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GeoBlueSM Xplorer Health Plans
Expatriate Health Insurance for Individuals and Families
Paper Application*Offered through the Global Citizens Association, Washington, D.C.
Global Innovator
GeoBlue is an innovator and leader in helping world travelers and expatriates stay safe and gain easy access to quality healthcare all around the world.
The GeoBlue Xplorer health plan is designed to support the
international lifestyles of those who travel to or from the United
States for extended periods of business, leisure and study. If you
leave home for six months or more, your health and financial
security are at serious risk because of significant gaps in most
available insurance coverage and services. This risk is only
heightened by limited knowledge of health and safety hazards
around the world, including medical treatment from unfamiliar
providers.
GeoBlue Xplorer is the ultimate
international health plan because it combines comprehensive
worldwide benefits with a new generation of medical assistance
services, which include an impressive array of online and mobile
tools used to identify, access and pay for quality healthcare all
around the world.
GeoBlue Xplorer gives you the
freedom to access care inside and outside the U.S. If you need
benefits outside the U.S. only, explore the GeoBlue Xplorer
Essential plan.
The administrator's Global Health and Safety Services - Because Insurance Isn't Enough.
The administrator provides unsurpassed service and the convenience of mobile technology to access the best medical care no matter what town, country or time zone.
The administrator has a network of doctors from almost every specialty in
over 190 countries to see you.
Only a small
fraction of doctors around the world meet the administrators standards -
participation is by invitation only. We seek out professionals
certified by the American or Royal Board of Medical Specialties
who speak English, and we factor in recommendations by over 165
Physician Advisors from all over the world. Then we assemble
in-depth profiles so our members can choose with confidence, and
we put formal contracts in place to ensure patient access. Once
they've seen you, the administrator's doctors bill directly so you don't
have to file a claim.
In the U.S. you have cashless
access to the Blue Cross and Blue Shield network in all fifty
states.
Strength of the Blue Brands in the U.S.
Members have access to the Blue Cross and Blue Shield
network within the U.S.
More than 92 percent of
physicians and more than 96 percent of hospitals across the U.S.
are a part of the BlueCard Network.
Personal Safety Intelligence
The administrator maintains unsurpassed resources designed to promote
personal safety by giving members convenient access to vitally
important news, health and safety analysis and medical translation
tools.
- Global Health and Safety news alerts published daily and delivered by email or smartphone.
- City and country level profiles on crime, terrorism and natural disasters.
- Brandname equivalents for more than 400 common over-the-counter and prescription drugs in 44 of the most frequently visited countries.
- Translation of hundreds of medical terms and phrases into the 14 most widely spoken languages.
Around-the-Clock Assistance Call Center
The administrator maintains a 24/7, toll-free call center to assist members with everything from routine requests to medical emergencies. The staff has years of experience with international medical assistance and has close working relationships with the best doctors around the globe.
The administrator coordinates emergency services with a worldwide network of contracted Physician Advisors as well as air ambulance operators selected for their safety records. Members in need of life-saving medical intervention are treated in Centers of Excellence in the U.S. and around the world. whenever possible.
When GeoBlue Xplorer members experience an unanticipated medical problem, they can request a second opinion and referral through the Informed Choice service. A Regional Physician Advisor is available to discuss the member's diagnosis and treatment plan directly with the attending physician.
Personalized Recruitment
If GeoBlue Xplorer members need a physician or specialist in an area not currently covered by the network, the administrator will make every effort to recruit and contract with an appropriate, qualified doctor.
Personal Solutions
GeoBlue Xplorer members enjoy a full range of Personal Solutions. Your online and mobile tools allow you to check medical symptoms, understand your health risks and access personalized prevention and wellness recommendations.
Direct Pay
Members can avoid paying out of pocket for care by using Direct Pay. Through this service participating providers outside the U.S. bill the administrator directly for covered medical treatment.
The administrator is a recognized leader in international health insurance and medical assistance services, serving hundreds of thousands of world travelers annually.
