus) — up to $50,000 for a sudden non-life-threatening condition requiring hospitalization when local facilities are inadequate; available for insured persons under age 65; must be approved by IMG
• Interfacility Ambulance Transfer — paid at 100% when resulting in an inpatient hospital admission; pre-certification required
• Emergency Local Ambulance — subject to deductible and coinsurance; covered for injury or illness resulting in inpatient admission
• Remote Transportation — up to $20,000 lifetime / $5,000 per period; must be approved in advance
• Emergency Reunion — up to $100,000 for reasonable travel costs and accommodations for one person to join you when hospitalized; up to 15 days; $25/day meal maximum; must be approved by IMG
• Return of Minor Children — up to $100,000 to return unattended minor children to their home country; must be approved by IMG
• Return of Mortal Remains — up to the policy maximum for return to country of residence; local burial or cremation up to $5,000; must be approved by IMG
• Political Evacuation & Repatriation — up to $100,000; must be approved in advance by IMG
• Natural Disaster Evacuation — up to $25,000; must be approved in advance by IMG
• Natural Disaster Lodging — $250/day for up to 5 days for accommodations during a covered natural disaster
• Bedside Visit — up to $1,500 for a visitor's reasonable travel expenses when you are hospitalized in the intensive care unit; not subject to deductible
• Return Travel — up to $10,000 to return home following a covered emergency

Accidental Death & Dismemberment

• AD&D — $50,000 Principal Sum; death must occur within 90 days of the accident; covers loss of sight in one eye (50%), one hand or foot (50%), combinations at 100%
• Common Carrier Accidental Death — $100,000 per adult / $25,000 per child / $250,000 per family maximum; not subject to deductible or coinsurance

Additional Benefits

• Acute Onset of Pre-Existing Conditions — for insured persons under age 70; U.S. citizens under 65 with a primary health plan: up to $1,000,000; U.S. citizens under 65 without a primary health plan: up to $20,000; U.S. citizens ages 65–69: up to $2,500; non-U.S. citizens under 70: up to $1,000,000; emergency evacuation arising from covered acute onset: up to $25,000
• Hospital Indemnity — $250 per overnight inpatient confinement; up to 10 nights; outside country of residence and U.S.; not subject to deductible
• Terrorism — up to $50,000; not subject to deductible
• Identity Theft — up to $500; not subject to deductible
• Personal Liability — up to $25,000 combined; $100 per-injury and per-damage deductible; secondary to other insurance; no coverage for related-party injury or property damage
• Dental Treatment — up to $300 for unexpected pain or accident to sound natural teeth; subject to deductible and coinsurance
• Traumatic Dental Injury — up to the policy maximum for hospital treatment; additional dental provider treatment for the same injury also paid at 100%
• Emergency Eye Examination — up to $150 for loss or damage to prescription corrective lenses due to an accident; $50 per-occurrence deductible
• Lost Luggage — up to $500 ($50 per item); not subject to deductible
• Pet Return — up to $1,000 for a traveling cat or dog; not subject to deductible
• Small Pet Common Air Carrier Accidental Death — up to $500 for a cat or dog under 30 pounds; not subject to deductible

COVID-19

COVID-19 is not specifically excluded. Charges for treatment resulting from COVID-19/SARS-CoV-2 are covered the same as any other illness, subject to all plan terms and conditions.

The Patriot Platinum plan is designed for travelers who want top-tier coverage — the highest medical maximums, the lowest out-of-pocket exposure (plan pays 100% after deductible), and a full suite of benefits for emergencies of every kind. It's available to both U.S. and non-U.S. citizens.

Two versions of the plan:

• Patriot International Platinum — for U.S. citizens traveling outside the United States (with emergency coverage for brief transits through the U.S.)
• Patriot America Platinum — for non-U.S. citizens visiting the United States or traveling outside their home country

This plan is an excellent fit for:

• International vacationers and leisure travelers wanting premium-level protection
• Business travelers making frequent or extended international trips
• Non-U.S. visitors and relatives coming to the United States
• Students and scholars studying or researching abroad
• Mission, church, and volunteer workers traveling internationally
• Expats and long-term travelers who need coverage for up to 36 continuous months
• Families wanting comprehensive protection on a single policy
• Travelers who want telehealth access, non-emergency evacuation, and high-value personal property benefits included

Why your existing coverage may not be enough:

Most domestic health plans — including employer group plans and Medicare — provide limited or no coverage outside the U.S. provider network and zero emergency medical evacuation coverage. The Patriot Platinum fills those gaps with up to $8,000,000 in medical coverage, full-pay coinsurance after the deductible, and a comprehensive set of evacuation and crisis response benefits that far exceeds typical travel medical plans.

Eligibility notes:

• Available for 5 days up to 12 months; extendable up to 36 continuous months
• Pre-existing conditions are excluded (see Acute Onset benefit above for emergency exception)
• Telehealth (Teladoc) is embedded in all Patriot Platinum plans at no additional cost
• Pre-certification required for certain services; failure to pre-certify results in a 50% reduction of eligible expenses

Expand your Patriot Platinum coverage with add-on riders available at the time of application.

Adventure Sports Rider

Provides coverage for injuries sustained during certain extreme sports and adventure activities that would otherwise be excluded from the base plan.

Lifetime maximum by age:

• Ages 0–49: $50,000
• Ages 50–59: $30,000
• Ages 60–64: $15,000
• Not available for ages 65+

Covered activities include (but are not limited to) high-risk adventure sports such as extreme skiing, mountaineering, rock climbing, skydiving, BASE jumping, bungee jumping, and similar activities. Refer to the Certificate of Insurance for the complete list of covered and excluded activities.

