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International Travel & Medical Plan
What is Covered?
Benefits for Medical Expenses
If injury or illness occurs during the period of coverage and you or your covered dependents require medical and surgical treatment, the Plan will pay (subject to co-insurance and deductible) reasonable and customary charges for the following covered expenses, up to the selected Plan's maximum. The covered charges shall in no event include any amount, which is in excess of reasonable and customary charges for the geographical area where the services are rendered, as determined by the LRFA, Inc. Benefits payable under this plan may not be assigned. Charges must be from a licensed physician or an accredited medical facility to be eligible for benefits. LRFA may require documentation prior to payment.
| BENEFITS |
Choice of two plans: |
Plan A - Maximum benefit amount $50,000.00* |
Plan B - Maximum benefit amount $100,000.00* |
| Plan A Benefits: |
Plan B Benefits: |
| Accident and Sickness Medical - $50,000 Max |
Accident and Sickness Medical - $100,000 Max |
| Emergency Medical Evacuation - $10,000 Max |
Emergency Medical Evacuation - $15,000 Max |
| Deductible - $200 |
Deductible - $250 |
| Accidental Death and Dismemberment - Adult - $10,000 Max |
Accidental Death and Dismemberment - Adult - $15,000 Max |
| Child/Children - $5000 Max |
Child/Children - $7500 Max |
| Repatriation of Remains - $5,000 Max |
Repatriation of Remains - $10,000 Max |
*Ages 80+ are limited to a $15,000 maximum benefit for Plan A and $20,000 for Plan B
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These pages are designed to provide general descriptions of our benefit plans and further restrictions may apply or may have changed. For further information, please contact the LRFA office or refer to specific plan Regulations.
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