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September 2, 2010  
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TravelGap Multi-Trip Benefits

Medical Benefits

Maximum Benefits Silver Gold
Maximum International Medical Benefits per Insured per policy period $50,000 $250,000*
Maximum Domestic Medical Benefits per Insured per policy period $2,500 $25,000
Deductible** $50 $50
Medical Evacuation $250,000 $500,000
Repatriation Of Remains $15,000 $25,000
Accidental Death and Dismemberment $0 $25,000

Bedside Visit Maximum Benefit per Trip Period up to $1,500 for the cost of one economy round trip air fare ticket to the place of the Hospital Confinement for one (1) person

*For individuals aged 70-84, the Maximum International Medical
Benefit for TravelGap Gold is $100,000.

**After the Deductible is satisfied, benefits are paid for Covered
Expenses as follows up to the Medical Limit. Deductible waived for physician and hospital services delivered by HTH International Healthcare Community Providers.

Benefits

Insurance Benefits Benefit After Deductible
Professional Services: a. Surgery, anesthesia, radiation therapy, in-hospital doctor visits, diagnostic X-ray and lab 100%
Professional Services: b. Office Visits: including X-rays and lab work billed by the attending physician. 100%
Inpatient Hospital Services: a. Surgery, X-rays, In-hospital doctor visits 100%
Inpatient Hospital Services: b. In-patient medical emergency 100%
Ambulatory Surgical Center 100%
Ambulance Service (non Medical Evacuation) 100% up to $1000
Benefits for claims resulting from:
  • downhill (alpine) skiing
  • scuba diving (certification by the Professional Association of Diving Instructors (PADI) or the National Association of Underwater Instructors (NAUI) required or diving under the supervision of a certified instructor)
  • Maximum Benefit up to $10,000
    Outside the U.S. Outpatient prescription drugs 100% of Covered Expenses
    Dental Care required due to an Injury 100% of Covered Expenses up to $200 maximum per Trip Period and $200 per tooth
    Dental Care for Relief of Pain 100% of Covered Expenses up to $100 maximum per Trip Period and $100 per tooth

    Services provided in addition to the benefits above

    HTH Global Health and Security Services
    • Access to contracted doctors in more than 155 countries
    • Access to worldwide security information in more than 150 countries and 190 cities
    • Online doctor search with more than 3,000 contracted physicians.
    • Access to Drug Translation Guide
    • Health and security news alerts
    • Provided through the HTH Travelers Club
    24 Hour/ 7 Day Global Medical Assistance
    • Provided by Worldwide Assistance Services, a Europ Assistance Company
    • Alarm centers in 33 countries and agents in 208 countries
    • Evacuation assistance, Medical monitoring and referral
    • Legal assistance and emergency cash advancements

    Available to U.S. residents enrolled in a primary health plan, age 84 or younger, who live in approved states. Individuals aged 70-84 are eligible only for the $100,000 medical limit. Covers all trips (domestic & international) in a 12 month period not exceed 70 days per trip. 

    There is no pre-existing condition exclusion.

    For more information about the benefits, including information about exclusions, limitations and State to State variation in benefits, see the Certificate.

    The benefits outlined in the table show the payment percentages for Covered Expenses AFTER the Insured Person has satisfied any Deductibles and prior to satisfaction of his/her Out-of-Pocket. Covered Expenses are based on Reasonable Charges which may be less than actual billed charges. Providers can bill the Insured Person for amounts exceeding Covered Expenses.

    10 Day Money Back Guarantee
    YOUR SATISFACTION IS GUARANTEED. We are so confident in our products that we offer the best guarantee in the business! If you are not completely satisfied with our TravelGap Vacationer Product, simply return your Certificate of Insurance and your ID Card to HTH within 10 days of receipt and include a letter indicating your desire to cancel. If you have not already left for your trip before the date of your letter, you will receive a full refund.





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