Highest Standards of Service
The administrator meets the highest expectations of quality. For medical care outside the U.S., members are free to see any provider and their benefits will remain the same.
World-Class Healthcare
The administrator has the expertise and capability to meet any medical need efficiently and effectively. This can be a matter of support for a minor issue or help for a major issue no matter where you are.
Top 10 Advantages over Competing Plans
- Provides an unlimited annual and lifetime maximum.
- No waiting periods associated with any preventive services.
- The pre-existing condition exclusion can be waived with proof of prior creditable insurance.
- Covers injuries or illnesses that are a result of a terrorist act.
- No pre-certification required for inpatient and outpatient care.
- Deductible is waived for office visits and a small copay applies.
- Generous U.S. Coverage.
- Access to our elite providers can lead to better diagnosis, treatment and medical outcomes.
- Our providers bill the administrator directly, which eliminates paperwork hassles.
- The strength of the Blue brand. The administrator is an independent licensee of the Blue Cross and Blue Shield Association.
GeoBlue Xplorer Premier and GeoBlue Xplorer Essential plans offer
comprehensive benefits and a range of deductible options that
allow members to select the right amount of insurance coverage for
their budget and lifestyle. For detailed benefit schedule and
rates, please see below. To calculate your total out-of-pocket
expense, add the deductible and coinsurance maximum.
For
families, the deductible and coinsurance maximum is a multiple of
2.5.
After 364 days of continuous coverage, GeoBlue
Xplorer members may re-enroll in a plan that matches their
existing benefits.
| GeoBlue Xplorer Premier Options | ||||
| Plan | Deductible | Coinsurance Maximum |
||
| Outside U.S. | U.S. In-Network | U.S. Out-of-Network | ||
| Elite | $0 | $0 | $1,000 | $2,000 |
| 1000 | $500 | $1,000 | $2,000 | $4,000 |
| 2000 | $1,000 | $2,000 | $4,000 | $8,000 |
| 5000 | $2,500 | $5,000 | $10,000 | $10,000 |
| GeoBlue Xplorer Essential Options | ||||
| Plan | Deductible | Coinsurance Maximum |
||
| Outside U.S. | U.S. In-Network | U.S. Out-of-Network | ||
| Elite | $0 | n/a | n/a | $2,000 |
| 1000 | $1,000 | n/a | n/a | $8,000 |
| 2500 | $2,500 | n/a | n/a | $10,000 |
| 5000 | $5,000 | n/a | n/a | $10,000 |
Applications are available online
or may be initiated by telephone
or email.
A personal check, money order or credit
card number must accompany the application and must be sufficient
to pay for one month of standard premium. The administrator will hold the
form of payment until an underwriting decision is made. If your
application is accepted, the payment will be applied to your
account. Quotes obtained online or by telephone are advisory only.
Actual premium is determined by the medical underwriting process.
The administrator will review your medical history as
provided on the application and may request an Attending
Physician's Statement. The administrator publishes standard premium rates
for non-smokers. Smokers and other applicants with certain medical
histories may be offered a policy at a higher rate. Not all
applicants will be accepted. Your effective date of insurance will
be on the 1st or 15th day of the month following underwriting
approval.
Member Welcome Kit
When your application is accepted, the administrator will mail you and any family members covered under the plan a Welcome Kit with identification cards, a certificate of insurance and instructions on how to register online. Procedures for filing a claim or requesting direct payment of participating providers will also be included.
About the Global Citizens Association
The Global Citizens Association is a national organization dedicated to promoting the interests of international travelers. Established more than 24 years ago, the GCA, is a not for profit affinity association located in Washington D.C., established to enhance global learning and lifestyles through safe and healthy world travel; to provide its members with useful international travel services and to make group international travel and health insurance coverages available to its members.
Eligibility
GeoBlue Xplorer is designed for extended living abroad. You can choose to enroll in a new plan when your existing plan expires. When you do, there are no medical questions and premium rates do not change based on your individual claims history. Your new rate will be the same as all persons covered in your rating class.
