The Gateway International Plan provides accident and health insurance coverage for individuals who are traveling outside their home country/country of residence, except for travel to the United States. Insurance coverage is available from a minimum of 15 days up to a maximum of 180 days.
Designed Expressly for International Travel Abroad
When planning international travel, it is important to think about insurance, which may be needed for an unexpected or emergency medical situation. For instance, health plans designed for coverage at home may not be adequate or even available outside the Home Country.
Gateway International offers a solution to this challenge. The Plan provides insurance for accident and medical expenses, medical evacuation and repatriation, and accidental death and dismemberment. Worldwide medical and travel assistance services are also included.
Eligibility Requirements
Eligibility for Gateway International requires the insured(s) to meet all of the following conditions:
- travel is to a destination(s) outside Home Country/Country of Residence, except travel to the United States
- travel abroad is for 180 days or less
Spouse and/or unmarried dependent children (over 14 days old and under the age of 18) are also eligible if they meet the requirements outlined above.
A child over the age of 18 is not considered a dependent child for this insurance plan. Children over the age of 18 can apply under separate Application and must meet the eligibility requirements shown above.
If the Home Country is different from the Country of Residence, there is no coverage in either location.
If the United States is the Home Country/Country of Residence, for the purposes of eligibility, the United States means the 48 contiguous states, plus Alaska, Hawaii, and the District of Columbia.
Home Country and Country of Residence Defined
- Home Country is the country from which the Insured Person holds a passport.
- Country of Residence is the country where the Insured Person maintains a primary permanent residence.
Plan Features
Medical Insurance
Medical Expense*:
Plan A: $25,000 Maximum or
Plan B: $100,000 Maximum
- Medical Expense Maximum applies per injury or illness
- $100 Deductible per person, per Term of Insurance
*Only Covered Medical Expenses which are considered reasonable and customary are eligible expenses.
Other Insurance
- Emergency Medical Evacuation: $100,000
- Return of Minor Children: $5,000
- Repatriation of Remains: $20,000
- Accidental Death & Dismemberment (AD&D): $25,000 Principal Sum (Options for higher limits available)
Services
Worldwide Medical and Travel Assistance: Included
How the Medical Insurance Works
For Covered Medical Expenses during a Term of Insurance, the Gateway International plan works like this:
- Each Insured Person must meet the $100 Deductible once during each Term of Insurance.
- After the Deductible, the Plan pays 100% of the reasonable and customary charges for Covered Medical Expenses up to the Medical Expense Maximum or the Maximum Coverage Period, whichever occurs first.
- The Medical Expense Maximum is applied to Covered Medical Expenses for each separate, distinct, and unrelated condition.
- The Maximum Coverage Period is 26 weeks from the date of covered injury or onset of covered illness.
The Description of Coverage section provides details about Covered Medical Expenses, Exclusions, and Limitations.
Effective Date and Expiration Date of Insurance
Once the Administrator receives and accepts the Application and premium, the Effective Date of insurance is the latest of these dates:
- departure from the Home Country/Country of Residence
- the date Application and premium are received
- the date requested on the Application form
The Expiration Date of insurance is the earlier of these dates:
- the date of return to the Home Country/Country of Residence
- 180 days after the Effective Date of insurance
- the date shown on the insurance coverage documents mailed upon issuance
Term of Insurance
A Term of Insurance starts on the Effective Date of insurance and ends on the Expiration Date of insurance.
- Minimum term is 15 days
- Maximum total term is 180 consecutive days
Enrollment
Gateway International is a short-term insurance plan, which cannot be renewed. If additional days of coverage are needed after the initial Term of Insurance expires, a new Application can be submitted. Each subsequent Application represents a new Term of Insurance, subject to all policy provisions.
Description of Coverage
Medical Expenses
If an injury or illness occurs during the Term of Insurance, only those expenses specifically described below, and which are incurred within the Maximum Coverage Period (26 weeks from the date of such injury or onset of such illness), and which are not excluded (see Exclusions section) are considered Covered Medical Expenses. Initial treatment of an injury must occur within 60 days of the accident.
