Visitors insurance plans fall into essentially two major categories: fixed coverage plans and comprehensive coverage plans.
What is covered in fixed vs. comprehensive is essentially
the same for most parts. However, how much is covered is what is different in these different types
of plans.
Fixed coverage plan:
This type of visitors insurance is much cheaper than comprehensive
coverage plans. It is also called a scheduled benefit plan. In such type of
insurance plans, you have to first pay the deductible (which can be either
once per every sickness/accident or once per policy period), then the insurance company
pays a set maximum amount for every procedure such as $55 for doctor's office
visit, $450 for ambulance service, $330 for emergency room visit, so on and so
forth.
You have to pay any difference beyond that yourself. There is no way to figure
out how many percent of actual expenses would be covered in such insurance.
The $50,000 or $100,000 policy maximum you see is the overall limit for the total of all the scheduled benefits, and it does not mean that all your medical expenses will be completely
paid up to $50,000 or $100,000.
Even though prices for such visitors insurance plans are attractive, you should really
understand what you are purchasing so that it will meet your expectations in
case you need to use it.
If there is no PPO network in a particular fixed coverage plan, you can visit any
doctor or hospital you like. You get a health insurance card that has all the
information that the provider may need to bill the insurance company directly.
Therefore, most providers would do so. However, in case a particular provider
declines to do so, you would first need to pay up front and file for reimbursement.
Fixed coverage visitors insurance plans are basic medical insurance plans and don't provide many
travel related benefits such as loss of checked luggage.
Please look at the brochure of each plan for more details.
Comprehensive coverage plan:
This type of visitors insurance provides much better coverage compared to the
fixed coverage plan. In such visitors insurance plans, you have to first pay
the deductible (which can be either per year, or once per policy period),
after that
insurance company pays 80% for first the $5,000 for
eligible medical expenses, you pay the remaining 20%. After
$5,000, the insurance will pay 100% up to policy maximum for eligible medical
expenses.
In most such visitors insurance plans, you have to pay a 20% co-insurance for the first $5,000
of expenses once per policy period. (Protection America from IMG
has the option to buy-up the co-insurance, at 5% extra premium, so that it will pay
90% for the first $5,000, you pay 10% for the first $5,000. Patriot America from IMG has a 90/10 coinsurance
for the first $5,000).
After the co-insurance, you get 100% coverage up to
the policy maximum after the first $5,000 of expenses, once per policy period.
Some plans have a 20% co-insurance for the first $5,000 of expenses for every
sickness/incident, and you get 100% coverage up to policy maximum after
the first $5,000 also per every sickness/incident.
Notable Exception: For Diplomat America and Diplomat
Long Term, the maximum total payment under the policy for an Illness
that is first manifested, treated or diagnosed during an Insured
Person's first thirty(30) days of coverage, commencing as of the
Insured Person's effective date, is $1,000.
Most comprehensive coverage visitors insurance plans are PPO plans. That means that the insurance
company has contracted many providers all across the United States who participate
in the PPO network, accept the insurance card, bill the insurance company
directly and charge you the network negotiated fees which are typically
lower than their regular fees.
Comprehensive coverage visitors insurance plans also provide travel related benefits such
as loss of checked luggage, terrorism (optional or standard), hazardous
sports coverage (optional), trip cancellation coverage (optional in some plans).
Please look at the brochure of each plan for more details.
Specialty coverage plan:
These type of visitors insurance products are similar to comprehensive coverage in many aspects. However,
some benefits may not be present or be limited or out of pocket expenses may be a lot more than
that in standard comprehensive coverage.
Each product requires more explanation:
Patriot Go Travel America/International: It is similar to Patriot America/International insurance for core
medical benefits. However, it does not have the emergency travel benefits such as emergency
medical evacuation, repatriation of remains, emergency reunion, return of minor children and loss of
checked baggage, emergency dental.
Liaison Continent: It is similar to Liaison International. However, instead of 80/20 coinsurance for the first
$5,000 in Liaison International, Liaison Continent has 4 different options:
Inside the United States and Canada:
Plan A: After you pay the deductible, the program pays 80% of the
next $2,500 of eligible expenses, then 90% of the next $5,000 of eligible expenses, then 100% to the selected Medical Maximum.
Plan B: After you pay the deductible, the program pays 75% of eligible expenses to the selected Medical Maximum.
Outside the United States and Canada:
Plan E: After you pay the deductible, the program pays 100% to the selected Medical Maximum.
Plan F: After you pay the deductible, the program pays 80% of eligible expenses to the selected Medical Maximum.
PIU Online Major Medical: Outpatient prescription drugs are not covered and cardiac/cancer related expenses are limited to $25,000.
Please look at the brochure of each plan for more details.
Accidental coverage plan:
This type of insurance plan is different than fixed or comprehensive
coverage. It has either very limited (such as $5,000) or no coverage for sicknesses/diseases,
but it works like comprehensive coverage for accidents/injuries.
In such insurance plans,
you have to first pay
the deductible (which can be either per year, or once per policy period),
after that
insurance company pays 80% for the first $5,000 for
eligible medical expenses, you pay the remaining 20%. After
$5,000, the insurance will pay 100% up to policy maximum for eligible medical
expenses.
In most such plans, you have to pay 20% co-insurance for the first $5,000 expense once per policy period. You get coverage 100% coverage up to
policy maximum after the first $5,000 in expenses, once per policy period.
Some plans have a 20% co-insurance for the first $5,000 in expenses for every
sickness/incident, and you get 100% coverage up to the policy maximum after
the first $5,000 in expeses, also per every sickness/incident.
Please look at the brochure of each plan for more details.