How Coverage Ends
Your coverage ends on the earlier of:
- The last day of the month after the date the Insured Person is no longer eligible;
- The end of the last period for which premium has been paid;
- The date the Policy terminates;
- The date of fraud or misrepresentation of a material fact by the Insured Person, except as indicated in the Time Limit on Certain Defenses provision.
Extension of Benefits
If an Insured Person is Totally Disabled on the date of termination of the Policy, coverage will be extended until the earlier of:
- The date payment of the maximum benefit occurs;
- The date the Insured person ceases to be Totally Disabled; or
- The end of 90 days following the date of termination.
Pre-existing conditions
The GeoBlue
Xplorer plan does not cover services for treatment of a medical
condition for which medical advice, diagnosis, care, or treatment
was recommended or received during 180 days immediately preceding
the member's eligibility date.
Creditable coverage
The 180-day
pre-existing conditions period can be reduced or eliminated if you
have been covered by a creditable group or individual health
insurance plan.
For benefits, exclusions, eligibility and other important information, please see below.
For benefits, exclusions, eligibility and other important information, please see below.
GeoBlue Xplorer Premier has three tiers of coinsurance: 100% outside the U.S.; 80% in-network inside the U.S.; 60% out-of-network inside the U.S. All plans have an unlimited lifetime maximum and a $250,000 maximum benefit for emergency medical evacuation. The Out-of-Pocket Maximum is calculated by adding the deductible and coinsurance maximum together. Please refer to the chart above.
| Benefits | Outside U.S. | U.S. (In-Network) | U.S. (Outside Network) |
| Preventive and Office Visits - Insurer Waives Deductible | |||
| Physician Office Visits (Adult) | All except a $10 copay per visit | All except a $30 copay per visit | 60% to Out-of-Pocket Maximum then 100% |
| Physician Office Visits (Children 0-18) | 100% | 80% to Out-of-Pocket Maximum then 100% | 60% to Out-of-Pocket Maximum then 100% |
| Unlimited Well Baby Visits | 100% | 80% to Out-of-Pocket Maximum then 100% | 60% to Out-of-Pocket Maximum then 100% |
| Child Immunizations, Lab and X-rays | 100% | 80% to Out-of-Pocket Maximum then 100% | 60% to Out-of-Pocket Maximum then 100% |
| Women: (19 and Older) Routine Pap Smears, Annual Mammogram | 100% | 80% to Out-of-Pocket Maximum then 100% | 60% to Out-of-Pocket Maximum then 100% |
| PSA for Men | 100% | 80% to Out-of-Pocket Maximum then 100% | 60% to Out-of-Pocket Maximum then 100% |
| One Routine Physical Per Year | 100% | 80% to Out-of-Pocket Maximum then 100% | 60% to Out-of-Pocket Maximum then 100% |
| Professional Services - Insurer Pays After Deductible is Met | |||
| Surgery, Anesthesia, Radiation Therapy, In-hospital Doctor Visits, Diagnostic X-ray and Lab Work | 100% | 80% to Out-of-Pocket Maximum then 100% | 60% to Out-of-Pocket Maximum then 100% |
| Inpatient Hospital Services - Insurer Pays After Deductible is Met | |||
