Overview
Expatriates headed into areas of conflict or participating in hazardous sports will find few insurance companies willing to offer coverage. The Worldwide Major Medical plan is a very unique international health plan because it offers coverage (through its optional benefits) that are excluded from most plans.
- Global Coverage – Coverage can be worldwide including the United States (with optional rider).
- High Risk Coverage – Benefits can be extended to war zones and extreme sports.
- Optional U.S.A. Coverage – Premium can be reduced in half by eliminating U.S. coverage.
- Preexisting Condition Coverage – Coverage may be extended to preexisting conditions provided they were disclosed on the application and approved.
- Renewable – Coverage is conditionally renewable based upon residency requirements and payment of premium. Underwriters reserve the right to modify coverage by class.
Plan Administrator and Carrier Information
Petersen International Underwriters (PIU) has been creating unique insurance products for over 40 years. PIU serves as a plan administrator coordinating product design and marketing. Their unique product line includes high limit disability insurance, kidnap & ransom coverage, international AD&D, medical insurance and life insurance. PIU has been recognized as an industry innovator receiving awards such as the LPRT Golden Eagle Award, the NAHU Distinguished Service Award and the Paladin Award for Leadership and Education.
The risk for PIU’s plan is underwritten by Lloyds of London, the worlds oldest insurance market. Lloyds receives an A (excellent) from A.M. Best, A+ (strong) from Fitch and an A+ (strong) from Standard & Poor’s.
Why U.S. domestic coverage doesn’t work overseas
If you are planning either a long trip or residency overseas, we encourage you to review your current health insurance policy for residency and overseas coverage explanations. If working with a broker or carrier representative, please ask to see the clauses specific to these areas below in writing. Note: these clauses typically apply to both individual and group health insurance plans.
- Residency Clause – Residency clauses are primarily designed to keep people who are not residents of a state from purchasing coverage. These clauses typically state that the member must be a resident of the state the policy was purchased in at least 6 months a year. If the residency clause is violated, the policy can become void and the insurance company is no longer responsible for paying claims.
For American expatriates and long-term travelers, this creates a serious problem. International health insurance plans avoid this problem by allowing the member to reside outside the U.S. for indefinite periods of time.
- Out of U.S. Coverage Clause - The majority of U.S. health insurance plans offer emergency care only when outside the U.S. In addition to this dramatic reduction in benefits, most U.S. health insurance companies are not set up to assist members outside the U.S. That means if you have a medical emergency overseas and require a medical evacuation or access to a reputable hospital, it will be your responsibility to arrange for your care.
Travel medical and international health insurance plans remove the burden of care on the member by offering services such as 24/7 multilingual assistance, medical evacuation services, networks of overseas providers and the ability to navigate foreign healthcare systems.
Benefits Summary
The Worldwide Major Medical plan offers a wide range of benefits and services on a reimbursement basis. Eligible benefits include;
- Hospital room and board (limited to semi-private daily rate)
- Hospital intensive care unit
- Local area ambulance service
- Physician services consisting of home, office and hospital visits, and any other medical care and treatment
- Diagnostic services, supplies and therapy
- Prescription medication prescribed at the time of discharge from the hospital, not to exceed a 12-month benefits period.
Sample Policy
For more detailed information about Worldwide Major Medical, please contact ITG Worldwide for a sample policy.
Optional Benefits
The Worldwide Major Medical plan offers a number of optional benefits to enhance coverage. These benefits are subject to approval and do require additional premium. Please see the brochure for more details about optional benefits.
U.S.A. Coverage
Clients seeking the ability to be covered while in the U.S. or return to the U.S. for treatment need to include the U.S.A.. Coverage option.
Hazardous Sports or Activities
Coverage for sports such as SCUBA diving and snow skiing can be included with an additional premium of 10% or $80, whichever is greater. Other sports can also be included such as mountain climbing, racing and skydiving. Those sports are underwritten and priced individually. Please contact ITG Worldwide for more information.
War or Act of War Coverage
Most insurance carriers will exclude coverage for war risk. Petersen International offers this very unique option for those headed into war zones and areas of instability. Pricing depends upon a number of factors. Please contact ITG Worldwide for pricing.
Global Medical Transportation
The underwriters will reimburse you for all medically necessary expenses for stabilization and transportation to the facility nearest your home, which can provide the appropriate care.
