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Accidents and unforeseen illnesses do occur. And, once we pass our years as teens and young adults, the odds of having an accident or unexpected illness increase. A slip, a fall, a broken bone, they happen. Prior planning and appropriate insurance are the best ways to protect your health—and your bank accounts—when traveling overseas. Medical insurance and assistance for overseas travelers are as important as your passport, at a price that’s less than dinner for two.

When planning a trip overseas, check with your health insurance provider to determine what’s covered. With limited exceptions in Canada and Mexico, Medicare does not cover health care costs outside of the United States.

What you should know about HealthCare Abroad:

The medical insurance provides up to $500,000 for each covered personal injury and sickness that occurs while you are traveling overseas. Medical evacuation, if warranted, to a more suitable hospital or your home is included, as are the costs of hospitalization, visits to doctors’ offices, prescriptions, lab fees, x-rays, local ambulance, and emergency dentistry arising from an accident. In the very unlikely event of accidental death, the return of your remains to your home is covered.

  On-Line Brochure Download PDF of Brochure & Application

 

International assistance is not insurance. Rather it is the service (24 hours per day, 7 days a week) of an English-speaking personal assistant, professionally trained and fluent in local languages and culture to help you quickly find the medical care you need. These pros act as your advocate in communicating with local medical services. Your assistant can help you revise travel plans and facilitate emergency communications with your personal physician and family back home. They’ll assist you in getting knowledgeable legal advice if needed. It’s as if you had a good friend wherever you are—no further away than a toll free phone call.

Optional trip cancellation and curtailment coverage reimburses you for unrecoverable deposits and charges and/or unexpected travel expenses should your trip be cancelled or shortened due to a covered illness or accident.

Overseas medical services often demand full payment from international travelers at the time care is delivered. Thus, splinting an ankle broken in a misstep from a curb could require an immediate payment of $7,500 or more. Should it be desirable for you to return to your home country for treatment, the cost of medical evacuation can run from $15,000 on a commercial flight to more than $100,000 for an air ambulance and medically trained crew.
 

What you should do:

   
Review your personal medical insurance to determine if your current insurance covers you overseas and includes medical evacuation coverage.
Read the detailed description of coverages below.
Visit the Department of State web page Travel and Living Abroad (www.state.gov/travel/) for health advisories and related information about the countries you will visit.

Call Wallach & Company (800-237-6615) with questions and concerns about emergency medical and related assistance.

    

Medical Expense Benefits

$500,000 Accident and Sickness Benefit
$100, $500 or $1,000 deductible

(This benefit is reduced to a maximum of $100,000 for persons between the ages of 71 and 84.)

After the deductible you select, the Company will pay up to $500,000 for those medical expenses incurred outside the USA during the Period of Insurance which are the direct result of each covered injury or sickness which first manifests itself during the Period of Insurance. Covered expenses include, but are not limited to, the necessary medical or surgical treatment, services and supplies, hospital services, local ambulance, prescriptions, x-rays, laboratory fees and visits to a physician's office. The benefit for downhill (alpine) skiing and scuba diving (certification by PADI or NAUI required) is limited to $10,000.

The Accident and Sickness Benefit also includes coverage for medical evacuation and repatriation of remains.

Medical Evacuation
If a covered injury or sickness occurs during the Period of Insurance and requires your evacuation, the Company with your concurrence and that of the attending physician, may evacuate you to a more suitable hospital or to your home location in the event you are hospitalized more than five consecutive days. An evacuation to your home location will terminate coverage under this policy.

Repatriation of Remains
If a covered injury or sickness results in the loss of your life during the Period of Insurance, the Company will pay the expenses for the preparation and transportation of your body back to your home.

All medical evacuations and repatriations of remains must be approved (in advance) and coordinated by the Assistance Center.

Dental Expense Benefit
The Company will pay up to $200 for the immediate relief of dental pain; or up to $200 per tooth (subject to a $1,000 maximum) for dental treatment resulting from a covered accident.
 