| Surgery, X-rays, In-hospital Doctor Visits, Organ/Tissue Transplant | 100% | 80% to Out-of-Pocket Maximum then 100% | 60% to Out-of-Pocket Maximum then 100% |
| Inpatient Medical Emergency | 100% | 80% to Out-of-Pocket Maximum then 100% | 60% to Out-of-Pocket Maximum then 100% |
| Inpatient Drugs | 100% | 80% to Out-of-Pocket Maximum then 100% | 60% to Out-of-Pocket Maximum then 100% |
| Ambulatory and Therapeutic Services - Insurer Pays After Deductible is Met | |||
| Ambulatory Surgical Center | 100% | 80% to Out-of-Pocket Maximum then 100% | 60% to Out-of-Pocket Maximum then 100% |
| Ambulance Service | 100% | 80% to Out-of-Pocket Maximum then 100% | 60% to Out-of-Pocket Maximum then 100% |
| Accidental Dental | $1,000 per year, $200 per tooth | $1,000 per year, $200 per tooth | $1,000 per year, $200 per tooth |
| Acupuncture and Chiropractic Services | 100% up to $2,000 | 80% up to $2,000 | 60% up to $2,000 |
| Durable Medical Equipment | 100% | 80% to Out-of-Pocket Maximum then 100% | 60% to Out-of-Pocket Maximum then 100% |
| Infusion Therapy | 100% | 80% to Out-of-Pocket Maximum then 100% | 60% to Out-of-Pocket Maximum then 100% |
| Physical/Occupational Therapy* | $50 max each visit, 12 visits per year | $50 max each visit, 12 visits per year | $50 max each visit, 12 visits per year |
| Inpatient Mental Health | 100% up to 60 days | 80% up to 60 days | 60% up to 60 days |
| Outpatient Mental Health | 75% up to 40 visits/60% thereafter | 75% up to 40 visits/60% thereafter | 75% up to 40 visits/60% thereafter |
| Inpatient Substance Abuse | 100% up to 60 days detox | 80% up to 60 days detox | 60% up to 60 days detox |
| Outpatient Substance Abuse | 75% up to 40 visits/60% thereafter | 75% up to 40 visits/60% thereafter | 75% up to 40 visits/60% thereafter |
| Prescription Drug Benefit Options - Insurer Waives Deductible | |||
| Basic Prescription Drug Benefit Subject to $1000 Maximum per Insured Person per Coverage Period | 100% of actual charges | Generics: 100% after $10 copay Brandname: 100% after $25 copay Injectables: 70% |
Generics: 100% after $10 copay Brandname: 100% after $25 copay Injectables: 70% |
| Optional rider, subject to $25,000 Maximum Benefit per Insured Person per Coverage Period. | 100% of actual charges | Generics: 100% after $10 copay Brandname: 100% after $25 copay Injectables: 70% | Generics: 100% after $10 copay Brandname:100% after $25 copay Injectables: 70% |
| Global Travel Benefits - Insurer Waives Deductible | |||
| Emergency Medical Transportation | Up to $250,000 | n/a | n/a |
| Repatriation of Mortal Remains | Up to $25,000 | n/a | n/a |
| Accidental Death and Dismemberment | $50,000 | $50,000 | $50,000 |
| Other Benefits | Limits |
| Home Health Care | 100% Covered Expenses, as many as 30 visits per year |
| Skilled Nursing Facilities | 100% with a maximum Covered Expense of $250 per day, as many as 50 days per year |
| Hospice | 100% with a maximum Covered Expense of $5,000 per lifetime |
This is intended to be a sample benefit schedule.
* Deducible is waived for this
benefit.
GeoBlue Xplorer Essential covers most services outside the U.S. at 100%. All plans have an unlimited lifetime maximum and a $250,000 maximum benefit for emergency medical evacuation.
| Benefits | Outside U.S. Only |
| Preventive and Office Visits - Insurer Waives Deductible | |
| Physician Office Visits (Adult) | All except a $10 copay per visit |
| Physician Office Visits (Children 0-18) | 100% |
| Unlimited Well Baby Visits | 100% |
| Child Immunizations, Lab and X-rays | 100% |
| Women (19 and Older) Routine Pap Smears, Annual Mammogram | 100% |
| PSA for Men | 100% |
| One Routine Physical Per Year | 100% |
| Professional Services - Insurer Pays After Deductible is Met | |
| Surgery, Anesthesia, Radiation Therapy, In-hospital Doctor Visits, Diagnostic X-ray and Lab Work. | 100% |
| Inpatient Hospital Services - Insurer Pays After Deductible is Met | |
| Surgery, X-rays, In-hospital Doctor Visits, Organ/Tissue Transplant | 100% |
| Inpatient Medical Emergency | 100% |
| Inpatient Drugs | 100% |
| Ambulatory and Therapeutic Services - Insurer Pays After Deductible is Met | |
| Ambulatory Surgical Center | 100% |
| Ambulance Service | 100% |
| Accidental Dental | $1,000 per year, $200 per tooth |
| Acupuncture and Chiropractic Services | 100% up to $2,000 |
| Durable Medical Equipment | 100% |
| Infusion Therapy | 100% |
| Physical/Occupational Therapy* | $50 max each visit, 12 visits per year |
| Inpatient Mental Health | 100% up to 60 days |
| Outpatient Mental Health | 75% up to 40 visits/60% thereafter |
| Inpatient Substance Abuse | 100% up to 60 days detox |
| Outpatient Substance Abuse | 75% up to 40 visits/60% thereafter |
| Prescription Drug Benefit Options - Insurer Waives Deductible | |
| Basic Prescription Drug Benefit | 100% of actual charges up to $1,000 |
| Optional Rider, subject to $25,000 maximum per Insured Person per Coverage Period. | Maximum Benefit 100% of actual charges |
| Global Travel Benefits - Insurer Waives Deductible | |
| Emergency Medical Transportation | Up to $250,000 |
| Repatriation of Mortal Remains | Up to $25,000 |
| Accidental Death and Dismemberment | $50,000 |
| Other Benefits | Limits |
| Home Health Care | 100% Covered Expenses, as many as 30 visits per year |
| Skilled Nursing Facilities | 100% with a maximum Covered Expense of $250 per day, as many as 50 days per year |
| Hospice | 100% with a maximum Covered Expense of $5,000 per lifetime |
This is intended to be a sample benefit schedule.
* Deducible is waived for this
benefit.
GeoBlue Xplorer - Frequently Asked Questions
- You no longer meet the eligibility requirements
- You fail to pay your premium
- We discover that you committed fraud or misrepresented a material fact to us, except as indicated in the time limit of certain defenses provision
- We terminate the plan in your state or geographic service area
The zip code that applies is 20036.
Founded in 1994 to serve international students, the GCA has grown to encompass world travelers and expatriates in all corners of the globe. The Association has sponsored the administrator and affiliated insurance programs for travelers for more than 25 years and is organized as a not-for-profit corporation under the laws of the District of Columbia.
The plan does not provide benefits for:
- Hospitalization, services and supplies that are not Medically Necessary.
- Services or supplies that are not specifically mentioned in this Certificate.
- Services or supplies for any illness or injury arising out of or in the course of employment for which benefits are available under any Workers' Compensation Law or other similar laws whether or not you make a claim for such compensation or receive such benefits.
- Services or supplies that are furnished to you by the local, state or federal government and for any services or supplies to the extent payment or benefits are provided or available from the local, state or federal government whether or not that payment or benefits are received.
- Conditions caused by or contributed by: (a) An act of war; (b)The inadvertent release of nuclear energy when government funds are available for treatment of Illness or Injury arising from such release of nuclear energy; (c) An Insured Person participating in the military service of any country;(d) An Insured Person participating in an insurrection, rebellion, or riot; (e) Services received for any condition caused by an Insured Person's commission of, or attempt to commit a felony or to which a contributing cause was the Insured Person being engaged in an illegal occupation; (f) An Insured 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.
- Services or supplies that do not meet accepted standards of medical and/or dental practice.
- Investigational Services and Supplies and all related services and supplies.
- Custodial Care Service.
- Routine physical examinations, unless otherwise specified in this Certificate.
- Services or supplies received during an Inpatient stay when the stay is primarily related to behavioral, social maladjustment, lack of discipline or other antisocial actions that are not specifically the result of Mental Illness.
- Cosmetic Surgery and related services and supplies, whether or not for psychological purposes, except for the correction of congenital deformities or for conditions resulting from accidental injuries, scars, tumors or diseases that occur after your Coverage Date.
