Frequently asked questions about Expat Underground insurance plans for Cruisers, Expats and Travelers
Am I Eligible?
- What are my home country limitations?
- Who is Eligible?
The only restriction is that you can’t live in the USA or spend more than 6 months per year cumulatively there. Otherwise there are no geographical limitations.
Anybody under age 75 is eligible provided they are not living in the USA or spending cumulatively more than 6 months per year there. With this policy and Area 3 cover, you can return to the USA for medical treatment.
Generally Asked Questions
- What if I have a denied claim that I wish to dispute?
- Can I change my Area of cover?
- What is the Accompanying Relative or Friend Travel Reunion Benefit?
- What is the difference between Travel and Medical Insurance?
- What is outpatient treatment?
- What is Inpatient treatment?
- Are hazardous sports excluded?
- What are the major exclusions?
- Can I seek treatment anywhere in the world?
- What is the refund policy?
- Underwriting
What about pre existing medical conditions?
- What if I have a pre-existing condition that I’m unaware of or asymptomatic for?
- What if I have a Pre-existing condition?
The policy covers pre-existing conditions that you could not have been reasonably aware of. So, if you had bowel cancer before policy inception for example, and you could not have been reasonably aware of it because you had no symptoms, then you would be covered for that. If you had blood in your stool though, and did nothing about it, then there would be an issue.
Option A: Full Medical Underwriting (FMU)
Our underwriters won’t enroll you if you have unacceptable pre-existing conditions. If you’re accepted, then after 2 years we will pay up to $50,000 lifetime to a maximum of $5,000 per year to treat pre-existing conditions. You could have pre-existing conditions excluded under this option as a condition of acceptance. Our underwriters accept 98% of all applications.
Option B: Moratorium Underwriting
Our underwriters won’t enroll you if you have unacceptable pre-existing conditions, but if you have pre-existing medical conditions you want covered without limitation, for a small additional premium, the Moratorium Underwriting Option is available. The Moratorium is a 2 year wait period where pre-existing conditions are not covered. So long as you have 2 clear years where you haven’t had treatment, a consultation, symptoms, or taken medication, or had a recurrence, the condition can be deemed as if it was a new condition after the 2nd year on the policy.
If you have a chronic condition, obviously you’ll never complete a 2 year Moratorium period. An example where this method of underwriting would be useful is if you had a hip replacement in the past and it deteriorated after the moratorium period was completed. Another example would be if you had cancer in the past, a recurrence could be potentially covered without limit under Moratorium underwriting. It could be very useful to have cover greater than $5000 per year for a pre-existing condition. In all cases if you have a pre-existing condition you’re concerned about, please discuss this with us so we can get some specific direction from the underwriter on your case. The Moratorium option is not available for the Bronze benefit level and is limited to age 54.
What if I go to hospital?
- What happens in the case of hospitalization for accidental trauma?
- What is Pre-Certification, Verification of Benefits, and Pre-authorization?
- What is the State Hospital Cash Benefit?
- What is the Daily Hospital Indemnity Cash Benefit?
- Will I be required to make down payments to a hospital?
- Can I go to any hospital?
In this case there is no dispute about medical necessity and if you’re already in hospital the insurer will quickly contact them to guarantee payment if you’re covered.
Pre-certification: Is a review of the proposed course of treatment and claim by IMG the insurer such that they agree there is medical necessity and there is a bona fide requirement for medical treatment.
Verification of Benefits: Is a procedure that confirms that proposed treatment is covered. For both insureds and facilities (clinics/hospitals) direct billing, please confirm verification of benefits with IMG. Just because there is a medical need, does not necessarily mean that there is a benefit payable under the policy.
Guarantee of Payment Letter: This is a letter to a hospital guaranteeing payment for a course of treatment, this can be requested after benefits have been verified.
Pre-Authorization: You and any hospital can consider this Pre-certification plus Verification of Benefits and a Guarantee that the insurer will pay for the proposed course of treatment.
No, if you call IMG Assistance and pre-authorize treatment as you are required to do, then IMG Assistance will make arrangements ahead of time to settle the hospital bill directly. In the event of an emergency, you are required to contact IMG Assistance within 48 hours. They will intervene with the hospital to advance funds and guarantee payment before you are discharged. The only thing we want you to worry about is getting better, not about money!
Extra Addons
The State Hospital Cash Benefit is a standard benefit paying $300 per night that you are hospitalized up to 60 nights ($18,000) but only if there are no costs to you or the insurer. It does not apply in cases where you are in an emergency or accident ward. So if you get cancer for example, and return home for treatment where you can be in a government hospital on your home country national health insurance plan, then you can claim this benefit. Many people prefer to return home for medical treatment, and this is an incentive to do so.
If you have purchased the extra add-on Daily Hospital Indemnity benefit, then you can double dip and get an additional $100 per night, up to $25,000 per year per unit, by claiming both benefits.
The Daily Hospital Indemnity Benefit is an extra add-on benefit costing $100 extra that pays $100 cash for every night spent in a hospital. This would replace your income up to $3100 per month while you are hospitalized up to $25,000 per year. It is available with all benefit levels. It costs $100 extra per year and you can buy multiple units. It also goes a long way to offset a deductible. This does not include time spent in the hospital for maternity.
Restrictions on medical facilities.
No restrictions are made outside the USA. In the US, IMG has a preferred provider network of 4700 hospitals. If you attend one of these facilities and pre-authorize your claim, your deductible will be reduced by half. If you do not pre-authorize and attend a PPO facility in the USA, your benefit may be reduced by 50%. If you wish to find a hospital, clinic, or doctor in the USA near you, please search our Preferred Provider network list on-line: Search List
We don’t have an approved hospital list except in the USA. All health insurance policies however, have the phrase “usual, reasonable and customary costs” (URC) in their policy wordings. They will not pay more than URC for treatment in the country where you are located. If you go to a hospital that charges ten times the going rate, there will be a problem. It is very important to contact IMG Assistance, and cooperate with them so that there are no surprises later. You must contact IMG Assistance if you expect a medical bill to be more than US $500 and pre-authorize the claim or your benefit may be reduced by 50% no matter what country you are in.