Inbound Choice Insurance | Be Safe Insurance

Low cost, Limited (Fixed) benefits plan
For Non-U.S. citizens traveling to U.S.A. only
Fixed benefit limits increase with Policy Maximum
Cancelable and Renewable
Same as Policy Maximum (up to $130,000) coverage for acute onset of pre-existing conditions for age under 70 years
Includes international travel if coverage purchase is for 30 days or more
Deductible and Policy Maximum are per injury/sickness per person
Must be purchased and effective with in 24 months of arrival to USA
Coverage is available from 5 days to 24 months for ages 14 days to 69 years
No PPO Network
Not available if correspondence address in Kentucky(KY), Maryland(MD) & Washington(WA)
Administrator: Seven Corners
Underwriter: Lloyd’s of London
Application Fee: $5
More coverage length (24 months) but only covers until 69 years when compared to Inbound USA
Other Benefits: • Ambulance Services •Chemotherapy and/or Radiation Therapy •Common Carrier Accidental Death & Dismemberment •Dental Treatment for Injury to Sound Natural Teeth •Emergency Medical Evacuation •Home Country Coverage •Initial Orthopedic Prosthesis/Brace •International Travel Coverage •Mental & Nervous Disorder & Substance Abuse •Physiotherapy •Return of Remains

Benefits

For Age 14 days to Age 69

	Plan A $50,000 max per injury/sickness	Plan B $75,000 max per injury/sickness	Plan C $100,000 max per injury/sickness	Plan D $130,000 max per injury/sickness
INPATIENT
Hospital Room & Board including Laboratory Tests, X-rays, Prescription Medical and other miscellaneous	Up to $1,500/day, 30 day max	Up to $2,000 per day, 30 day max	Up to $2,500/day, 30 day max	Up to $3,000/day, 30 day max
Hospital Intensive Care Unit	Additional $500/day, 8 day max	Additional $500/day, 8 day max	Additional $500/day, 8 day max	Additional $800/day, 8 day max
Surgical Treatment	Up to $2,100	Up to $4,800	Up to $5,800	Up to $7,200
Anesthetist	Up to $500	Up to $750	Up to $1,000	Up to $1,650
Assistant Surgeon	Up to $500	Up to $750	Up to $1,000	Up to $1,650
Physician’s Non-Surgical Visits	Up to $38/visit, 1/day, 30 visits	Up to $56/visit, 1/day, 30 visits	Up to $75/visit, 1/day, 30 visits	Up to $100/visit, 1/day, 30 visits
Consultant Physician, when requested by attending Physician	Up to $250	Up to $325	Up to $500	Up to $575
Pre-Admission Tests w/in 7 days before Hospital admission	Up to $650	Up to $975	Up to $1,300	Up to $1,300
Private Duty Nurse	Up to $650	Up to $650	Up to $650	Up to $650
OUTPATIENT
Surgical Treatment	Up to $2,100	Up to $4,800	Up to $5,800	Up to $7,200
Anesthetist	Up to $500	Up to $750	Up to $1,000	Up to $1,650
Assistant Surgeon	Up to $500	Up to $750	Up to $1,000	Up to $1,650
Physician’s Non-Surgical /Urgent Care Visits	Up to $38/visit, 1/day, 10 visits	Up to $56/visit, 1/day, 10 visits	Up to $75/visit, 1/day, 10 visits	Up to $100/visit, 1/day, 10 visits
Diagnostic X-rays & Lab Services	Up to $250; Additional $325 - One CAT scan, PET scan or MRI	Up to $375; Additional $325 - One CAT scan, PET scan or MRI	Up to $500; Additional $975 - One CAT scan, PET scan or MRI	Up to $575; Additional $975 - One CAT scan, PET scan or MRI
Hospital Emergency Room	Up to $200 max	Up to $300 max	Up to $400 max	Up to $650 max
Prescription Drugs	Up to $68	Up to $101	Up to $135	Up to $200
Outpatient Surgical Facility	Up to $600	Up to $900	Up to $1,200	Up to $1,400
OTHER SERVICES
Ambulance Services	Up to $500	Up to $500	Up to $500	Up to $500
Initial Orthopedic Prosthesis/Brace	Up to $663	Up to $994	Up to $1,325	Up to $1,600
Chemotherapy and/or Radiation Therapy	Up to $663	Up to $994	Up to $1,325	Up to $1,600
Dental Treatment for Injury to Sound, Natural Teeth	Up to $650	Up to $650	Up to $650	Up to $650
Mental & Nervous Disorder & Substance Abuse	Same as any Sickness	Same as any Sickness	Same as any Sickness	Same as any Sickness
Physiotherapy	Up to $45/visit, 1/day, 12 visits	Up to $45/visit, 1/day, 12 visits	Up to $45/visit, 1/day, 12 visits	Up to $45/visit, 1/day, 12 visits
Emergency Evacuation	$50,000	$50,000	$50,000	$50,000
Return of Remains	$7,500	$7,500	$7,500	$7,500
Common Carrier AD&D Principal Sum	$25,000	$25,000	$25,000	$25,000
Acute Onset of a Pre-existing Condition	$50,000 per policy period for Medical Expense Benefits (subject to the sublimits for each benefit shown above) & $25,000 per policy period for Emergency Medical Evacuation.	$75,000 per policy period for Medical Expense Benefits (subject to the sublimits for each benefit shown above) & $25,000 per policy period for Emergency Medical Evacuation.	$100,000 per policy period for Medical Expense Benefits (subject to the sublimits for each benefit shown above) & $25,000 per policy period for Emergency Medical Evacuation.	$130,000 per policy period for Medical Expense Benefits (subject to the sublimits for each benefit shown above) & $25,000 per policy period for Emergency Medical Evacuation.