Gateway Global Educators Medical (GEM)

Offers worldwide group coverage to full-time employees of international schools.

  • Plan highlights

    • Comprehensive, long-term employer-sponsored medical plan
    • Policy maximum $5,000,000
    • Deductible options to $25,000
    • Coverage for groups
    • Access to MyIMG
    • Dental coverage
    • $500 per year wellness benefit
    • Continuation of coverage benefit
    • Mail Order Drug benefit
    • Flexible plan design

    Who the plan is designed for:
    The staff of international schools and universities including:
    • U.S. and non-U.S. employees
    • Third country national employees
    • Local national employees
    • Dependents may be located in their home country

  • Worldwide coverage

    Maximum Lifetime Benefit Per Person  |  $5,000,000 (Standard)
    Deductible (Calendar Year)  |  $100 – $25,000
    The deductible is reduced 50% when using the U.S. independent Preferred Provider Organization (provided through The First Health Network)
    Family Deductible (Calendar Year)  |  Maximum of three (3) deductibles per family
    Deductible Carry Forward  |  Expenses incurred during the last 3 months of a calendar year will be applied toward satisfaction of the deductible for the next calendar year, but only if the deductible was not met during the prior calendar year

    COINSURANCE PERCENTAGES
    Adult Wellness Benefit  |  Plan pays up to $500 per calendar year
    Child Wellness Benefit  |  Plan pays up to $500 per calendar year
    Illness or Accident Benefit  |  Subject to deductible and applicable coinsurance

    PHYSICIAN OFFICE SERVICES
    Medical expenses incurred outside the U.S., Canada, or Puerto Rico  |  Plan pays 100% of eligible charges after deductible
    Medical expenses incurred in the U.S. using the PPO  |  Plan pays 100% of eligible charges after deductible
    Medical expenses incurred in the U.S., Canada, or Puerto Rico outside the PPO | Plan pays 80% up to $2,500 of eligible charges after deductible; thereafter the plan pays 100% of eligible charges

    HOSPITAL SERVICES
    Inpatient & Outpatient
    Emergency Room (injury or illness)  |  Subject to deductible and applicable coinsurance
    Eligible Medical Expenses  |  Subject to deductible and applicable coinsurance
    Local Ambulance  |  Subject to deductible and coinsurance for emergency local transport deemed medically necessaryEmergency Medical Evacuation  |  Up to the lifetime maximum benefit per person
    Emergency Reunion  |  $10,000 per insured person (return to home country)
    Return of Mortal Remains  |  $10,000 per insured person (return to home country)
    Maternity Coverage  |  Covered as any other illness
    Pre-natal care; delivery of newborn; post-natal care  |  Subject to deductible & coinsurance per person
    Newborn baby care  |  Routine care for first 31 days of life
    Human Organ Covered Transplants  |  $5,000,000 lifetime maximum inside transplant network facilities per person
    Durable Medical Equipment  |  $10,000 (lifetime maximum benefit)
    Home Health Care & Extended Care Facility  |  URC up to a maximum of
    90 days coverage  |  Chiropractic Care$30 per visit, maximum of $1,000 per calendar year
    Physical Therapy  |  $50 maximum benefit per visit
    Prescription Drugs  |  Mail order and retail pharmacies usual, reasonable, and customary charges
    Supplemental Accident  |  $300 benefit per accident, deductible and coinsurance thereafter

    VISION BENEFITS
    Exams  |  Plan pays up to $100 per 24 months
    Materials (frames, lenses, contacts)  |  Plan pays up to $150 per 24 months

    MENTAL/NERVOUS, ALCOHOL & SUBSTANCE ABUSE TREATMENT
    Inpatient  |  Maximum of 30 days confinement
    Outpatient  |  Payable at 50% after deductible
    Inpatient and outpatient  |  $25,000 lifetime maximum
    Family Counseling  |  $500 lifetime maximum
    Bereavement Counseling  |  $100 benefit per person within 6 months of the covered insured person’s death
    Pre-Admission Certification  |  Failure to pre-certify maternity, admissions, and surgeries could reduce benefits

    COMPLEMENTARY MEDICINE BENEFITS
    Acupuncture  |  $150
    Aroma Therapy |  $50
    Herbal Therapy |  $50
    Magnetic Therapy |  $75
    Massage Therapy |  $150
    Vitamin Therapy |  $100
    Hospice Care  |  Up to the lifetime maximum limit

