Mission Trip Insurance: Individual Missionary Travel Outreach Benefits

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	GMMI^SM brochure

Global Mission Medical Insurance® covers the Usual, Reasonable and Customary (URC) charges for eligible expenses in the area where you receive treatment. Each person will only need to satisfy their deductible once per period of coverage (12 months) with a maximum of three deductibles per family. For eligible expenses incurred in the U.S. and Canada (if applicable): once the deductible is met, Global Mission Medical Insurance pays 80% of the next US$5000 in eligible expenses then 100% of eligible expenses up to the Policy Maximum. For eligible expenses incurred outside the U.S. and Canada: once the deductible is met, Global Mission Medical Insurance will pay 100% of eligible expenses up to the Policy Maximum.


MEDICAL INSURANCE	BENEFIT Subject to deductible and coinsurance
Coverage Area	Two options: Worldwide or worldwide excluding U.S. and Canada
Policy Maximum Per Individual	US$5,000,000 lifetime

Hospitalization Semi-private room and board • Nursing services • Prescription medication • Physician charges • Diagnostic and laboratory testing • X-rays • Chemotherapy and radiation • Durable medical equipment • Treatment, services and supplies routinely provided	URC

Intensive Care Unit	URC

Surgery Surgical care • Second surgical opinion • Anesthetics • Physician charges for surgery • Treatment, services and supplies routinely provided	URC

Transplants Limited to certain transplants and covered only within designated transplant facilities that are members of IMG's independently contracted PPO network	US$1,000,000 lifetime

Outpatient Emergency treatment of illness or injury • Surgery • Rehabilitative treatment • Treatment, services or supplies routinely provided • Prescription medication	URC

Emergency Surgery or dental treatment following an accident • Emergency room following an accident • Charges incurred for the use of the Emergency Room for treatment of an illness are subject to an additional (extra) US$250 deductible if treatment does not require admittance to the hospital.	URC

Emergency Transportation by Ground Ambulance	URC

Emergency Medical Evacuation Included with Emergency Medical Evacuation is an Emergency Reunion benefit of US$10,000 lifetime	Up to policy maximum

Return of Mortal Remains	US$25,000

Supplemental Accident The first $300 will be covered for each accidental injury	US$300 per occurrence (not subject to the deductible or coinsurance)

Child Wellness Available for eligible children under 18 years of age after 12 months of continuous coverage	US$200 maximum per period of coverage (not subject to deductible or coinsurance)

Pre-existing Conditions Only available after 24 months of continuous coverage	US$50,000 lifetime (maximum of US$5,000 per period of coverage)

Mental/Nervous Care Only available after 12 months of continuous coverage • Inpatient and outpatient care by a licensed psychiatrist	US$10,000 per period of coverage, US$50,000 lifetime

Wellness Females age 30 and over, only after 12 months of continuous coverage • Routine physicals • Mammogram, ob/gyn visit, etc. (exams must be separated by 12 months) Males age 30 and over, only after 12 months of continuous coverage • Routine physicals (exams must be separated by 12 months)	US$250 per period of coverage (not subject to deductible or coinsurance)

Dental Emergency Necessary treatment of sudden, unexpected pain to sound natural teeth	US$100 per period of coverage

Complementary Medicine	(Each per period of coverage)
Acupuncture	US$150
Aroma Therapy	US$50
Herbal Therapy	US$50
Magnetic Therapy	US$75
Massage Therapy	US$150
Vitamin Therapy	US$100

Recreational SCUBA Coverage Illness or injury while using safe diving practices as laid down by an Authoritative Diving Body	URC

Other Chiropractor when referred by a physician • Radiation treatment • Home nursing care • Hospice care • Physical therapy (maximum US$50 per visit) • Prosthetic devices	URC

The foregoing list is only a summary of available benefits and coverages, and is subject to the specific terms and conditions of the plan concerning eligible benefits, limitations, eligibility and exclusions. Please refer to the Certificate Wording for a complete description, which is available upon request.