Inbound Choice 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 miscellaneousUp to $1,500/day, 30 day maxUp to $2,000 per day, 30 day maxUp to $2,500/day, 30 day maxUp to $3,000/day, 30 day max
Hospital Intensive Care UnitAdditional $500/day, 8 day maxAdditional $500/day, 8 day maxAdditional $500/day, 8 day maxAdditional $800/day, 8 day max
Surgical TreatmentUp to $2,100Up to $4,800Up to $5,800Up to $7,200
AnesthetistUp to $500Up to $750Up to $1,000Up to $1,650
Assistant SurgeonUp to $500Up to $750Up to $1,000Up to $1,650
Physician’s Non-Surgical VisitsUp to $38/visit, 1/day, 30 visitsUp to $56/visit, 1/day, 30 visitsUp to $75/visit, 1/day, 30 visitsUp to $100/visit, 1/day, 30 visits
Consultant Physician, when requested by attending PhysicianUp to $250Up to $325Up to $500Up to $575
Pre-Admission Tests w/in 7 days before Hospital admissionUp to $650Up to $975Up to $1,300Up to $1,300
Private Duty NurseUp to $650Up to $650Up to $650Up to $650
OUTPATIENT
Surgical TreatmentUp to $2,100Up to $4,800Up to $5,800Up to $7,200
AnesthetistUp to $500Up to $750Up to $1,000Up to $1,650
Assistant SurgeonUp to $500Up to $750Up to $1,000Up to $1,650
Physician’s Non-Surgical /Urgent Care VisitsUp to $38/visit, 1/day, 10 visitsUp to $56/visit, 1/day, 10 visitsUp to $75/visit, 1/day, 10 visitsUp to $100/visit, 1/day, 10 visits
Diagnostic X-rays & Lab ServicesUp to $250; Additional $325 - One CAT scan, PET scan or MRIUp to $375; Additional $325 - One CAT scan, PET scan or MRIUp to $500; Additional $975 - One CAT scan, PET scan or MRIUp to $575; Additional $975 - One CAT scan, PET scan or MRI
Hospital Emergency RoomUp to $200 maxUp to $300 maxUp to $400 maxUp to $650 max
Prescription DrugsUp to $68Up to $101Up to $135Up to $200
Outpatient Surgical FacilityUp to $600Up to $900Up to $1,200Up to $1,400
OTHER SERVICES
Ambulance ServicesUp to $500Up to $500Up to $500Up to $500
Initial Orthopedic Prosthesis/BraceUp to $663Up to $994Up to $1,325Up to $1,600
Chemotherapy and/or Radiation TherapyUp to $663Up to $994Up to $1,325Up to $1,600
Dental Treatment for Injury to Sound, Natural TeethUp to $650Up to $650Up to $650Up to $650
Mental & Nervous Disorder & Substance AbuseSame as any SicknessSame as any SicknessSame as any SicknessSame as any Sickness
PhysiotherapyUp to $45/visit, 1/day, 12 visitsUp to $45/visit, 1/day, 12 visitsUp to $45/visit, 1/day, 12 visitsUp 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.