  • Exclusions

    The following is a summary of services that are not covered under GEM:
    War and terrorism (limited “innocent bystander” coverage is included under the plan)

    Treatment, services or supplies that are not administered or ordered by a licensed physician, or services or supplies performed or provided by a relative

    Treatment, services, or supplies that are not medically necessary or charges that exceed Usual, Reasonable, and Customary charges

    Surgeries or treatments that are investigational, experimental, or for research purposes

    Confinement primarily for custodial, educational or rehabilitative care

    Exercise programs, weight modification or treatment for obesity

    Treatment or surgery for cosmetic or aesthetic reasons, except for reconstructive surgery incidental to or following other covered surgery

    Treatment for a person who was HIV+ prior to the person’s effective date

    Artificial insemination, infertility, impotency, sterilization or reversal of sterilization

    Hearing aids, TMJ dysfunction, orthoptics and visual eye training

    Injury sustained from Hazardous Sports activities

    Self-inflicted injury or illness, charges resulting from or during the commission of a crime or felony, or injury sustained while under the influence of alcohol or drugs

    Speech, vocational, occupational, biofeedback, acupuncture, recreational, sleep or music therapy

    Certain care, treatment or supplies for the feet

    Care and treatment for hair loss

    Injury or illness that is covered under workers’ compensation or similar laws

  • Additional services

    Emergency Travel Assistance
    Even the smallest disruption can be an emergency when you are abroad. You may lose your prescription medication and need a replacement, or maybe you are a victim of a “pick pocket” and your passport is stolen and you need assistance replacing it. IMG offers a complete arrangement of emergency travel assistance services so you can spend more time enjoying your international experience and spend less time worrying about your medical security.

    Emergency Travel Arrangements
    In the event you must return home or discontinue your trip as a result of an interruption in travel due to an illness of your spouse, child, parent, in-law, or grandparent, IMG will help you make the appropriate travel arrangements. You are responsible for the cost of the travel tickets that are not eligible under your benefit plan.

    Lost Passport/Travel Documents Assistance
    IMG will help you report, retrieve or replace lost or stolen travel documents, such as your passport, credit cards and airline tickets.

    Lost Luggage Assistance
    IMG will assist you in communicating with the commercial carrier for the return of your lost luggage.

    Embassy or Consulate Referrals
    IMG will inform you of the location and contact telephone numbers for the nearest embassy or consulate, no matter where you are.

    Emergency Message Relay
    IMG will receive or transmit emergency messages between you, your family and your employer.

    Emergency Prescription Replacement
    IMG will assist with the replacement of lost or damaged prescription medication. You are responsible for the cost of the actual medication and shipping costs (if any).

    Medical Referrals
    If urgent medical advice or care is needed, IMG is prepared to refer you to the nearest appropriate care facility or provide a listing of available medical care to you. IMG will also help with obtaining an appointment with the medical care provider you have chosen.

    24-Hour Medical Monitoring
    If you are hospitalized, IMG will provide medical professionals to communicate with your treating doctor(s) and help you monitor your condition. IMG can also communicate with your family doctor as you direct.

    Emergency Cash Transfer
    IMG will help you transfer your funds in the event of a medical or travel emergency.

    Legal Referrals
    IMG will provide you with a referral to an international attorney specializing in the area of your specific need.

    Emergency Translations
    IMG will provide personal, emergency telephone translation services and referral to a local interpreter sevice should you require language assistance.

  • Contact us

    If you have any questions regarding IMG or the products located on this website, please contact us. We are available to provide support to our producers and prospective clients. Our contact information is below. Additionally, you may use the online inquiry form. An IMG representative will review your questions or comments, and respond in a timely manner.

    International Medical Group
    2960 North Meridian Street
    Indianapolis, IN USA 46208-4715

    Telephone: 1.317.655.4500 or 1.877.808.7434
    Fax:1.317.655.4505
    Email: insurance@imglobal.com

    For all claims correspondence, please use the following address:
    International Medical Group
    Claims Department
    PO Box 88500
    Indianapolis, IN 46208-0500

    To submit applications, underwriting information or premium, please use the following address:
    International Medical Group
    PO Box 88509
    Indianapolis, IN 46208-0509

For questions call

 

For questions call

1.877.808.7434

 

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