This is a descriptive brochure containing a summary of the coverages provided by the Master Policy. Once insured you will receive a Certificate of Insurance which contains details of the coverage. This Insurance is underwritten by Pan-American Life Insurance Company, 601 Poydras Street, New Orleans, Louisiana 70130.

$25,000 Accidental Death & Dismemberment Benefit
The principal sum benefit is $25,000. If a covered injury occurs to you during the Period of Insurance, which is independent of all other causes and results in one of the following losses within 180 days of the covered injury, the Company will pay the sum indicated below:
Loss Benefit
Life Principal Sum
Any two limbs (above the elbow/knee) Principal Sum
Sight in both eyes (irrecoverable) Principal Sum
One limb and the sight in one eye Principal Sum
One limb or the sight in one eye One-half Principal Sum

The Company will not pay more than the principal sum for all losses incurred as a result of the same accident.

Period of Insurance
Coverage for the Medical Expense Benefits and the Accidental Death & Dismemberment Benefit starts: (a) at 12:01 a.m. local time on the departure date requested on the Application; (b) when your Application and premium are received by the Administrator; or (c) when you board a conveyance at the actual start of your planned trip, whichever occurs later. Coverage ends: (a) when you alight from a conveyance at the completion of your trip; or (b) at 11:59 p.m. local time on the last day of coverage specified on your Application, whichever occurs earlier.

Evacuation Benefit

$1,000 Benefit
The Company will reimburse you up to $1,000 if you evacuate yourself from an area for which the U.S. Department of State has issued a “TRAVEL WARNING” urging U.S. citizens not to travel to the immediate area, or to leave the affected area if you are already there.  Examples of “TRAVEL WARNINGS” may include natural disasters such as earthquake, volcanic eruption, flood, tsunami, biological outbreaks such as SARS, Avian Flu or civil unrest (including a significant increase in terrorist activity).

This benefit is applicable only if you are in the affected area before the WARNING is issued and evacuate yourself from that area as soon as possible before the WARNING is cancelled.

The U.S. Department of State maintains a list of countries on its website (www.travel.state.gov) where short-term conditions pose risks to travelers.  This Evacuation Benefit will not cover any evacuation expenses from an area listed on its website prior to your arrival in that area.

IMPORTANT INFORMATION
1. This insurance cannot be renewed. However; another policy may be purchased. If a new policy is issued, any claims incurred under the previous policy will be considered a pre-existing condition and therefore not covered under the new policy.
2. HealthCare Abroad covers injuries resulting from random acts of terrorism. However, if it is your intention to travel to an area where a state of war exists, that is faced with the threat of war, or is in a state of civil unrest, that information must be included on the Application. Additional premium may be required.
3. Right of Subrogation — If you are injured or become sick as a result of another person's negligence, the Company has the right to seek reimbursement on your behalf against the negligent party for any claims paid under this insurance.

Optional Coverage

$500–$10,000 Trip Cancellation and Curtailment Benefit

Trip Cancellation
The Company will pay up to the benefit limit selected on the Application, for the loss of unrecoverable deposits or charges paid in advance, due to the necessary cancellation of the entire trip prior to the scheduled departure; provided that the covered injury, sickness or death giving rise to the cancellation begins within the Period of Insurance.

Trip Curtailment
The Company will pay up to the benefit limit selected on the Application for either: (a) any additional reasonable transportation and/or lodging expenses for the emergency return trip home; or (b) the balance of unrecoverable trip costs; whichever is lesser, provided that the covered injury, sickness or death giving rise to the curtailment occurs after your trip commenced and prior to the termination of the coverage as specified on the Application.

The Trip Cancellation and Curtailment Benefit may also be applicable if a covered injury, sickness or death is sustained by your traveling companion (named on the Application), immediate family (spouse, children, mother, father, sister, brother), and immediate family in-laws. See Exclusion A.

Period of Insurance
Coverage for the Trip Cancellation and Curtailment Benefit begins at 12:01 a.m. local time 30 days prior to your scheduled departure, but no sooner than the date your Application and premium are received by the Administrator. Coverage ends at: (a) the completion of your trip or; (b) 11:59 p.m. local time on the last day of coverage specified on your Application, whichever occurs earlier.