The above is a summary of the plan and options. Please review the brochure and policy certificate for more details.
Providers & Services
The Worldwide Major Medical Plan does not utilize any provider networks inside or outside the United States. Members are eligible to seek care with providers anywhere in the world.
IRMG
Petersen International utilizes the services of International Risk Management Group (IRMG) for all emergencies. If you are in need of emergency assistance, please contact IRMG.
Toll Free in the U.S. – 888 622 4764
Collect Call outside the U.S. – 215 794 1488
Eligibility
The PIU Worldwide Major Medical Plan is available to U.S. citizens who reside outside the United States for more than 5 months per year. Persons between the ages of 14 days and 74 years old may apply for coverage. Persons older than 74 years of age are not eligible. Certain other restrictions may also apply.
Members must also continue to reside outside the U.S. 5 months out of the certificate period to renew coverage.
Eligible families will receive discount coverage for dependent children ages 17 or under when insured with a parent. Family members requesting coverage must each complete an application.
If you have questions about eligibility, please contact ITG Worldwide.
Important Note - This is a description of Eligibility. Eligibility does not guarantee that a policy will be issued. An application must be submitted and applications are subject to Underwriting. Therefore, it is not guaranteed that a policy will be issued. Do not terminate any existing insurance until receipt of written approval from Petersen International Underwriters.
Claims
Simplifying the Process
The Worldwide Major Medical Plan is a reimbursement type international health insurance plan. Members are able to seek care with any provider, as there is no network in either the U.S. or abroad. Claims are submitted to a third party administrator (TPA) for reimbursement to the member. If the claim underwriters agree, the TPA can pay the provider directly.
Filing Claims
PIU uses International Risk Management Group (IRMG) for its TPA services. If you need to be reimbursed for out-of-pocket medical expenses, complete the claim form and submit your original itemized bills and paid receipts within 90 days to IRMG. Do not hold your bills or receipts until the end of the year. Please use the claim form below.
Medical Claim Form PDF
Mail the completed claim form and all required information to:
International Risk Management Group
PO Box 2104
Doylestown, PA 18901
Phone: 215 794 1488
Fax: 215 794 1498
www.IRMGroup.com
How to Apply
The PIU Worldwide Major Medical Plan requires the applicant to complete the forms contained in the brochure to the right. When applying, please provide accurate and current information.
For some groups, coverage can be underwritten using a spreadsheet. If your organization has several people requiring coverage, please contact ITG Worldwide for additional information.
Current Coverage – Please do not terminate any current health insurance coverage until you have received written confirmation by Petersen International Underwriters that your Worldwide Major Medical Plan is effective and you accept PIU’s terms and conditions.
Download Application
Please click on the application image to download the application. Completed applications need to be either faxed or scanned and emailed to ITG Worldwide. Please mail us the original application to our Novato office. Our staff will review your application for accuracy and may contact you if additional information is required.
ITG Worldwide recommends that you review the entire brochure and policy before applying. If you have any questions, please feel free to contact us.
PDF of the brochure/application
Please mail the original application to our Novato office:
Mailing Address
ITG Worldwide
Attn: Application Department
500 Professional Center Drive
Suite 515
Novato, CA 94947
| Phone |
|
| Toll Free |
877 598 8646 |
| Novato Office |
415 898 0584 |
| San Diego Office |
858 271 5300 |
| Dallas Office |
972 722 6399 |
| Fax |
415 373 0786 |
Email
info@ITG Worldwide.com
The Underwriting Process
PIU’s underwriters will review applications for health history, eligibility and accuracy. The underwriters may require additional information such as medical records or paramedical exams before coming to a final decision.
Once the underwriting process has been completed, underwriters will issue one of three outcomes:
- Approved as applied for;
- Approved with limitations and/or medical exclusions; or
- Decline
ITG Worldwide works hard to make sure applicants receive fair and equitable treatment in the underwriting process. Ultimately it is PIU’s final decision on whether or not applications are approved.
Please allow at least 5 business days for a decision to be reached or for PIU to request additional information.
Contact ITG Worldwide
If you have questions or concerns, we suggest contacting an ITG Worldwide broker before applying for coverage. We can help verify the plan you are considering will best meet your needs. Our staff can also assist and advise you during the underwriting process. We’re here to answer questions and guide you through the process.
