GeoBlue Voyager Essential Plan Description
Disclaimer: Please note that Non-admitted carriers are usually referred to as "surplus" or "excess lines insurers". Non-admitted carriers are not regulated and do not contribute to the State Guaranty Fund, which protects policyholders from the bankruptcy of its insurance carrier. Non-Admitted Carriers are not regulated by state insurance authority, you cannot seek any recourse from Non-Admitted Carriers for unpaid claims.
GeoBlue provides peace of mind to world travelers and expats living abroad anywhere in the world via an elite network of providers, innovative mobile and online tools, and exceptional customer service. We are proud to set the standard for complete, reliable, convenient protection of your health and safety in the global community.
It’s a worldwide, all-access pass to an exclusive level of care. Use your mobile device to quickly and conveniently connect to quality care across the globe for anything from emergency needs, to filling a simple prescription, to translating your symptoms, to finding the right doctor at home or abroad.
With a few simple taps, get detailed profiles of carefully selected primary care physicians and specialists, as well as a broad range of hospitals, pharmacies, even dentists-where you are, when you need it. Review qualifications, make an appointment, and get directions, right from the App or a mobile device.
Plus, proof of coverage is always at your fingertips, ready to show and share with providers. Mobile Assistance is backed 24/7 by our toll free assistance line.
Safe Travels International Plan Features:
GeoBlue Voyager Essential Benefits
schedule of benefits
Medical Limits and Deductibles
|Maximum Benefit per Insured Person per policy period||Options include $50,000; $100,000; $500,000; $1,000,000|
|Deductible per Insured Person per policy period||Options include $0; $100; $250; $500|
Inpatient & Outpatient Benefits
Insurer Pays After Deductible is Met:
|a. Surgery, anesthesia, in-hospital doctor visits, diagnostic X-ray and lab||100%|
|b. Office Visits: including X-rays and lab work billed by the attending physician.||100%|
|Inpatient Hospital Services:|
|a. Surgery, X-rays, In-hospital doctor visits||100%|
|b. In-patient medical emergency||100%|
|Ambulatory Surgical Center||100%|
|Ambulance Service ( non-Medical Evacuation )||100% up to $1000|
Prescriptions, DentalCare, and Physical Therapy
Insurer Pays After Deductible is Met:
|Outside the U.S. Outpatient prescription drugs||50% of Covered Expenses up to $5,000|
|Dental Care required due to an Injury||100% of Covered Expenses up to $200 maximum per Trip Period and $200 per tooth|
|Dental Care for Relief of Pain||100% of Covered Expenses up to $100 maximum per Trip Period and $100 per tooth|
|Physical and Occupational Therapy||6 visits per Period of Insurance. $100 Maximum payment per visit.|
Travel Assistance and Evacuation
Insurer Waives Deductible
|Accidental Death and Dismemberment||Maximum Benefit Principal Sum up to $25,000|
|Repatriation Of Remains||Maximum Benefit up to $25,000|
|Emergency Medical Transportation||Maximum Benefit per Trip Period for all Evacuations up to $500,000|
|Emergency Family Travel Arrangements||Maximum Benefit per Trip Period up to $2,500 for the cost of one economy round trip air fare ticket to the place of the Hospital Confinement for one (1) person|
|Baggage & Personal Effects Coverage||Maximum benefit of $500 per Trip Period and limited to $100 maximum benefit per bag or Personal Effect|
|Post Departure Trip Interruption||Maximum benefit of $500 per Trip Period|
Insurer Pays After Deductible is Met:
|Benefits for claims resulting from downhill (alpine) skiing and scuba diving (certification by the Professional Association of Diving Instructors (PADI) or the National Association of Underwater Instructors (NAUI) required or diving under the supervision of a certified instructor).||Maximum Benefit up to $10,000|
Short term international travel medical plan for leisure, missionary or business travel.Eligibility Requirements
- Home Country is the U.S.; and
- You must be under Age 75 and;
- For Children under age 6, must be enrolled with a parent and;
- Initial purchase must be made in home country prior to departing on trip
- Your spouse; civil union partner or domestic partner age 74 or younger, and/or your eligible child(ren) or other eligible dependent(s)—see Eligible Dependents.
- Resident(s) of the United States.
- Traveling outside the U.S. and scheduled to spend at least 24 hours away from his/her home
Pre-existing medical conditions are treated differently depending upon the plan you have selected.
The GeoBlue Voyager Choice plan is available to those who have primary insurance inside the U.S. and will cover medical treatments for pre-existing conditions. Please refer to the definition of a primary health plan for more specific information on what plans qualify as a primary insurance.