$100,000 Additional Accidental Death & Dismemberment Benefit

The Accidental Death & Dismemberment Benefit (as previously defined) may be optionally increased from the included $25,000 benefit to a total benefit of $125,000. This benefit is not available to persons age 71 or older.

This insurance does not cover, nor has premium been charged for losses resulting from:

Exclusions & Limitations
This insurance does not cover, nor has premium been charged for losses resulting from:
 
A.

A Pre-existing Condition defined as: Any injury or sickness or complications arising therefrom, which manifests itself, or for which a physician was consulted or for which treatment or medication was prescribed or taken in the 180 days immediately prior to the Period of Insurance. With reference to the Trip Cancellation/Curtailment Benefit this exclusion also applies to any condition or set of circumstances known to you at the time of purchasing the insurance where such condition or set of circumstances could reasonably have been expected to give rise to the cancellation or curtailment of the trip.
 

B.

Any claim in respect of:

  1. Congenital conditions; cosmetic surgery and/or dental care (except as covered under the Dental Expense Benefit); suicide, self-inflicted injury or any attempt thereat;
  2. Examinations/treatment where there is no objective impairment of normal health;
  3. Eyeglasses, contact lenses or hearing aids;
  4. Sexually transmittable diseases (this exclusion does not apply to HIV, AIDS, ARC or any derivative or variation thereof);
  5. Birth control, fertility or infertility treatment, or pregnancy including miscarriage or abortion;
  6. "Off-Road," All-Terrain Vehicle accidents; mountaineering (where ropes or guide persons are customarily used); or
  7. Other vehicle accident, if such expenses are recoverable under any other valid and collectible insurance, regardless of whether you assert your rights to obtain benefits from these sources. Nor will this plan cover you while operating a vehicle unless you are properly licensed to operate said vehicle at the time and place of the accident.
     
C.

Any claim arising from war, declared or undeclared, or any act of war or while in military service. An act of terrorism shall not be considered an act of war.
 

D.

Participation in professional sports; or involving aviation other than as a passenger in a powered aircraft currently licensed for the carrying of passengers.
 

E. Expenses not considered medically necessary; or not recommended and approved by the attending physician.
 
F.

Amounts covered under any occupational or other benefit plan, or any other insurance or public assistance program.
 

G.

Those claim expenses incurred after the Period of Insurance or in your home country.
 

H.

Any loss that occurs:

  1. From medical expenses incurred within the United States;
  2. While traveling against the advice of a physician;
  3. While on a waiting list for a specific treatment; or
  4. When traveling for the purpose of obtaining medical treatment.

Medical Expense Benefits
If you are under the age of 71, the daily premium is based upon the deductible you select. If you are between 71 and 84, the daily premium is based upon the deductible and the amount of coverage you select.

Cost Per Person Chart
 

Example:
Age 78
Coverage Requested: $100,000
Deductible Requested: $500.00
Departure Date: April 7; Return Date: April 30
Period of Coverage: 24 Days
(includes departure & return dates)
$8.50 x 24 Days = $204.00 Premium

$100,000 Additional Accidental Death & Dismemberment Benefit
$.50 per day
(Minimum 10 days)
This optional benefit is not available to persons
between the ages of 71-84.
Trip Cancellation and Curtailment Benefit
Coverage Available: $500 minimum; $10,000 maximum
Premium = Coverage Requested x .05
Example: $ 1,250 Coverage Requested x .05 = $ 62.50 Premium

Refund Policy
Premium (less applicable credit card processing fees) will be refunded only if Wallach & Company, Inc. receives a written request for the refund before your insurance begins. Once your insurance begins, all premium is considered fully earned and none will be refunded.

 

HealthCare Abroad Application
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Eligibility: You must be a U.S. resident and under age 85 to enroll in HeathCare Abroad.

