Visit USA-HealthCare™
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Brief Outline of Coverages
This is descriptive text, not a Policy. Upon receipt of your Certificate of Insurance, please read it carefully as it will describe the provisions of the Master Policy which will prevail. Your benefit limits depend upon your choice of Plan A or Plan B, plus your purchase of the Optional Benefits.
Included Benefits
- Illness and Injury Medical Expense / Incident
- Emergency Medical Evacuation Expense
- Accidental Death & Dismemberment (AD&D)
- Repatriation of Remains Expenses
- Family Travel Benefit
- Incidental Travel (to Canada, Mexico, U.S. Territories, maximum 14 days)
- Emergency Travelers Assistance Service
Optional Benefits
Policy Exclusions
Medical
Expense A: $50,000* / B: $100,000* per incident
No Per Policy Maximum Limit
If Injury or Illness occurs during the Period of Coverage and you, your insured spouse or dependent children require medical or surgical treatment, the policy will pay, after you pay the selected deductible per period of coverage, 80 percent of all reasonable and customary charges per incident for Covered Expenses up to $5000, then 100 percent up to the maximum amount applicable to the insurance plan selected.
*The Medical Expense Benefit Limit is reduced to $10,000 for Insureds who are age 80+ on the effective date.
Covered Expenses
- Charges made by a hospital for room and board, floor nursing and other services, including charges for professional services and with the exception of personal services of a non-medical nature; provided, however, that expenses do not exceed the hospital’s average charge for semiprivate room and board accommodation.
- Charges made for diagnosis, treatment and surgery by a physician.
- Charges made for the cost and administration of anesthetics.
- Charges for medication, x-ray services, laboratory tests and services, the use of radium and radioactive isotopes, oxygen, blood transfusions, iron lungs, and medical treatment.
- Charges for physiotherapy, if recommended by a physician for the treatment of a specific disablement and administered by a licensed physiotherapist.
- Dressings, drugs and medicines that can only be obtained upon a written prescription of a physician or surgeon.
Illness must be contracted and manifest itself, or Injury must occur, during the Period of Coverage. The first expense must be incurred within 30 days of the commencement of covered Injury or Illness. Benefit period is 26 weeks. However, all benefits will cease when an Insured Person arrives in his home country from the United States, or from Incidental Travel (14 days maximum) to Canada, Mexico, or U.S. territories.
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Emergency Medical Evacuation Expense A: $50,000 / B: $100,000
If Injury or Illness commencing during the Period of Coverage requires emergency evacuation to either the nearest medical facility where appropriate medical treatment can be obtained, or to the Country of Residence, all expenses incurred are covered up to the maximum benefit selected. An emergency evacuation must be recommended by a legally licensed physician who certifies that the severity of Injury or Illness necessitates such emergency evacuation and agreed to by you or your representative. Arrangements must be made by AIGAssist.
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Accidental Death & Dismemberment (AD&D) A: $50,000 / B: 100,000
If an Injury occurs during your Period of Coverage and results in one of the following losses within 365 days after an accident, the Policy will pay as follows:
| Benefit | Plan A Limit | Plan B Limit |
| Loss of Life | $50,000 | $100,000 |
| Loss of two Members | $50,000 | $100,000 |
| Loss of one Member | $25,000 | $50,000 |
Regarding this Included coverage, “Member” means hand, foot or eye. Only one amount, the largest to which you are entitled, will be paid for all losses resulting from one accident.
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Repatriation of Remains Expenses A: $10,000 / B: $20,000
If Injury or Illness commencing during the Period of Coverage results in death, all reasonable expenses incurred for preparation and return of the remains to the Country of Residence will be paid up to the maximum selected. Arrangements must be made by AIGAssist.
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Family Travel Benefit A: $10,000 / B: $10,000
- When covered Emergency Medical Evacuation is necessary and the attending physician considers it beneficial for the Insured Person to have a family member join him, the Company will pay for the family member’s economy fare travel and lodging (maximum $5,000).
- When covered hospitalization of the Insured Person causes accompanying minor child(ren) to be unattended, the Company will pay up to the one way economy fare (maximum $5,000) less the applied value of the child’s/children’s unused travel tickets to their country of origin.
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Emergency Travelers Assistance
VISIT USA-HEALTHCARE™ includes a special service. You are eligible to use any of these assistance services during the Period of Coverage:
- 24-hour verification of medical coverage for hospitals and physicians.