Under the GeoBlue Voyager Essential plan, benefits are not available for any services received on or within 6 months after the Eligibility Date of an Insured Person, if those services are related to a Pre-existing Condition as defined in the Definitions section of the Plan Description. This exclusion does not apply to a Newborn that is enrolled within 31 days of birth or a newly adopted child that is enrolled within 31 days from either the date of placement of the child in the home, or the date of the final decree of adoption.
The pre-existing conditions exclusion under GeoBlue Voyager Essential does not apply to the Emergency Medical Transportation benefit, Repatriation Of Mortal Remains benefit, or the Emergency Family Travel Arrangements benefit. GeoBlue Voyager Essential does not require that insureds have primary insurance at the time of enrollment.
Excluded Services The Plan does not provide benefits for: 1. Any amounts in excess of maximum amounts of Covered Expenses stated in this Plan. 2. Services not specifically listed in this Plan as Covered Services. 3. Expenses incurred in the Home Country. 4. Services or supplies that are not Medically Necessary as defined by the Insurer. 5. Services or supplies that the Insurer considers to be Experimental or Investigative. 6. Expenses incurred for elective treatment or elective surgery which can safely be done after the Covered Person returns to their Home Country. 7. Services received before the Effective Date of Coverage or during an inpatient stay that began before that Effective Date of Coverage. 8. Services received after coverage ends unless an extension of benefits applies as specifically stated under Extension of Benefits in the ‘Who is Eligible for Coverage’ section of this Plan. 9. Services for which the Covered Person has no legal obligation to pay or for which no charge would be made if he/she did not have a health policy or insurance coverage. 10. Services for any condition for which benefits are recovered or can be recovered, either by adjudication, settlement or otherwise, under any workers’ compensation, employer’s liability law or occupational disease law, even if the Covered Person does not claim those benefits. 11. Treatment or medical services required while traveling against the advice of a Physician, while on a waiting list for a specific treatment, or when traveling for the purpose of obtaining medical treatment. 12. Services related to pregnancy or maternity care other than for complications of pregnancy that may arise during a Trip Coverage Period. 13. Conditions caused by or contributed by (a) The inadvertent release of nuclear energy when government funds are available for treatment of Illness or Injury arising from such release of nuclear energy; (b) A Covered Person participating in the military service of any country; (c) A Covered Person participating in an insurrection, rebellion, or riot; (d) Services received for any condition caused by a Covered Person’s commission of, or attempt to commit a felony or to which a contributing cause was the Covered Person being engaged in an illegal occupation; (e) A Covered Person voluntarily using illegal drugs; intentionally taking over the counter medication not in accordance with recommended dosage and warning instructions; and intentionally misusing prescription drugs. 14. Any services provided by a local, state or federal government agency except when payment under this Plan is expressly required by federal or state law. 15. Professional services received or supplies purchased from the Covered Person, a person who lives in the Covered Person's home or who is related to the Covered Person by blood, marriage or adoption, or the Covered Person’s employer. 16. Inpatient or outpatient services of a private duty nurse. 17. Inpatient room and board charges in connection with a Hospital stay primarily for environmental change, physical therapy or treatment of chronic pain; Custodial Care or rest cures; services provided by a rest home, a home for the aged, a nursing home or any similar facility service. 18. Inpatient room and board charges in connection with a Hospital stay primarily for diagnostic tests which could have been performed safely on an outpatient basis. 19. Dental services, dentures, bridges, crowns, caps or other dental prostheses, extraction of teeth or treatment to the teeth or gums, except as specifically stated under Dental Care for Relief of Pain and/or Dental Care for Accidental Injury in the Benefits section of this Plan. 20. Dental and orthodontic services for Temporomandibular Joint Dysfunction (TMJ). 21. Orthodontic Services, braces and other orthodontic appliances. 22. Dental Implants: Dental materials implanted into or on bone or soft tissue or any associated procedure as part of the implantation or removal of dental implants. 23. Routine hearing tests or hearing aids. 24. Optometric services, eye exercises including orthoptics, eyeglasses, contact lenses, routine eye exams, and routine eye refractions, except as specifically stated in this Plan. 25. An eye surgery solely for the purpose of correcting refractive defects of the eye, such as near-sightedness (myopia), astigmatism and/or farsightedness (presbyopia). 26. Outpatient speech therapy. 27. Any Drugs, medications, or other substances dispensed or administered in any outpatient setting except as specifically stated in this Plan. This includes, but is not limited to, items dispensed by a Physician. 28. Any intentionally self-inflicted Injury or Illness. This exclusion does not apply to the Emergency Medical Evacuation Benefit, to the Repatriation of Mortal Remains Benefit and to the Bedside Visit Benefit. 