Safe Travels for visitors to the USA is a low cost Scheduled Benefits Accident and Sickness Medical Coverage for persons traveling to North America from other countries. Coverage can be purchased online for a minimum of five (5) days up to a maximum of one (1) year. This policy has a one-time renewable feature that must be completed PRIOR to expiry of the exiting policy. We accept the credit Card. Policy documents and ID cards are issued online immediately upon payment of the premium. Coverage can be applied for online.
There are five plan options that are available: Basic, Silver, Gold, Platinum and Diamond. If you get into an accident or just get hurt, you can get medical care and our Safe Travels for visitors to the USA . Coverage includes Inpatient care, Outpatient Care, Ambulance or doctor's visits. It covers Acute Onset of a Pre existing condition. No matter which plan you choose, travel medical insurance is a must when planning a trip out of your home country.
For visitors to the USA 5 days up to maximum period of 364 days
MEDICAL SCHEDULE OF BENEFITS | |||||
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AGE 14 DAYS TO AGE 69 |
BASIC | SILVER | GOLD | PLATINUM | DIAMOND AGE 50 to 89 |
Policy Maximums | $50,000 Max per Injury/Sickness | $75,000 Max per Injury/Sickness | $100,000 Max per Injury/Sickness | $175,000 Max per Injury/Sickness | $50,000 Annual Policy Max |
Deductible options(per Incidence) | $100 or $200 | ||||
INPATIENT | |||||
Hospital Room and Board Charges: | Up to $1400/day,30 day max | Up to $1750/day,30 day max | Up to $2000/day,30 day max | Up to $2700/day,30 day max | Up to $1500 /day,15 day max |
Hospital Intensive Care Unit | Additional $700/day, 8 day Max | Additional $800/day, 8 day Max | Additional $900/day, 8 day Max | Additional $1150/day, 10 day Max | Additional $500/day, 8 day Max |
Surgical Treatment | Up to $3500 | Up to $4750 | Up to $6000 | Up to $7500 | Up to $3500 |
Anesthetist | Up to $850 | Up to $1200 | Up to $1400 | Up to $1800 | Up to $850 |
Assistant Surgeon | Up to $850 | Up to $1200 | Up to $1400 | Up to $1800 | Up to $850 |
Physician's Non-Surgical Visits | Up to $55/visit, 1/day, 30 visits Max | Up to $70/visit, 1/day, 30 visits Max | Up to $85/visit, 1/day, 30 visits Max | Up to $115/visit, 1/day, 30 visits Max | Up to $55/visit, 1/day, 30 visits Max |
A Consulting Physician, when requested by attending Physician | Up to $450 | Up to $550 | Up to $550 | Up to $700 | Up to $450 |
Private Duty Nurse | Up to $450 | Up to $550 | Up to $550 | Up to $700 | Up to $450 |
Pre-Admission Tests w/in 7 days before admission | Up to $1100 | Up to $1100 | Up to $1200 | Up to $1500 | Up to $1100 |
OUTPATIENT | |||||
Surgical Treatment | Up to $3500 | Up to $4750 | Up to $6000 | Up to $7500 | Up to $3000 |
Anesthetist | Up to $850 | Up to $1200 | Up to $1400 | Up to $1800 | Up to $700 |
Assistant Surgeon | Up to $850 | Up to $1200 | Up to $1400 | Up to $1800 | Up to $700 |
Physician's Visits/ Urgent Care | Up to $55/visit, 1/day, 30 visits Max | Up to $70/visit, 1/day, 30 visits Max | Up to $85/visit, 1/day, 30 visits Max | Up to $115/visit, 1/day, 30 visits Max | Up to $55/visit, 1/day, 30 visits Max |
Diagnostic X-rays
& Lab Services Scans, PET scan or MRI |
$450 Up to $650 Scan PET scan or MRI | $475 $875 scan, PET scan or MRI | $500 Up to $1050 scan, PET scan or MRI | $675 Up to $1300 Scan, PET scan or MRI | $450 Up to $650 Scan PET scan or MRI |
Hospital Emergency Room (all expenses incurred therein) | Up to $350 | Up to $450 | Up to $550 | Up to $800 | Up to $350 |
Prescription Drugs (outpatient) Per Sickness/Injury | Up to $100 | Up to $125 | Up to $150 | Up to $200 | Up to $90 |
Outpatient Surgical Facility | Up to $1000 | Up to $1150 | Up to $1275 | Up to $1400 | Up to $1000 |
Physical Therapy | Up to $40/visit, 1/day, 12 visits Max | Up to $40/visit, 1/day, 12 visits Max | Up to $40/visit, 1/day, 12 visits Max | Up to $60/visit, 1/day, 12 visits Max | Up to $40/visit, 1/day, 12 visits Max |
OTHER TREATMENT AND SERVICES | |||||
Ambulance Services | Up to $500 | Up to $500 | Up to $500 | Up to $750 | Up to $500 |
Initial Orthopedic Prosthesis/brace | Up to $1100 | Up to $1225 | Up to $1350 | Up to $1750 | Up to $1100 |
Chemotherapy &/ or radiation therapy | Up to $1100 | Up to $1225 | Up to $1350 | Up to $1750 | Up to $1100 |