Enhanced AD&D Rider

Increases your Accidental Death & Dismemberment benefit beyond the base $50,000 Principal Sum, up to $400,000, if death or dismemberment is the direct result of an accident. Available to the primary insured only; requires a minimum of 3 months of medical coverage purchased alongside the rider. Premium charged in whole-month increments.

Trip Cancellation, Interruption & Travel Delay Rider

(Available to U.S. residents on individual plans only)

Adds trip cancellation, trip interruption, and travel delay protection to your Patriot Platinum plan. If you are prevented from taking your trip for a covered, unforeseen reason, this rider can reimburse up to 100% of prepaid, non-refundable trip costs. Covers travel delay expenses and additional transportation costs to rejoin or return from your trip.

Note: All Patriot Platinum plans include a Return Travel benefit up to $10,000; this rider provides the additional layer of pre-departure trip cancellation coverage.

Mobile Device Protection Rider

(Available on individual plans only)

Covers repair or replacement of your cell phone if lost, stolen, or accidentally damaged during your trip. Keeps you connected throughout your travels without the worry of being without your device.

Provided by International Medical Group (IMG) — 24/7 Global Concierge & Assistance Services

Every Patriot Platinum plan includes access to IMG's expert global assistance team, available around the clock in multiple time zones, languages, and currencies.

To reach IMG Assistance:

• Phone: +1 (317) 655-4500
• Online: www.imglobal.com
• MyIMG Member Portal & Mobile App — manage your plan, submit claims, view Explanations of Benefits, and search for providers 24/7

What assistance services include:

• Coordination and pre-authorization of Emergency Medical Evacuation and Repatriation
• Coordination of Non-Emergency Medical Evacuation (Evacuation Plus)
• Arrangement of Political and Natural Disaster Evacuations
• Emergency Reunion, Return of Minor Children, and Return of Mortal Remains coordination
• Location of physicians and facilities through IMG's global networks:
  • U.S. Network (UnitedHealthcare): 1.4M+ physicians, 6,797 hospitals, 45,000+ clinics, 67,000 pharmacies
  • International Provider Access (IPA): 18,550+ physicians and facilities worldwide with direct billing
• Multilingual staff including nurses, doctors, and case managers
• Travel Intelligence — location-specific alerts across 10 threat categories (health, transportation, security, weather) via the IMG mobile app
• Universal Rx Pharmacy Discount Program — savings at 35,000+ participating U.S. pharmacies

Important: Emergency Medical Evacuation requires advance approval and coordination by IMG. Interfacility Ambulance Transfers require pre-certification. Failure to obtain pre-certification for required services results in a 50% reduction of eligible expenses.

• Patriot International Platinum Certificate of Insurance (Sample) — full benefit schedule, provisions, exclusions, and definitions for U.S. citizens traveling outside the U.S.
• Patriot Travel Series Brochure — plan overview and benefit comparison across Lite, Plus, and Platinum levels
• Find a Doctor — search IMG's U.S. and international provider networks
• Get a Quote / Apply Online

The Certificate of Insurance and governing policy documents are the only source of actual benefits provided. This page is a summary for illustration purposes only. Benefits are subject to exclusions, limitations, and Usual, Reasonable, and Customary charge requirements.

IMG offers multiple ways to manage and submit claims, including a full online self-service portal and mobile app.

Step-by-step claims process:

1. Pre-certify when required — certain services require pre-certification before treatment. Failure to pre-certify results in a 50% reduction of eligible expenses. Contact IMG's assistance line before scheduled inpatient admissions, surgery, or other listed services.
2. Log in to MyIMG at www.imglobal.com/member/login to access claim management tools, submit claims, and view Explanations of Benefits.
3. Submit your claim with supporting documentation including itemized bills, physician statements, and proof of payment.
4. Mail or fax if not submitting online — refer to the mailing address, fax number, or email on your IMG policy documents.

Claims contact:

International Medical Group, Inc. 9200 Keystone Crossing, Suite 800 Indianapolis, IN 46240 USA Phone: +1 (317) 655-4500 Email: Insurance@imglobal.com

Online resources:

• Claims Center
• Forms Library
• MyIMG Member Portal
• Secure Message Center — for sending medical records, payment info, or other sensitive documents

The Patriot Platinum plan does not include a free look or post-purchase review period. Please review all plan details carefully before your coverage begins.

Refund of Premium — A refund, less any applicable processing fee, will be considered only if a written request is received by IMG prior to the Effective Date of coverage. Once coverage has begun, the premium is considered fully earned and non-refundable for the period of coverage already elapsed. Partial refunds may be available for unused future months depending on your plan terms — contact IMG directly to confirm.

In plain terms:

• Cancel before your start date for a full refund (less any processing fee)
• Contact IMG promptly if your travel plans change before coverage begins
• After coverage begins, refund eligibility depends on your specific plan terms; contact IMG for details

To request a cancellation or refund, contact IMG:

International Medical Group, Inc. 9200 Keystone Crossing, Suite 800 Indianapolis, IN 46240 USA Phone: +1 (317) 655-4500 Email: Insurance@imglobal.com Online: www.imglobal.com/contact

This page is a general summary only and does not supersede the Certificate of Insurance or governing policy documents, which are the only source of actual benefits. Benefits are subject to exclusions, limitations, and Usual, Reasonable, and Customary charge requirements. Owned by SiriusPoint, rated A- (Excellent) by A.M. Best. This insurance is not subject to and does not provide benefits required by PPACA. For complete plan details, refer to your Certificate of Insurance.