- 24-hour medical care location service.
- Medical case monitoring, arranging communication between patient, family, physicians, employer, consulate or embassy.
- Emergency medical transportation arrangements.
- Emergency message service for medical situations.
- Multilingual services.
- 24-hour contact for legal emergencies.
- Legal referral, to help you locate a consular official or attorney.
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Optional Benefit: Additional Accidental Death & Dismemberment
Flight Only AD&D
- $250,000 and AD&D - $100,000
This optional benefit may be purchased in addition to Basic Plan A or Plan B. If the optional benefit is selected and the premium paid in advance of the Period of Coverage, the policy will pay, in addition to Basic Plan limits, as follows:
Flight Only AD&D |
Benefit | Limit |
In the event injury is sustained while riding as a fare paying passenger on a scheduled airline: |
Loss of Life | $250,000 |
| Loss of two Members | $250,000 | |
| Loss of one Member | $125,000 | |
AD&D |
Loss of Life | $100,000 |
| In the event injury is sustained by any other cause, and not otherwise excluded from the policy: | Loss of two Members | $100,000 |
| Loss of one Member | $50,000 | |
Regarding this Optional coverage, “Member” means hand, foot or eye. Only one amount, the largest to which you are entitled, will be paid for all losses resulting from one accident.
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Optional Benefit: Hazardous Activity Coverage
This optional benefit may be purchased in addition to Basic Plan A or Plan B. If the optional benefit is selected and the premium paid in advance of the Period of Coverage, Medical Expense Coverage will be provided for motorcycling, scuba diving, jet, snow and water skiing, mountain climbing, sky diving, amateur racing, piloting an aircraft, bungee jumping, spelunking, whitewater rafting, surfing or parasailing.
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For Medical Expense Benefit, this insurance does NOT cover:
- Pre-Existing Conditions, defined as any injury or illness which was contracted or which manifested itself, or for which treatment or medication was prescribed within three years prior to the effective date of this insurance.
- Services, supplies or treatment, including any period of hospital confinement, which are not recommended, approved and certified as necessary and reasonable by a physician, or expenses which are non-medical in nature.
- Expenses incurred as a result of or in connection with: a) Declared or undeclared war, or any act thereof; b) Injury sustained while participating in professional athletics; c) Intentionally self-inflicted injury, suicide while sane or attempted suicide while insane; d) Motorcycling, scuba diving, jet, snow and water skiing, mountain climbing, sky diving, professional or amateur racing, piloting an aircraft, bungee jumping, spelunking, whitewater rafting, surfing or parasailing; or e) Commission of a felony.
- Expenses for: a) Pregnancy, childbirth, or miscarriage; b) Routine physicals; c) Cosmetic or plastic surgery, except as the result of an accident; d) Elective surgery; e) Any mental and nervous disorders or rest cures; f) Dental care, except as the result of injury to natural teeth caused by accident; g) Eye refractions or eye examinations for the purpose of prescribing corrective lenses for eyeglasses or contact lenses or for the fitting thereof, unless caused by accidental bodily injury incurred while insured hereunder; h) Alcoholism, drug addiction, or use of any drug or narcotic agent; i) Treatment by the Insured’s Immediate Family; or j) Expenses incurred within the Insured’s home country.
- Traveling expressly for the purpose of obtaining medical treatment.
- All coverages, except Accidental Death and Dismemberment, shall be in excess of all other valid and collectible insurance indemnity and shall apply only when such benefits are exhausted.
For
Accidental Death and Dismemberment, this insurance does NOT cover:
Any
loss, fatal or non-fatal, caused by or resulting from: a) Intentionally self-inflicted
injury, suicide while sane or attempted suicide while insane; b) War or any act
of war, declared or undeclared, or service in the military, naval or air service
of any country; c) Piloting or acting as a crew member, or riding in any aircraft
except as a fare paying passenger on a scheduled airline; d) Illness, disease,
pregancy, childbirth, miscarriage; e) Any bacterial infection other than one occuring
from an accidental cut or wound; f) Hernia; or g) The insured being under the
influence of drugs (unless taken under the advice of a physician and within the
amounts prescribed by a physician) or intoxicants of any type including alcohol.
For Emergency Medical Evacuation and Repatriation of
Remains Expense, this insurance does NOT cover:
Any loss fatal or non-fatal
caused by or resulting from (a), (b) or (c) above.
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