Dental Treatment for Injury to Sound, Natural Teeth | Up to $600 | Up to $600 | Up to $600 | Up to $600 | Up to $600 |
Mental & Nervous Disorder & Substance Abuse | Up to $5000 | Up to $5000 | Up to $5000 | Up to $20,000 30 days Max | Up to $5000 |
Emergency Medical Evacuation* | $100,000 | $100,000 | Unlimited | Unlimited | $50,000 |
Repatriation of Remains* | $7,500 | $10,000 | $20,000 | $25,000 | $7,500 |
Natural Disaster, Political Evacuation & Repatriation* | Up to $500 | Up to $1,000 | Up to $1,500 | Up to $2,000 | Up to $500 |
Return of Minor Children or Grand-Children* | Up to $5,000 | Up to $7,500 | Up to $7,500 | Up to $10,000 | Up to $5,000 |
Felonious Assault AD&D* | Up to $5,000 | Up to $7,500 | Up to $7,500 | Up to $10,000 | Up to $5,000 |
Return to Home Coverage | Up to 30 days per 12 months Max $2000 | Up to 60 days per 12 months Max $2500 | Up to 60 days per 12 months Max $5000 | Up to 90 days per 12 months Max $7,500 | N/A |
AD&D Principal Sum* | $25,000 Common Carrier | $35,000 Common Carrier | $35,000 Common Carrier | $35,000 Common Carrier | N/A |
Acute Onset of Pre-existing Condition(s) per policy period for Medical Expense Benefits and Emergency Medical Evacuation. Subject to the sub limits for each benefit listed. | Up to the Maximum policy limit per Period of Coverage with age limit of having attained the age of 70. Upon attaining age 70 benefits will be reduced to a maximum of $25,000; Maximum Lifetime Limit for Emergency Medical Evacuation of $25,000. | Up to the Maximum policy limit per Period of Coverage with age limit of having attained the age of 70. Upon attaining age 70 benefits will be reduced to a maximum of $25,000; Maximum Lifetime Limit for Emergency Medical Evacuation of $25,000. | Up to the Maximum policy limit per Period of Coverage with age limit of having attained the age of 70. Upon attaining age 70 benefits will be reduced to a maximum of $25,000; Maximum Lifetime Limit for Emergency Medical Evacuation of $25,000. | Up to the Maximum policy limit per Period of Coverage with age limit of having attained the age of 70. Upon attaining age 70 benefits will be reduced to a maximum of $25,000; Maximum Lifetime Limit for Emergency Medical Evacuation of $25,000. | Up to the Maximum policy limit per Period of Coverage with age limit of having attained the age of 70. Upon attaining age 70 benefits will be reduced to a maximum of $25,000; Maximum Lifetime Limit for Emergency Medical Evacuation of $25,000. |
Pre- certification | 50% reduction of Eligible Medical Expenses if Precertification provisions are not met | 50% reduction of Eligible Medical Expenses if Precertification provisions are not met | 50% reduction of Eligible Medical Expenses if Precertification provisions are not met | 50% reduction of Eligible Medical Expenses if Precertification provisions are not met above | 50% reduction of Eligible Medical Expenses if Precertification provisions are not met |
Travel Assistance by GBG Assist | Included | Included | Included | Included | Included |
Cancellation and refund will only be considered if written request is received by Us prior to the Effective Date of Coverage as listed on this certificate. If written request is received after the Effective Date of coverage, the following conditions apply if the Insured Person wishes to cancel the insurance and a written partial refund request has been made
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ELIGIBILITY | |
Safe Travels For Visitors To The USA plan provides Accident and Sickness Medical, Accidental Death and Dismemberment, Emergency Medical Evacuation, Emergency Reunion, Political Evacuation, Repatriation, and Travel Assistance to individuals while visiting the United States. It can provide coverage for you, your spouse/domestic partner/traveling companion and dependent children/grandchildren up to age 21 years. Coverage for Travel with Trip Cancellation is available through the Safe Travel USA or Safe Travel Care 360. Customized coverage for groups of 5 or more people is available under the Safe Travels for Groups |
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EFFECTIVE DATE | |
Effective Date under the program shall become effective at 12:01 AM North American Central Time on the latest of the following dates:
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EXPIRATION 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:
