Visitors insurance coverage provides protection against unexpected medical issues while visiting USA.
What is a per incident deductible, a per visit deductible, a per policy period deductible and an annual deductible?
There are various types of deductibles:
Per incident deductible: Every time you get a new sickness or injury for covered medical expenses, you have to first pay the deductible before the insurance company starts paying anything.
E.g., Inbound USA and Inbound Immigrant from Seven Corners have a per incident deductible.
Per visit deductible: Every time you visit a provider(doctor, hospital, lab or any other medical facility), you will have to pay the deductible before the insurance company starts paying anything for the covered medical expenses.
Per policy period deductible: You have to pay the deductible only once during the entire policy period, no matter how many times you get sick or injured during the policy period. E.g., Visitors Care from IMG has a per policy period deductible. If you initially bought insurance for 3 months with a $50 deductible and then you renew for another 2 months, in case you become sick or injured for covered medical expenses, you will have to pay the deductible once in the first 3 months, and again if you became sick in the 4th or 5th month, you will have to pay the deductible once again during those 2 months.
Annual deductible: No matter how many times you get sick or injured during an entire year for covered medical expenses, you have to pay the deductible only once in a year. E.g.; Atlas America from Tokio Marine HCC - MIS Group has an annual deductible. It is a renewable plan for durations as little as 5 days. If you take a $100 deductible, and renew the plan on a monthly basis, you have to pay the deductible of $100 once during the year. This is the best type of deductible.
No matter which type of deductible it is, you have to pay that first before the insurance company starts covering anything. This is somewhat similar to car insurance. In regular domestic insurance that you may have through your employer, whenever you visit a doctor, you pay a co-pay and the deductible is only for major things like hospitalization, surgery etc. Short term plans such as visitors insurance work differently.
I see that after I pay the deductible, I still have to pay 20% of the medical expenses up to $5,000 in many plans, that is up to $1,000 out of my pocket if the expenses are more than $5000. Is there any insurance that would cover me 100%, if I get sick?
No. Plans in which you pay a $5 or $10 co-pay and then the rest is covered by insurance every time you visit the doctor, are usually offered by regular domestic insurance companies. These plans are made available through employers to their employees who are working in the U.S. on permanent (long-term) basis, such as U.S. citizens, green card holders and H-1B/L1 visa holders etc. These kind of plans are not offered in case of visitor medical insurance. (That kind of insurance can easily cost the employer a big amount like $600-$700 per month per employee.) Such insurance plans are not available to visitors.
Visitors Care from IMG and Inbound USA from Seven Corners mentions that for an emergency room visit, it will pay up to $330 max for $50,000 coverage. It also says it will pay up to $100/sickness in Inbound USA and up to $250 per policy period in Visitors Care for prescription drugs and up to $55 for a physician visit. If I visit the emergency room, the hospital provides the service through the attending physician, and I also get some medicines and/or injections in the hospital, and the hospital bill is $550 for emergency room, $130 for the physician and $120 for medicines. How much will the insurance company pay and how much will I have to pay?
When you visit the emergency room, the insurance company will pay up to $330 max for all the services performed in the emergency room including attending physician services, medicines, injections, x-rays, labs or any other charges in the emergency room, even if you get an itemized bill describing separate charges for the emergency room, attending physician and medicines. Hence, in this case, insurance company will pay a maximum $330 and you will have to pay the difference of $500. ($550 + $130 + $120 - $330.)
Please note that insurance company will pay up to $55 for physician's visit if you visited the physician in his/her office. It will pay up to $100/sickness in Inbound USA and up to $250 per policy period in Visitors Care for prescription drugs, if you came out with the prescription in your hand either in the emergency room or during physician's office visit and got the prescription filled at the pharmacy such as CVS, Rite Aid etc.
If I buy the visitors insurance coverage insurance for $50,000 with a $0 deductible, does it mean that, if I need to use the insurance, I don't have to pay anything and the insurance company will pay all the expenses up to $50,000?
No. The deductible is the amount you have to first pay before the insurance company starts paying anything at all. If you choose a $0 deductible, the insurance company starts paying right away but that does not mean it will pay 100%. It will pay according to the coverage defined in a given insurance plan.
There are two major types of insurance plans:
Please read 'How Plan Works' provided for each insurance plan to understand how it works. Please refer to the brochure for further details.