VisitorSecure

Plan Detail

Plan Administrator: Tokio Marine HCC Medical Insurance Services Group | AM Best Rating: A "Excellent" | Underwriter: Lloyd's

Eligibility: Non US citizen age 0-99 traveling to USA and traveling outside their home country.
Coverage length: Min 5 days up to max 364 days.
Renew Online: Min 5 days renewal. $5 renewal fee
PPO Network: Visit any doctor, hospital or other medical provider.
Acute onset of Pre-x coverage: Age 0-69 max up to $100,000 varies by policy max
ID card & Visa Letter comes in email instantly.
Note: Plan not available in states NY, MD & WA.

Benefits Pre-existing Coverage Description Exclusions Renew Cancel Claims

Benefits

SCHEDULE OF BENEFITS AND LIMITS

All benefits, except Emergency Medical Evacuation; Repatriation of Remains; and Common Carrier Accidental Death and Dismemberment, are subject to deductible and are the maximum per certificate period unless stated otherwise.

Penalty for Failure to Pre-Certify: 50% of Eligible Medical Expenses

All benefits are per sickness and per injury.

Benefit	Plan A	Plan B	Plan C	Plan D
Maximum per Injury / Illness Ages 14 days through 69 years	$50,000	$75,000	$100,000	$130,000
Overall Policy Maximum Ages 70-79	$50,000	$75,000	Not available	Not available
Overall Policy Maximum Ages 80 and above	$10,000	Not available	Not available	Not available
Deductible Ages 14 days through 69 years	$0, $50, or $100 per Injury or Illness	$0, $50, or $100 per Injury or Illness	$0, $50, or $100 per Injury or Illness	$0, $50, or $100 per Injury or Illness
Deductible Ages 70 and above	$100 or $200 per Injury or Illness	$100 or $200 per Injury or Illness	Not available	Not available
Penalty for failure to Pre-certify	50% of Eligible Medical Expenses	50% of Eligible Medical Expenses	50% of Eligible Medical Expenses	50% of Eligible Medical Expenses
Inpatient Treatment
Hospital Room and Board, including miscellaneous	$1,450 per day, maximum 30 days	$1,725 per day, maximum 30 days	$2,000 per day, maximum 30 days	$2,585 per day, maximum 30 days
Intensive Care Unit, including miscellaneous	$2,110 per day, maximum 8 days max	$2,480 per day, maximum 8 days max	$2,850 per day, maximum 8 days max	$3,690 per day, maximum 8 days max
Surgery	$3,300 per session	$4,400 per session	$5,500 per session	$7,150 per session
Consultant physician	$450	$475	$500	$650
Private duty nurse	$550	$550	$550	$700
Physician visits	$60 per visit, 30 visits max	$75 per visit, 30 visits max	$90 per visit, 30 visits max	$115 per visit, 30 visits max
Outpatient Treatment
Surgery	$3,300 per session	$4,400 per session	$5,500 per session	$7,150 per session
Outpatient Surgical Facility	$1,000	$1,050	$1,100	$1,400
Pre-admission Testing	$1,100	$1,100	$1,100	$1,450
Diagnostic X-ray and Labs	$450, plus $250 for one CAT Scan, MRI or PET	$475, plus $375 for one CAT Scan, MRI or PET	$500, plus $500 for one CAT Scan, MRI or PET	$650, plus $600 for one CAT Scan, MRI or PET
Emergency Room (all expenses incurred therein)	$355	$465	$575	$750
Outpatient Prescription Drugs	$100	$125	$150	$200
Office Visits, including Urgent Care	$60 per visit, 10 visits max	$75 per visit, 10 visits max	$90 per visit, 10 visits max	$115 per visit, 10 visits max
Miscellaneous Inpatient & Outpatient Treatment
Anesthesiologist	$825	$1,110	$1,375	$1,775
Assistant Surgeon	$825	$1,110	$1,375	$1,775
Local Ambulance	$475	$475	$475	$475
Dental Accident	$550	$550	$550	$550
Physical Therapy	$40 per visit, 1 visit per day, maximum 12 visits	$40 per visit, 1 visit per day, maximum 12 visits	$40 per visit, 1 visit per day, maximum 12 visits	$40 per visit, 1 visit per day, maximum 12 visits
Durable Medical Equipment	$1,100	$1,200	$1,300	$1,700
Acute Onset of Pre-existing Condition (only available to Memvers under age 70)	$50,000 Lifetime Maximum for Eligible Medical Expenses. $25,000 Lifetime Maximum for Emergency Medical Evacuation.	$75,000 Lifetime Maximum for Eligible Medical Expenses. $25,000 Lifetime Maximum for Emergency Medical Evacuation.	$100,000 Lifetime Maximum for Eligible Medical Expenses. $25,000 Lifetime Maximum for Emergency Medical Evacuation.	$100,000 Lifetime Maximum for Eligible Medical Expenses. $25,000 Lifetime Maximum for Emergency Medical Evacuation.
Other Benefits