- Charges made by a hospital for room and board, floor nursing and other services, exclusive of charges for professional services and with the exception of personal services of a non-medical nature; provided, however, that expenses do not exceed the hospital's average charge for semiprivate room and board accommodation, or intensive care when medically necessary;
- Charges made for diagnosis, treatment and surgery by a physician;
- Charges made for the cost and administration of anesthetics;
- Charges for medication, X-ray services, laboratory tests and services, the use of radium and radioactive isotopes, oxygen, blood transfusions and medical treatment;
- Charges for physiotherapy, if recommended by a physician for the treatment of a specific disablement and administered by a licensed physiotherapist;
- Dressings, drugs and medicines that can only be obtained upon a written prescription of a physician or surgeon.
The charges listed above shall in no event include any amount of such charges which are in excess of reasonable and customary charges.
Exclusions
For Medical Expenses, this insurance does not cover:
- Pre-existing Conditions, defined as illness, injury or manifestation of symptoms for which a licensed physician was consulted, or for which treatment or medication was prescribed, within 12 months prior to the Insured Person's Effective Date of insurance;
- Services, supplies or treatment, including any period of hospital confinement, which are not recommended, approved and certified as necessary and reasonable by a physician, or expenses which are non-medical in nature;
- Expenses incurred as a result of or in connection with a) declared or undeclared war, or any act thereof; b) injury sustained while participating in professional sports, sponsored scholastic or amateur athletics, which are defined as organized sports activities associated with a team, league, or similar group; c) intentionally self-inflicted injury, suicide while sane or attempted suicide while insane; d) scuba diving, mountain climbing, sky diving, professional or amateur racing, piloting an aircraft; or e) commission of a felony;
- Expenses for a) pregnancy, childbirth or miscarriage; b) routine physicals; c) cosmetic or plastic surgery, except as the result of an accident; d) elective surgery; e) any mental and nervous disorders or rest cures; f) dental care, except as the result of injury to natural teeth caused by accident; g) eye refractions or eye examinations for the purpose of prescribing corrective lenses for eye glasses or for the fitting thereof, unless caused by accidental bodily injury incurred while insured; h) alcoholism or drug addiction or use of any drug or narcotic agent; or i) treatment by a family member;
- Treatment paid for or furnished under any other individual or group policy, or other service or medical pre-payment plan arranged through an employer to the extent so furnished or paid, or under any mandatory government program or facility set up for treatment without cost to any individual;
- Loss or expense caused by, contributed to, or resulting from any loss that occurs while traveling or enrolling solely for the purpose of obtaining medical treatment, while on a waiting list for a specific treatment, or while traveling against the advice of a physician.
Emergency Medical Evacuation Expenses
If injury or illness commencing during the Term of Insurance warrants immediate transportation to the nearest medical facility where appropriate medical treatment can be obtained, or if after being treated at a local hospital the condition warrants transportation to the Home Country/Country of Residence for further medical treatment or to recover, or both, all eligible expenses incurred are covered up to a maximum of $100,000. An emergency evacuation must be recommended by a legally licensed attending physician who certifies that the severity of injury or illness necessitates such emergency evacuation and must be agreed upon by you or your representative. In the event this coverage is needed, arrangements are made by the Assistance Services provider.
If an Insured Person is hospitalized for more than 7 days following a covered emergency evacuation and is receiving care outside the Home Country/Country of Residence, the Plan will pay up to the cost of round-trip economy airfare to bring a person chosen by the Insured Person to and from his/her bedside, if the Insured Person is not accompanied by immediate family. These transportation arrangements must be authorized in advance and made by the Assistance Services provider.
Return of Minor Child(ren)
If an adult insured is traveling alone with a Minor Child(ren) up to the age of 18 and is hospitalized because of a covered illness or injury and the minor children are left unattended, the Plan will arrange and pay for one-way economy fares (less the value of applied credit from any unused travel tickets per person) to their Home Country/Country of Residence, not to exceed the maximum of $5,000. These arrangements will be made at no cost to you. If an attendant/escort is necessary to ensure the safety and welfare of Minor Child(ren), the Plan will arrange and pay for these services. All arrangements must be made by the Assistance Services provider.