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ECONOMY - $0, $50 & $100 DEDUCTIBLE $25,000 PER INJURY OR SICKNESS MEDICAL MAXIMUM
Deductible per period of coverage |
Option 1 US$0.00 |
Option 2 US$50.00 |
Option 3 US$100.00 |
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AGE | Daily Rates | ||
14 Days -18 Years | $0.82 | $0.70 | $0.67 |
19-29 | $0.76 | $0.63 | $0.55 |
30-39 | $0.83 | $0.69 | $0.62 |
40-49 | $0.86 | $0.73 | $0.65 |
50-59 | $1.20 | $0.95 | $0.90 |
60-69 | $1.45 | $1.18 | $1.13 |
BASIC - $0, $50 & $100 DEDUCTIBLE $50,000 PER INJURY OR SICKNESS MEDICAL MAXIMUM
Deductible per period of coverage |
Option 1 US$0.00 |
Option 2 US$50.00 |
Option 3 US$100.00 |
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AGE | Daily Rates | ||
14 Days -18 Years | $1.30 | $1.05 | $1.00 |
19-29 | $1.10 | $0.85 | $0.80 |
30-39 | $1.20 | $1.00 | $0.90 |
40-49 | $1.30 | $1.05 | $1.00 |
50-59 | $1.75 | $1.45 | $1.30 |
60-69 | $1.90 | $1.60 | $1.50 |
SILVER - $0, $50 & $100 DEDUCTIBLE $75,000 PER INJURY OR SICKNESS MEDICAL MAXIMUM
Deductible per period of coverage |
Option 1 US$0.00 |
Option 2 US$50.00 |
Option 3 US$100.00 |
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AGE | Daily Rates | ||
14 Days -18 Years | $1.50 | $1.25 | $1.15 |
19-29 | $1.25 | $1.00 | $0.95 |
30-39 | $1.40 | $1.15 | $1.05 |
40-49 | $1.50 | $1.25 | $1.15 |
50-59 | $2.00 | $1.65 | $1.55 |
60-69 | $2.20 | $1.85 | $1.80 |
GOLD - $0, $50 & $100 DEDUCTIBLE $100,000 PER INJURY OR SICKNESS MEDICAL MAXIMUM
Deductible per period of coverage |
Option 1 US$0.00 |
Option 2 US$50.00 |
Option 3 US$100.00 |
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AGE | Daily Rates | ||
14 Days -18 Years | $1.70 | $1.40 | $1.30 |
19-29 | $1.40 | $1.15 | $1.05 |
30-39 | $1.55 | $1.30 | $1.20 |
40-49 | $1.70 | $1.40 | $1.30 |
50-59 | $2.30 | $1.90 | $1.85 |
60-69 | $2.55 | $2.15 | $2.05 |
PLATINUM - $0, $50 & $100 DEDUCTIBLE $175,000 PER INJURY OR SICKNESS MEDICAL MAXIMUM
Deductible per period of coverage |
Option 1 US$0.00 |
Option 2 US$50.00 |
Option 3 US$100.00 |
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AGE | Daily Rates | ||
14 Days -18 Years | $2.20 | $1.85 | $1.70 |
19-29 | $1.85 | $1.55 | $1.40 |
30-39 | $2.05 | $1.70 | $1.55 |
40-49 | $2.20 | $1.85 | $1.70 |
50-59 | $3.00 | $2.45 | $2.40 |
60-69 | $3.30 | $2.75 | $2.70 |
DIAMOND - $100 & $200 Per Injury / Sickness Deductible Per Person I $50,000 Annual Maximum
Deductible per period of coverage |
Option 1 US$100 |
Option 2 US$200 |
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AGE | Daily Rates | |
50-59 | $1.30 | $1.10 |
60-69 | $1.50 | $1.25 |
70-74 | $2.50 | $2.10 |
75-79 | $2.75 | $2.30 |
80-84 | $5.55 | $4.60 |
85-89 | $8.00 | $6.80 |
”Pre-Existing Condition” means Any Injury, Illness, sickness, disease, or other physical, medical, Mental or Nervous Disorder, condition or ailment that, with reasonable medical certainty, existed at the time of Application or at any time during the two (2) years prior to the Effective Date of this insurance, whether or not previously manifested, symptomatic or known, diagnosed, Treated, or disclosed to the Company prior to the Effective Date, and including any and all subsequent, chronic or recurring complications or consequences related thereto or resulting or arising therefrom. 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.
Unless specified in the Schedule of Benefits, in any written endorsement, or agreed by the Company in writing, no claim can be made for compensation or payment for damage or expenses caused by or as a result of the following
The CMN network is for major medical, foreign travel and other expatriate benefit plans offering service at Centers of Excellence with over 400,000 physicians. The CMN network offers nationwide coverage across the U.S. with concentrations in metropolitan and urban cities, traditional travel states, and many rural areas. To search for providers participating in our network. For these plans you are not restricted to go to this specific list of doctors but it is recommended for easier claim process and negotiated rates.
1980 - 2015 © 2015 | 425 Huehl Road, Suite #22A, Northbrook IL 60062, USA | Email : Info@VisitorsInsurancequote.com | Privacy Policy
1980 - 2015 © 2015
425 Huehl Road, Suite #22A, Northbrook
IL 60062, USA
Email : Info@VisitorsInsurancequote.com
Privacy Policy