You may complete and submit your Application online and you will receive a receipt of your Application by email; or you may print your completed Application, mail it or fax it to:

Wallach & Company, Inc.
Post Office Box 480
107 West Federal Street
Middleburg, Virginia 20118 USA

Fax: (540) 687-3172

Please call (800) 237-6615 or (540) 687-3166 between 9:00 a.m. - 5:00 p.m. EST, Monday–Friday for telephone assistance.

 

This plan is not available to residents of the State of Washington, USA.
 

Required Information:

Applicant Name  
 First Name 
 Last Name 
Street Address
 
City
State
Zip or Postal Code
Email Address - Required
Telephone
Passport No.
Applicant's Date of Birth (Max age 84)
Destination Countries
Departure Date (First Day of Coverage)
Last Day of Coverage: 
(10 Day Minimum)

Person to be contacted in the event of an emergency:
Name
Telephone
Relationship

Required Coverage:
$500,000 Medical Expense Benefits (Maximum of $100,000 for age 71-84)

To calculate your premium please enter values for the items below.
 
Please start by indicating which plan you are interested in:
 
 I am under 71, $500,000 limit, $100 deductible
 I am under 71, $500,000 limit, $500 deductible
 I am under 71, $500,000 limit, $1,000 deductible
 I am 71-84, $50,000 limit, $100 deductible
 I am 71-84, $50,000 limit, $500 deductible
 I am 71-84, $50,000 limit, $1,000 deductible
 I am 71-84, $100,000 limit, $100 deductible
 I am 71-84, $100,000 limit, $500 deductible
 I am 71-84, $100,000 limit, $1,000 deductible

 
=   $0.00 - Cost per Day
x - Number of Days
= $0.00
x - Number of Persons to be Insured
= $0.00 - Required Coverage Premium
 
Optional Coverage:
$100,000 Additional Accidental Death & Dismemberment Benefit
(Available only to Persons under Age 71)
 Yes  No 
Name of Beneficiary
=   $0.50 - Cost Per Person Per Day
x 0 - Number of Days
= $0.00
x 0 - Number of Persons to be Insured
= $0.00 - Optional AD&D Premium

Optional Coverage:
Trip Cancellation and Curtailment Benefit ($500 minimum; $10,000 maximum)
This coverage is available only if purchased at least 10 days before the Departure Date.
Cost per Person: .05 times the coverage requested.
 Yes  No 
Name of Traveling Companion 
 Coverage Requested
= - Coverage Requested
x .05 - 5 Percent of Coverage Requested
= $0.00
x 0 - Number of Persons to be Insured
= - Optional Trip Cancellation Premium
       
Premium Calculation:
= $0.00 - Required Coverage
+ $0.00 - Optional Trip Cancellation
+ $0.00 - Optional AD&D
= $0.00 - Total Policy Premium

Payment:
Check payable in U.S. funds, drawn on a U.S. bank, and made payable to Wallach & Company, Inc.
Visa MasterCard American Express
Card Number
Security Code
Expiration Date  / 
Name on Credit Card
The Security Code provides an additional security measure to prevent card misuse within online transactions. For the majority of credit cards, the security code is the last three digits of the number shown above the signature strip on the reverse side of the credit card. For American Express Cards, the security code is the four digit number shown above the credit card number, on the right-hand side of the front of the card.


Declaration of Applicant:
I hereby apply to purchase the insurance. I declare to the best of my knowledge and belief that the information given in this Application is true and complete. I acknowledge (on behalf of the person(s) to be insured) that benefits will not apply to treatment arising from pre-existing medical conditions. It is agreed that this declaration and the information given herein shall form the basis of the contract between the Insured Person and the Company. Further, I hereby subscribe to the International Sojourners Insurance Trust and acknowledge enrolling in this group coverage for which I am eligible under the contract issued by the Company.
 
  Signature Date

Please sign and date this Application if you elect to print and mail it to Wallach & Company.
 

By submitting this Application you agree to the terms of the Applicant Declaration.

Your insurance documents will be sent to the email address supplied with this enrollment form.


Administered by Wallach & Company, Inc.
© Wallach & Company, Inc., 2014.

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