Emergency Medical Evacuation	$50,000 Lifetime Maximum, except as provided under Acute Onset of Pre-existing Condition. Available only to Members under age 70 If recommended by your attending Physician, who certifies that Evacuation is necessary to safeguard your life and that Medically Necessary treatment is not available locally, and if approved in advance and coordinated by MNU, the plan will provide the following benefits: Emergency air and/or ground transportation to the nearest Hospital that is qualified to provide the Medically Necessary treatment.	$50,000 Lifetime Maximum, except as provided under Acute Onset of Pre-existing Condition. Available only to Members under age 70 If recommended by your attending Physician, who certifies that Evacuation is necessary to safeguard your life and that Medically Necessary treatment is not available locally, and if approved in advance and coordinated by MNU, the plan will provide the following benefits: Emergency air and/or ground transportation to the nearest Hospital that is qualified to provide the Medically Necessary treatment.	$50,000 Lifetime Maximum, except as provided under Acute Onset of Pre-existing Condition. Available only to Members under age 70 If recommended by your attending Physician, who certifies that Evacuation is necessary to safeguard your life and that Medically Necessary treatment is not available locally, and if approved in advance and coordinated by MNU, the plan will provide the following benefits: Emergency air and/or ground transportation to the nearest Hospital that is qualified to provide the Medically Necessary treatment.	$50,000 Lifetime Maximum, except as provided under Acute Onset of Pre-existing Condition. Available only to Members under age 70 If recommended by your attending Physician, who certifies that Evacuation is necessary to safeguard your life and that Medically Necessary treatment is not available locally, and if approved in advance and coordinated by MNU, the plan will provide the following benefits: Emergency air and/or ground transportation to the nearest Hospital that is qualified to provide the Medically Necessary treatment.
Repatriation of Remains	$7,500 per Member In the event of a covered Injury or Illness resulting in your death, VisitorSecure^SMwill provide the following benefit: Air and/or ground transportation of bodily remains or ashes to the area of your Principal Residence, and reasonable costs of preparation of your remains necessary for transportation.	$7,500 per Member In the event of a covered Injury or Illness resulting in your death, VisitorSecure^SMwill provide the following benefit: Air and/or ground transportation of bodily remains or ashes to the area of your Principal Residence, and reasonable costs of preparation of your remains necessary for transportation.	$7,500 per Member In the event of a covered Injury or Illness resulting in your death, VisitorSecure^SMwill provide the following benefit: Air and/or ground transportation of bodily remains or ashes to the area of your Principal Residence, and reasonable costs of preparation of your remains necessary for transportation.	$7,500 per Member In the event of a covered Injury or Illness resulting in your death, VisitorSecure^SMwill provide the following benefit: Air and/or ground transportation of bodily remains or ashes to the area of your Principal Residence, and reasonable costs of preparation of your remains necessary for transportation.
Common Carrier Accidental Death & Dismemberment	$25,000 Lifetime Maximum Principal Sum per Member Death or Loss of Two Limbs – Principal Sum Loss of One Limb – One-half the Principal Sum In the event of your Accidental Death or Dismemberment while traveling on board a commercial common carrier (airplane or cruiseline), VisitorSecure^SMwill provide the following benefit, subject to a maximum of $125,000 per family: Accidental Death – $25,000 to the Beneficiary designated on your Application Loss of 2 eyes or 2 or more limbs – $25,000 to you Loss of 1 eye or 1 limb – $12,500 to you	$25,000 Lifetime Maximum Principal Sum per Member Death or Loss of Two Limbs – Principal Sum Loss of One Limb – One-half the Principal Sum In the event of your Accidental Death or Dismemberment while traveling on board a commercial common carrier (airplane or cruiseline), VisitorSecure^SMwill provide the following benefit, subject to a maximum of $125,000 per family: Accidental Death – $25,000 to the Beneficiary designated on your Application Loss of 2 eyes or 2 or more limbs – $25,000 to you Loss of 1 eye or 1 limb – $12,500 to you	$25,000 Lifetime Maximum Principal Sum per Member Death or Loss of Two Limbs – Principal Sum Loss of One Limb – One-half the Principal Sum In the event of your Accidental Death or Dismemberment while traveling on board a commercial common carrier (airplane or cruiseline), VisitorSecure^SMwill provide the following benefit, subject to a maximum of $125,000 per family: Accidental Death – $25,000 to the Beneficiary designated on your Application Loss of 2 eyes or 2 or more limbs – $25,000 to you Loss of 1 eye or 1 limb – $12,500 to you	$25,000 Lifetime Maximum Principal Sum per Member Death or Loss of Two Limbs – Principal Sum Loss of One Limb – One-half the Principal Sum In the event of your Accidental Death or Dismemberment while traveling on board a commercial common carrier (airplane or cruiseline), VisitorSecure^SMwill provide the following benefit, subject to a maximum of $125,000 per family: Accidental Death – $25,000 to the Beneficiary designated on your Application Loss of 2 eyes or 2 or more limbs – $25,000 to you Loss of 1 eye or 1 limb – $12,500 to you