29. Cosmetic surgery or other services for beautification, including any medical complications that are generally predictable and associated with such services by the organized medical community. This exclusion does not apply to Reconstructive Surgery to restore a bodily function or to correct a deformity caused by Injury or congenital defect of a newborn child, or to Medically Necessary reconstructive surgery performed to restore symmetry incident to a mastectomy. 30. Procedures or treatments to change characteristics of the body to those of the opposite sex. This includes any medical, surgical or psychiatric treatment or study related to sex change. 31. Treatment of sexual dysfunction or inadequacy. Page 17 of 22 120.201 03/18 32. All services related to the evaluation or treatment of fertility and/or Infertility, including, but not limited to, all tests, consultations, examinations, medications, invasive, medical, laboratory or surgical procedures including sterilization reversals and In vitro fertilization. 33. Cryopreservation of sperm or eggs. 34. All contraceptive services and supplies, including but not limited to, all consultations, examinations, evaluations, medications, medical, laboratory, devices, or surgical procedures. 35. Orthopedic shoes (except when joined to braces) or shoe inserts, including orthotics. 36. Services primarily for weight reduction or treatment of obesity including morbid obesity, or any care which involves weight reduction as a main method of treatment. 37. Routine physical exams or tests that do not directly treat an actual Illness, Injury or condition, including those required by employment or government authority. 38. Charges by a provider for telephone consultations. 39. Items which are furnished primarily for the Eligible Participant’s personal comfort or convenience (air purifiers, air conditioners, humidifiers, exercise equipment, treadmills, spas, elevators and supplies for hygiene or beautification, etc.). 40. Educational services except as specifically provided or arranged by the Insurer. 41. Nutritional counseling or food supplements. 42. Durable medical equipment not specifically listed as Covered Services in the Covered Services section of this Plan. Excluded durable medical equipment includes, but is not limited to: orthopedic shoes or shoe inserts; air purifiers, air conditioners, humidifiers; exercise equipment, treadmills; spas; elevators; supplies for comfort, hygiene or beautification; disposable sheaths and supplies; correction appliances or support appliances and supplies such as stockings. 43. All infusion therapy, chemotherapy, radiation therapy, hemodialysis together with any associated supplies, Drugs or professional services are excluded. 44. Joint replacement or arthroplasty surgery of any kind. 45. Surgical treatment to the spine, back, or discs of the spine, unless it is the result of an accident that occurred during the Trip Period. 46. Growth Hormone Treatment. 47. Routine foot care including the cutting or removal of corns or calluses; the trimming of nails, routine hygienic care and any service rendered in the absence of localized Illness, Injury or symptoms involving the feet. 48. Charges for which the Insurer are unable to determine the Insurer’s liability because the Eligible Participant or a Covered Person failed, within 90 days, or as soon as reasonably possible to: (a) authorize the Insurer to receive all the medical records and information the Insurer requested; or (b) provide the Insurer with information the Insurer requested regarding the circumstances of the claim or other insurance coverage. 49. Charges for the services of a standby Physician. 50. Charges for animal to human organ transplants. 51. Under the medical treatment benefits, for loss due to or arising from a motor vehicle Accident if the Covered Person operated the vehicle without a proper license in the jurisdiction where the Accident occurred. 52. Loss arising from a. participating in any intercollegiate/interscholastic sport, contest or competition; b. participating in any intramural sport competition, contest or competition; c. participating in any club sport competition, contest or competition; d. participating in any professional sport, contest or competition; e. while participating in any practice or condition program for such sport, contest or competition; f. Racing or speed contests; g. sky diving, mountaineering (where ropes or climbing gear are customarily used), ultra-light aircraft, parasailing, sailplaning, hang gliding, bungee cord jumping, spelunking, or extreme skiing. 53. Claims arising from loss due to riding in any aircraft except one licensed for the transportation of passengers. 54. Treatment for or arising from sexually transmittable diseases. (This exclusion does not apply to HIV, AIDS, ARC or any derivative or variation.) 55. Under the Accidental Death and Dismemberment provision, for loss of life or dismemberment for or arising from an Accident in the Covered Person's Home Country. 56. Under the Repatriation of Remains Benefit and the Medical Evacuation Benefit provision, for repatriation of remains or medical evacuation of the Covered Accident in the Covered Person's Home Country. 57. Treatment of Congenital Conditions. 58. Whenever coverage provided by this Certificate would be in violation of any U.S. economic or trade sanctions, such coverage shall be null and void.
Refund of premium
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Claims can be submitted through eClaim in the online Member Hub, by filing a paper claim, or through the GeoBlue app.
To file an eClaim, visit the Member Hub or use the GeoBlue app.
To file a paper claim, send a legible, itemized bill from the provider, along with the completed member claim form to GeoBlue at:
933 First Avenue
King of Prussia, PA 19406