Norman Wyatt Insurance Agency - 9717 E. 42nd. St. - Tulsa, Oklahoma 74146 - 800-909-7476 - Fax 918-369-5034
Atlas International Health Plan Schedule of Benefits and Limits
| Deductibles: | $100, $250, $500, $1,000 or $2,500 per Certificate Period. |
| Coinsurance - Claims incurred in US or Canada: | For the Certificate Period, Underwriters will pay 80% of the next $5,000 of Eligible Expenses after the Deductible, then 100% to the Overall Maximum Limit. |
| Coinsurance - Claims incurred outside US or Canada: | For the Certificate Period, Underwriters will pay 100% of Eligible Expenses after the Deductible up to the Overall Maximum Limit. |
| Hospital Room and Board: | Average Semi-private room rate, including nursing services. |
| Intensive Care Unit: | Usual, Reasonable and Customary charges |
| Outpatient Treatment: | Usual, Reasonable and Customary charges |
| All Other Eligible Expenses: | Usual, Reasonable and Customary charges. |
| Acute Onset of Pre-existing Condition: | Atlas Extra - $2,500 limit; Atlas International - $1,000 Limit; Atlas America - No Coverage |
| Emergency Dental - Acute onset of pain: | $100 limit per Certificate Period |
| Local Ambulance: | Usual, Reasonable and Customary charges. |
| Emergency Evacuation: | Overall Maximum Limit |
| Repatriation of Remains: | Overall Maximum Limit |
| Emergency Reunion: | $10,000 limit per Certificate Period |
| Trip Interruption: | $5,000 limit per Certificate Period |
| Lost Checked Luggage: | $250 limit per Certificate Period (not subject to Deductible or Coinsurance) |
| Accidental Death and Dismemberment: | Death - $25,000 Loss of 2 Limbs - $25,000 Loss of 1 Limb - $12,500 .Benefits reduce 50% at age 70 and an additional 50% at age 75. |
| Common Carrier Accidental Death: | $50,000 |
| Hospital Pre-Certification Penalty: | 50% of Eligible Medical Expenses. |
| Optional Hazardous Sports Rider: | $25,000 limit |
| Return of Minor Children | $5,000 limit | Physical Therapy | $50 per visit |
| Overall Maximum Limit per Certificate Period (includes all benefits except Accidental Death and Dismemberment and Common Carrier Accidental Death): | Age 14 days to 69 - $50,000, $100,000,
$250,000, $500,000 or $1,000,000. Age 70 to 79 - $50,000 Age 80 or older - $10,000. |
Additional Atlas Health Plan Information and FAQ
Back to home page Atlas Plan Quotes
