Available to individuals age 74 or younger, and their Eligible Family Members. For more information, please see our eligibility criteria.
Listed below is what the insurance will pay for each listed benefit.
| Features |
Outside U.S. |
U.S.(In Network) |
U.S.(Outside Network) |
| Lifetime Maximum per Insured Person |
$5,000,000 |
$5,000,000 |
$5,000,000 |
| Preventive and Office Visits |
Insurer Waives Deductible |
| Physician Office Visits (Adult) |
All except a $10 copay per visit1 |
All except a $30 copay per visit |
60% to Out-of-Pocket Maximum then 100% |
| Physician Office Visits (Children 0-18) |
100% |
80% to Out-of-Pocket Maximum then 100% |
60% to Out-of-Pocket Maximum then 100% |
| Child Immunizations, Lab work & X-rays |
100% |
80% to Out-of-Pocket Maximum then 100% |
60% to Out-of-Pocket Maximum then 100% |
Women: (25 and Older)
Routine Pap Smears, annual mammogram |
100% |
80% to Out-of-Pocket Maximum then 100% |
60% to Out-of-Pocket Maximum then 100% |
| PSA for Men |
100% |
80% to Out-of-Pocket Maximum then 100% |
60% to Out-of-Pocket Maximum then 100% |
| One Routine Physical Per Year |
100% |
80% to Out-of-Pocket Maximum then 100% |
60% to Out-of-Pocket Maximum then 100% |
| Professional Services |
Insurer Pays After Deductible is Met |
| Surgery, anesthesia, radiation therapy, in-hospital doctor visits, diagnostic X-ray and lab work. |
100% |
80% to Out-of-Pocket Maximum then 100% |
60% to Out-of-Pocket Maximum then 100% |
| Maternity |
100% |
80% to Out-of-Pocket Maximum then 100% |
60% to Out-of-Pocket Maximum then 100% |
| Inpatient Hospital Services |
Insurer Pays After Deductible is Met |
| Surgery, X-rays, in-hospital doctor visits, Organ/Tissue Transplant |
100% |
80% to Out-of-Pocket Maximum then 100% |
60% to Out-of-Pocket Maximum then 100% |
| In-patient medical emergency6 |
100% |
80% to Out-of-Pocket Maximum then 100% |
60% to Out-of-Pocket Maximum then 100% |
| In-patient drugs |
100% |
80% to Out-of-Pocket Maximum then 100% |
60% to Out-of-Pocket Maximum then 100% |
| Ambulatory and Therapeutic Services |
Insurer Pays After Deductible is Met |
| Ambulatory Surgical Center |
100% |
80% to Out-of-Pocket Maximum then 100% |
60% to Out-of-Pocket Maximum then 100% |
| Ambulance Service |
100% |
80% to Out-of-Pocket Maximum then 100% |
60% to Out-of-Pocket Maximum then 100% |
| Accidental Dental |
$1,000 per year, $200 per tooth |
$1,000 per year, $200 per tooth |
$1,000 per year, $200 per tooth |
| Acupuncture and Chiropractic Services |
100% up to $2000 |
100% up to $2000 |
100% up to $2000 |
| Durable Medical Equipment |
100% |
80% to Out-of-Pocket Maximum then 100% |
60% to Out-of-Pocket Maximum then 100% |
| Infusion Therapy |
100% |
80% to Out-of-Pocket Maximum then 100% |
60% to Out-of-Pocket Maximum then 100% |
| Physical/Occupational Therapy |
$30/visit, 12 visits per year |
$30/visit, 12 visits per year |
$30/visit, 12 visits per year |
| Basic Prescription Drug Benefit |
50% of actual charges up to $500 |
$0 |
$0 |
| Optional Prescription Drug Benefit |
Insurer Waives Deductible |
| Subject to $5,000 Maximum Benefit per Insured Person per Policy Period. |
100% of actual charges |
Generics: 100% after $10 copay
Brandname: 100% after $25 copay
Injectables: 70% |
Generics: 100% after $10 copay
Brandname: 100% after $25 copay
Injectables: 70% |
| Global Travel Benefits |
Insurer Pays Without a Deductible |
| Medical Evacuation |
Up to $100,000 |
n/a |
n/a |
| Repatriation of Remains |
Up to $25,000 |
n/a |
n/a |
| Accidental Death and Dismemberment |
$50,000 |
$50,000 |
$50,000 |
The Global Citizen also offers many extensive benefits beyond the usual health care coverage which encompasses: