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+1 (866) INSUBUY
+1 (866) 467-8289
8 AM - 9 PM US Central Time Seven Days a Week Source ID: Insubuy
+1 (866) INSUBUY467-82898 AM - 9 PM US Central TimeSeven Days a Week

Safe Travels Elite

Low cost fixed coverage, visitor’s insurance for USA

5 Days to 2 Years

Scheduled Benefits Accident and Sickness Medical Coverage

  • INCLUDING Medically Necessary treatment for COVID-19, SARS-CoV-2, and any mutation or variation of SARS-CoV
  • Emergency Medical Evacuation and Repatriation Coverage
  • For NON US Citizens/Residents traveling from other countries to USA or USA and Worldwide
  • Plans available for ages 14 days to 89 years
  • A minimum period of 5 days up to a maximum period of 364 days
  • Extendable for up to 24 months
Medical Schedule of Benefits by Plan
 
ECONOMY
AGE 14 DAYS TO AGE 69


BASIC
AGE 14 DAYS TO AGE 69


SILVER
AGE 14 DAYS TO AGE 69


GOLD
AGE 14 DAYS TO AGE 69


PLATINUM
AGE 14 DAYS TO AGE 69


DIAMOND and DIAMOND Plus
AGE 70 TO AGE 89

Policy Maximums$25,000 Max per
Injury/Sickness

Acute Onset of Cardiac Conditions/Treatment $25,000 per Policy Period Limit
$50,000 Max per
Injury/Sickness

Acute Onset of Cardiac Conditions/Treatment $25,000 per Policy Period Limit
$75,000 Max per
Injury/Sickness

Acute Onset of Cardiac Conditions/Treatment $25,000 per Policy Period Limit
$100,000 Max per
Injury/Sickness

Acute Onset of Cardiac Conditions/Treatment $25,000 per Policy Period Limit
$175,000 Max per
Injury/Sickness

Acute Onset of Cardiac Conditions/Treatment $25,000 per Policy Period Limit
Diamond $50,000
Annual Max
Diamond Plus $100,000
Annual Max

Acute Onset of Cardiac Conditions/ Treatment $15,000
Deductible Options
(per Incidence)
$0$100 or $200
Medical Expense Benefit and Expenses are payable up to the maximum amount listed

Inpatient Hospital Expense
Hospital Room and Board Expenses$1,400 per day to a maximum of 30 days$2,000 per day to a maximum of 30 days$2,000 per day to a maximum of 30 days$2,000 per day to a maximum of 30 days$3,000 per day to a maximum of 30 days$1,500 per day to a maximum of 15 days
Hospital Intensive Care Unit Expenses$2,100 per day to a maximum of 10 days$2,500 per day to a maximum of 8 days$2,500 per day to a maximum of 8 days$3,000 per day to a maximum of 8 days$4,500 per day to a maximum of 8 days$2,300 per day to a maximum of 8 days
Inpatient Ancillary Hospital Services Included under the Hospital Room and Board Expenses
Physician's Surgical Treatment$3,500 per Incident$5,000 per Incident$5,000 per Incident$6,000 per Incident$7,500 per Incident$3,500 per Incident
Anesthesiologist Expense$850 per Incident$850 per Incident$1,200 per Incident$1,400 per Incident$1,800 per Incident$850 per Incident
Assistant Physician’s Surgical Expenses$850 per Incident$850 per Incident$1,200 per Incident$1,400 per Incident$1,800 per Incident$850 per Incident
Physician's Non-Surgical VisitsLimited to $55 per visit, one visit per day and 30 visits per Policy Period Limited to $75 per visit, one visit per day and 30 visits per Policy Period Limited to $75 per visit, one visit per day and 30 visits per Policy Period Limited to $90 per visit, one visit per day and 30 visits per Policy Period Limited to $130 per visit, one visit per day and 30 visits per Policy Period Limited to $75 per visit, one visit per day and 30 visits per Policy Period
Consulting Physician$450 per Incident$450 per Incident$550 per Incident$550 per Incident$700 per Incident$450 per Incident
Private Duty Nurse$450 per Incident$450 per Incident$550 per Incident$550 per Incident$700 per Incident$450 per Incident
Pre-Admission Tests within 7 days of Admission$1,100 per Incident$1,100 per Incident$1,100 per Incident$1,200 per Incident$1,500 per Incident$1,100 per Incident
Outpatient - Maximum Daily Benefit All Services $10,000 up to the selected maximum
Outpatient Surgical Facility$1,000 per Incident$1,100 per Incident$1,150 per Incident$1,275 per Incident$1,400 per Incident$1,100 per Incident
Physician’s Surgical Treatment$3,500 per Incident$5,000 per Incident$5,000 per Incident$6,000 per Incident$7,500 per Incident$3,500 per Incident
Anesthesiologist Expense$850 per Incident$850 per Incident$1,200 per Incident$1,400 per Incident$1,800 per Incident$700 per Incident
Assistant Physician’s Surgical Expenses$850 per Incident$850 per Incident$1,200 per Incident$1,400 per Incident$1,800 per Incident$700 per Incident
Physician's Visits/Urgent Care or **TelemedicineLimited to $55 per visit, one visit per day and 30 visits per Policy PeriodLimited to $75 per visit, one visit per day and 30 visits per Policy PeriodLimited to $75 per visit, one visit per day and 30 visits per Policy PeriodLimited to $100 per visit, one visit per day and 30 visits per Policy PeriodLimited to $130 per visit, one visit per day and 30 visits per Policy PeriodLimited to $75 per visit, one visit per day and 30 visits per Policy Period
Diagnostic X-Rays and Lab Services$450 per Incident$750 per Incident$750 per Incident$750 per Incident$1,000 per Incident$750 per Incident
Scans, PET Scan or MRI$650 per Incident$650 per Incident$875 per Incident$1,050 per Incident$1,300 per Incident$650 per Incident
Emergency Room Illness with no direct Hospital Admission$350 and an additional $200 Deductible per visit - Only applies when receiving care in an Emergency room for an Illness that does not result in a hospital admittance.$500 and an additional $200 Deductible per visit - Only applies when receiving care in an Emergency room for an Illness that does not result in a hospital admittance.$500 and an additional $200 Deductible per visit - Only applies when receiving care in an Emergency room for an Illness that does not result in a hospital admittance.$600 and an additional $200 Deductible per visit - Only applies when receiving care in an Emergency room for an Illness that does not result in a hospital admittance.$800 and an additional $200 Deductible per visit - Only applies when receiving care in an Emergency room for an Illness that does not result in a hospital admittance.$500 and an additional $200 Deductible per visit - Only applies when receiving care in an Emergency room for an Illness that does not result in a hospital admittance.
Emergency Room injury/Accident or Illness with direct Hospital Admission$350 per Incident$500 per Incident$500 per Incident$600 per Incident$800 per Incident$500 per Incident
Prescription drugs and medications$250 per Incident$350 per Incident$350 per Incident$350 per Incident$350 per Incident$250 per Incident
Additional Medical Treatment and Services
Covid-19 ExpensesCovered and treated as any other Sickness
Acute Onset of Pre-Existing Condition For ages up to and including 69 the limit is up to the Medical Policy Maximum purchased per Period of Coverage except for any coverage related to cardiac disease or conditions, which will be limited to $25,000 up to and including age 69 and $15,000 for ages 70 and above. Upon attaining ages 70-79 Acute Onset benefits will be reduced to a Maximum of $35,000, upon attaining age 80 Acute Onset benefits will be reduced to a Maximum of $15,000 with a $25,000 Maximum Lifetime Limit for Emergency Medical Evacuation. Provides coverage for an Acute Onset of a Pre-Existing Condition. Any repeat/reoccurrence within the same policy period will no longer be considered Acute Onset of a Pre-Existing Condition and will not be eligible for additional coverage. A Pre-Existing Condition which is a chronic or congenital condition or that gradually becomes worse over time and/or known, scheduled, required, or expected medical care, drugs or treatments existing or necessary prior to the Effective Date are not considered to be an Acute Onset. This benefit covers only ONE (1) Acute Onset episode of a Pre-Existing condition. Sudden and Acute Onset of a Pre-Existing Condition Coverage expires upon medical advice that the condition and Onset is no longer acute, or you are discharged from a medical facility.
Well Doctor VisitPays up to $125 - One Visit per person per Policy Period. The Well Doctor Visit must occur within the first 21 days from the effective date of coverage. To be eligible you must purchase at least 30 days of coverage initially.
Dental Treatment for Injury to sound, natural teeth$600 per Incident$750 per Incident$750 per Incident$750 per Incident$750 per Incident$750 per Incident
Mental or Nervous Disorder & Substance Abuse treatment$5,000 per Incident$5,000 per Incident$5,000 per Incident$5,000 per Incident$20,000 per Incident / 30 days Max$5,000 per Incident
Physiotherapy Physical Medicine/Chiropractic ExpensesLimited to $40 per visit, one visit per day and 12 visits per Policy PeriodLimited to $50 per visit, one visit per day and 12 visits per Policy PeriodLimited to $50 per visit, one visit per day and 12 visits per Policy PeriodLimited to $60 per visit, one visit per day and 12 visits per Policy PeriodLimited to $60 per visit, one visit per day and 12 visits per Policy PeriodLimited to $50 per visit, one visit per day and 12 visits per Policy Period
Chemotherapy &/or radiation therapy$1,100 per Incident$1,100 per Incident$1,225 per Incident$1,350 per Incident$1,750 per Incident$1,100 per Incident
Initial Orthopedic Prosthesis/brace$1,100 per Incident$1,100 per Incident$1,225 per Incident$1,350 per Incident$1,750 per Incident$1,100 per Incident
*Return to Home CoverageUp to 30 days per 12 months Max $2,000Up to 30 days per 12 months Max $2,000Up to 60 days per 12 months Max $2,500Up to 60 days per 12 months Max $2,500Up to 90 days per 12 months Max $7,500N/A
Transportation Expenses
Ambulance Service Benefits$500 per Incident$650 per Incident$650 per Incident$650 per Incident$750 per Incident$650 per Incident
*Emergency Medical Evacuation$100,000$100,000$100,000UnlimitedUnlimited$50,000 and $25,000 Lifetime Maximum for Acute Onset over age of 80
*Natural Disasters, Political Evacuation & Repatriation$500$500$1,000$1,500$2,000$500
*Return of Minor Children or Grand-Children$5,000$5,000$7,500$7,500$10,000$5,000
*Repatriation of Mortal Remains$7,500$7,500$10,000$20,000$25,000$7,500
*Local Burial/Cremation$5,000 per Incident
Additional Benefits
*Common Carrier Accidental Death & Dismemberment (AD&D) - Insured$25,000 Principal Sum$25,000 Principal Sum$35,000 Principal Sum$35,000 Principal Sum$35,000 Principal SumN/A
*Felonious Assault Accidental Death & Dismemberment (AD&D) - Insured$5,000 per Policy Period$5,000 per Policy Period$7,500 per Policy Period$7,500 per Policy Period$10,000 per Policy Period$5,000 per Policy Period
**Travel AssistanceIncluded

*Not subject to the deductible
**This is a non-insurance service and is not a part of the insurance underwritten by Crum & Forster, SPC.

This is brief summary of the features available in this plan. It is not a contract of insurance. This plan includes both insurance and non-insurance benefits. Limitations and exclusions apply.

General Terms of Coverage

Eligibility

This Policy provides coverage to non-US citizens who reside outside the USA and are traveling outside of Their Home Country to visit solely the United States, or to visit a combination of the United States and other countries worldwide. The Insured must arrive in the USA before traveling to other countries. This Policy is not available to green card holders in the USA. This Policy is not available to anyone age 90 or above. Coverage in countries outside the USA and your Home Country is available for up to 180 days during your Policy Period.

We maintain Our right to investigate to verify that the eligibility requirements have been met. If and whenever We discover that the eligibility requirements have not been met, Our only obligation is refund of premium. Maximum Age: Coverage ceases on the Covered Person's 90th birthday.

Continuation of Treatment Period

If a covered Sickness or Injury requires continuing Treatment after the expiration of the Policy Period, a Covered Person may receive continuing Treatment for the covered Sickness or Injury for up to six (6) months per Sickness or Injury, subject to the following: if the Policy Period expires while the Covered Person is outside the Home Country, a covered Sickness or Injury incurred while outside and prior to returning to the Home Country, and that covered Sickness or Injury requires continuing Treatment, the Company will review and determine the date of initial Treatment for the covered Sickness or Injury, and if such date is prior to the expiration of the Policy Period, Eligible Medical Expenses for the covered Sickness or Injury will continue to be reimbursed until there has been at least the minimum number of days of continuous Treatment for the covered Sickness or Injury, subject to the limits set forth in the Schedule of Benefits/Limits, and all other Terms of the insurance plan. In order to be eligible for coverage under the Continuation of Treatment Period provision, the Covered Person must be covered by an insurance policy, benefit plan, or Other Coverage for expenses or charges incurred by the Covered Person, and the Other Coverage remains in effect during the duration of coverage with the Company.

Effective Date

An eligible person will be insured on the latest of the following dates: 1. the Insured Person’s departure from Their Home Country; 2. the date and time the Covered Person completed enrollment form and Their correct premium is received; or 3. the effective date requested and shown on the certificate.

Termination Date

The coverage provided with respect to the Named Insured shall terminate at 12:01 AM North American Central Time on the earliest of the following dates:
1. The date shown on the insurance confirmation card, for which the premium is paid; or 2. The date the Covered Person returns to Their Home Country, except as provided under Return to Home Country Benefit, if eligible; or 3. Three hundred and sixty-four (364) days after the Covered Person's original effective date, unless extended; or 4. The date the Covered Person becomes a United States citizen.

Extension Procedures

An extension notice will be sent to the Covered Person before the Policy Period ends and includes links to extend prior to the termination date. The Covered Person is subject to the following rules at extension: If it is initially purchased for a minimum of 5 days. If available, additional periods are charged at the premium rate in force at the time of extension. 5 days premium is the minimum acceptable extension premium and 364 days premium is the maximum. There are no grace periods for extension. Once the policy has lapsed, reapplication is required. Please note, upon application for a new policy, the Pre-Existing Condition exclusion, deductible and co-insurance start over.

Cancellation and Refund Procedure Provisions

Full cancellation and refund will only be considered if We receive written request prior to or on the Effective Date of the coverage. If We receive a written request for cancellation and refund after the Effective Date of coverage, a partial cancellation and refund may be allowed. The following conditions apply: a) If any claims have been filed with Us, the premium is fully earned and is non-refundable. b) If no claims have been filed with the Company, then (i) a cancellation fee of US $25 will be charged; and (ii) only unused days premiums will be considered as refundable; and c) If after a refund is made, it is determined that a claim was presented to Us on a Covered Person’s behalf, the Covered Person will be fully responsible for that claim in its entirety.

RATES per person per day– Plans include a $10.00 per person minimum premium

EconomyBasicSilverGoldPlatinumDiamondDiamondDiamond PlusDiamond Plus
Plan Maximum$25,000$50,000$75,000$100,000$175,000$50,000$50,000$100,000$100,000
Deductible$0
Deductible
$0
Deductible
$0
Deductible
$0
Deductible
$0
Deductible
$100
Deductible
$200
Deductible
$100
Deductible
$200
Deductible
0-18$0.54$1.01$1.15$1.41$1.70N/AN/AN/AN/A
19-29$0.54$1.01$0.95$1.41$1.63N/AN/AN/AN/A
30-39$0.60$1.14$1.10$1.53$1.90N/AN/AN/AN/A
40-49$0.63$1.18$1.23$1.59$2.00N/AN/AN/AN/A
50-59$0.90$1.69$2.11$2.25$2.72N/AN/AN/AN/A
60-69$1.13$2.10$2.44$2.77$3.62N/AN/AN/AN/A
70-74N/AN/AN/AN/AN/A$2.84$2.52$4.36$3.70
75-79N/AN/AN/AN/AN/A$2.84$2.53$4.36$3.80
80-84N/AN/AN/AN/AN/A$6.53$5.45$12.75$10.50
85-90N/AN/AN/AN/AN/A$8.00$6.80$18.00$15.75

Administrator

Trawick International Inc.
Post Office Box 2284
Fairhope, AL 36533

Underwriter

Co-Ordinated Benefit Plans, LLC on Behalf of Crum and Forster
PO Box 2069
Fairhope, AL 36533

FOR ADDITIONAL INFORMATION

Insubuy®, LLC.
4200 Mapleshade Ln, Suite 200
Plano, TX 75093

Toll Free: +1 (866) INSUBUY
Phone: +1 (972) 985-4400
Fax: +1 (972) 767-4470
Website: www.insubuy.com

Version: AH-3729
12/15/2021

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Visiting USA?

Healthcare costs are very high in the U.S.

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Did you know that your insurance may not cover you abroad or that it may only provide limited coverage?

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New immigrant to USA?

You are not eligible to enroll in Medicare for the first 5 years.

Purchase new immigrant medical insurance to bridge the gap.

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Going on a vacation?

You could lose your non-refundable trip costs if you had to cancel your trip.

Buy a trip cancellation insurance package plan and be worry-free.

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Are you an exchange visitor to USA?

The U.S. Department of State requires all J visa holders to purchase compliant insurance.

Buy J visa medical insurance to meet your requirements.

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Schengen countries require most non-US citizens to purchase Schengen visa insurance.

Make an instant purchase online and get instant visa letter.

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Traveling frequently throughout the year?

You don't need to purchase travel insurance for every trip.

Purchase annual multi trip travel insurance for your travels.

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Most schools require international students to purchase health insurance.

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