Repatriation of Remains Expenses
If injury or illness commencing during the Term of Insurance results in death, all reasonable expenses incurred for preparation and return of the remains to the Home Country/Country of Residence are covered up to a maximum of $20,000. In the event this coverage is needed, arrangements are made by the Assistance Services provider.
Exclusions
For Emergency Medical Evacuation and Repatriation, this insurance does not cover:
Expenses incurred as a result of or in connection with a) declared or undeclared war or any act thereof; b) injury sustained while participating in professional sports; c) intentionally self-inflicted injury, suicide while sane or attempted suicide while insane; d) commission of a felony; e) professional racing, participation in contests of speed, or piloting an aircraft; f) pregnancy, except complications of pregnancy; g) alcoholism or drug addiction.
Accidental Death & Dismemberment (AD&D)
$25,000 Principal Sum: Included
$100,000 Additional Principal Sum: Option 1
$250,000 Additional Principal Sum: Option 2
Gateway International includes $25,000 AD&D Principal Sum for each Insured Person and Insured Spouse, with partial coverage for each Insured Child(ren) (see Table of Losses below).
If you wish to purchase either Optional Additional Principal Sum it must be purchased for each adult (Insured Person and Insured Spouse) listed on the Application and additional premium must be paid at time of Application. This option is not available for Insured Persons under the age of 18. Purchase of this optional coverage does not affect the AD&D coverage amount for Insured Child(ren).
If an injury occurs during your Term of Insurance and results in one of the following losses within 365 days after an accident, the Plan will pay for loss as follows:
Table of Losses Insured or Spouse Each Child
Loss of life Principal Sum $5,000
Loss of two members Principal Sum $5,000
Loss of one member 50% of Principal Sum $2,500
"Member" means hand, foot or eye. "Loss" means with regard to hands and feet, actual severance through or above wrist or ankle joints, and with regard to eyes, entire and irrecoverable loss of sight. Only one amount, the largest to which you are entitled, is paid for all losses resulting from one accident.
Exclusions
For Accidental Death & Dismemberment, this insurance does not cover losses resulting from:
a) intentionally self-inflicted injury, suicide while sane or attempted suicide while insane; b) war or any act of war, declared or undeclared, or service in the military, naval or air service of any country; or c) piloting or acting as a crew member or riding in any aircraft except as a fare-paying passenger on a scheduled airline;
a) illness, disease, pregnancy, childbirth, miscarriage or any bacterial infection other than one occurring from an accidental cut or wound; or b) hernia.
Assistance Services
Assistance services are provided by AIGAssist (AIG International Services).
Eligibility for any of the assistance services outlined below is effective once insured. Services can be accessed 24 hours a day, 7 days a week.
- Pre-Departure Services - information on immunization requirements, passport and visa requirements.
- Travel Medical Emergency Services - help in obtaining local medical care, in arranging special medical services when traveling; medical case monitoring; arranging communication between patient, family, physicians, employer, consulate; health information and precautions for medically remote or underserved areas; guarantee payment for medical care using traveler's financial resources.
- Medical Evacuation - coordinate and arrange for medical transportation if traveler becomes injured or seriously ill and needs to be evacuated to an appropriate medical treatment facility.
- Repatriation - coordinate the return of remains to the Home Country/Country of Residence if death occurs while traveling.
- Emergency Travel Assistance - advice on handling losses and delays; help with lost passport, tickets and documents; advice on filing insurance claims; relaying emergency messages.
- Travel Emergency Legal Assistance - arranging for traveler to obtain needed help from local attorneys, embassies and consulates.
Refund of Premium
Full refund of premium is considered only upon written request received by the Gateway Administrator prior to the Effective Date of insurance. Premium is considered fully earned after the Effective Date of insurance. Partial refund is not available.
Plan Underwriter
The Gateway Plans are underwritten by the Insurance Company of the State of Pennsylvania, a Pennsylvania insurance company, with its principal place of business at 70 Pine Street, New York, New York 10270. It is currently authorized to transact business in all states and the District of Columbia. NAIC No. 19429. The Insurance Company of the State of Pennsylvania is a member of the American International Group of Companies (AIG).