- Services or supplies for which you are not required to make payment or would have no legal obligation to pay if you did not have this or similar coverage.
- Charges for failure to keep a scheduled visit or charges for completion of a Claim form.
- Personal hygiene, comfort or convenience items commonly used for other than medical purposes, such as air conditioners, humidifiers, physical fitness equipment, televisions and telephones.
- Special braces, splints, specialized equipment, appliances, ambulatory apparatus, battery implants, except as specifically mentioned in this Certificate.
- Orthopedic shoes (except when joined to braces) or shoe inserts, including orthotics.
- Blood derivatives that are not classified as drugs in the official formularies.
- Eyeglasses, contact lenses or cataract lenses and the examination for prescribing or fitting of glasses or contact lenses or for determining the refractive state of the eye, except as specifically mentioned in this Certificate.
- Treatment to change the refraction of one or both eyes (laser eye correction), including refractive keratectomy (RK) and photorefractive keratectomy (PRK).
- Vision care services unless elected by your Group
- Treatment of flat foot conditions and the prescription of supportive devices for such conditions and the treatment of subluxations of the foot.
- Routine foot care, except for persons diagnosed with diabetes, 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.
- Immunizations, unless otherwise specified in this Certificate.
- Maintenance Occupational Therapy, Maintenance Physical Therapy and Maintenance Speech Therapy.
- Hearing aids or examinations for the prescription or fitting of hearing aids unless otherwise specified in this Certificate.
- Services and supplies to the extent benefits are duplicated because the spouse, parent and/or child are employees of the Group and each is covered separately under this Certificate.
- Diagnostic Service as part of routine physical examinations or check-ups, premarital examinations, determination of the refractive errors of the eyes, auditory problems, surveys, casefinding, research studies, screening, or similar procedures and studies, or tests which are Investigational unless otherwise specified in this Certificate.
- Procurement or use of prosthetic devices, special appliances and surgical implants which are for cosmetic purposes, the comfort and convenience of the patient, or unrelated to the treatment of a disease or injury.
- Services and supplies rendered or provided for human organ or tissue transplants other than those specifically named in this Certificate.
- Investigational or experimental organ transplantation including animal to human organ transplants.
- Consultations performed by you, your spouse, parents or children.
- Charges for the services of a standby Physician.
- Treatment for overweight conditions other than for morbid obesity.
- Treatment for hair loss.
- Growth Hormone treatment.
- Dental treatment, dental surgery, dental prostheses and orthodontic treatment unless otherwise specified in this Certificate.
- Dental Implants: Dental materials implanted into or on bone or soft issue or any associated procedure as part of the implantation or removal of dental implants.
- Medical aids unless otherwise specified in this Certificate.
- Services and treatment related to elective abortions.
- Sterilization or the reversal of sterilization, unless otherwise specified in this Certificate.
- 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.
- Cryopreservation of sperm or eggs.
- Sex change operations.
- Treatment of sexual dysfunction or inadequacy.
- Non-prescription drugs.
- Educational services except as specifically provided or arranged by the Insurer.
- Nutritional counseling or food supplements, except for treatment of Phenylketonuria (PKU) and other inherited metabolic diseases and diabetes.
- Charges by a provider for telephone consultations.
GeoBlue is the trade name of Worldwide Insurance Services, LLC (Worldwide Services Insurance Agency, LLC in California and New York), an independent licensee of the Blue Cross and Blue Shield Association. GeoBlue is the administrator of coverage provided under insurance policies issued by 4 Ever Life International Limited, Bermuda, an independent licensee of the Blue Cross Blue Shield Association.
Insubuy®, Inc.
4200 Mapleshade Ln, Suite 200
Plano, TX 75093
Toll Free: (866) INSUBUY
Phone: (972) 985-4400
Fax: (972) 767-4470
Web site: insubuy.com
4EL-XPEX16/XMP-54372
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