Silver and Gold:
After coverage has been in effect for 24 continuous months, the Silver
and Gold plan options provide a US$50,000 lifetime benefit for eligible
pre-existing conditions that existed at or prior to the effective date,
subject to a maximum of US$5,000 per period of coverage. This benefit is
payable whether or not you have received consultation or treatment for
the condition(s) during the 24-month period. The Silver and Gold plan
options do not rider or charge additional premium for pre-existing conditions.
If you properly disclose a pre-existing condition at the time of application
and are accepted into the plan, you will be covered for eligible medical
expenses after 24 months of continuous coverage, subject to the foregoing
limits and the other terms of the plan.*
The following illnesses which exist, manifest themselves or are treated
or have treatment recommended prior to or during the first 180 days of
coverage from the initial effective date are considered pre-existing conditions
and are subject to the waiting period and other limitations of coverage
described above: asthma, allergies, tonsillectomy, back conditions,
adenoidectomy, hemorrhoids or hemorrhoidectomy, disorders of the reproductive
system, hysterectomy, hernia, gall stones or kidney stones, any condition
of the breast, and any condition of the prostate.
Platinum:
On the Platinum plan option, conditions that are fully disclosed on the
application and have not been excluded or restricted by a rider will be
covered the same as any illness. Conditions, including any complications
therefrom, that are not fully disclosed on the application will not be
covered.
OTHER EXCLUSIONS & LIMITATIONS*
- Treatment not ordered or received by a physician
- Treatment or supplies not medically necessary
- Investigational, experimental or research procedures
- Custodial care
- Weight modification
- Elective cosmetic or plastic surgery
- Treatment of impotency
- Contraceptive medication or treatment
- Drug and alcohol abuse treatment
- Organ transplants not specifically listed
- Routine foot care
- Treatment by a relative or family member
- Treatment as a result of war or riot
- Treatment resulting from illegal activities
- Speech therapy
- Persons HIV+ at effective date
- Organized amateur or professional sports
- Maternity and newborn care (unless the maternity rider or Platinum plan
option is purchased - see Summary Schedule of Benefits)
- Services and treatment eligible for payment by any government or other insurance
- Adult routine physical examinations are excluded under the Silver
plan option and for the first 12 months for the Gold and Platinum plan options
- Devices to correct sight or hearing are excluded under the Silver and Gold plan options
- Inpatient mental and nervous is excluded under the Silver plan option and
for the first 12 months for the Gold and Platinum plan options
- Outpatient mental and nervous for the first 12 months on all plan options
*This website contains only a consolidated and summary description of some of
the current Global Medical Insurance benefits, conditions, limitations and
exclusions. A certificate containing the complete Certificate Wording with all
terms, conditions and exclusions will be included in the fulfillment kit. IMG
reserves the right to issue the most current Certificate Wording for this
insurance plan in the event this application and/or brochure has expired, is
modified, or is replaced with a newer version. Current Certificate Wordings are
available upon request.
