Safe Travels USA Insurance

  • Comprehensive benefits plan
  • For Non-U.S. citizens traveling to U.S.A. only
  • In Network & Out of Network: After deductible, Plan pays 80% of $5,000 and then 100% to policy maximum
  • Cancelable and Renewable
  • $1,000 for unexpected recurrence of pre-existing conditions
  • Coverage is provided outside of home country including during travel
  • Deductible and Policy Maximum are per policy term per person
  • Coverage is available from 5 days to 2 years for ages 14 days to 100 years
  • Coventry Health Care PPO Network
  • Administrator: Trawick International
    Claims Administrator: GBG Administrative Services
    Underwriter: GBG Insurance
  • Competitive plan for age 80+
  • Other Benefits:  • Accidental Death & Dismemberment  •Adaptive Home and Vehicle  •Basic Lost Baggage  •Coma Benefit  •Emergency Medical Evacuation  •Emergency Reunion  •Exposure and Disappearance  •Felonious Assault and Violent Crime  •Hijacking and Air or Water Piracy  •Hospital Confinement  •Political/Natural DisasterEvacuation  •Repatriation of Remains  •Return of Minor Child(ren) or Travel Companion  •Seat Belt and Airbag Benefit  •Trip Interruption
  • Optional Riders:  • Accidental Death and Disability Upgrade  •Athletic Sports  •Baggage Upgrade  •Hazardous Activities  •Home Country/Follow Me Home

Benefits

BENEFITS AT A GLANCE (Per Person)
Medical Maximum per Policy:$50,000, $100,000, $250,000, $500,000, $1,000,000
Deductible Options per Policy:$0, $50, $100, $250, $500, $1,000, $2,500, $5,000
Co-insurance per Policy:80% of the first $5,000 of Covered Expenses then 100% up to the policy maximum


After you pay your deductible this plan will pay 80% of the first $5,000 of Covered Expenses then 100% up to the policy maximum. This plan covers Accident and Sickness Medical Expenses after the Insured satisfies any Deductible, without regard to any other Health Care Plan Benefits or to any Coordination of Benefits provision in any other Health Care Plan payable.

Medical Expense Benefits (subject to Policy Maximum, Deductible and Co-Insurance)
Hospital Room and Board Charges:The average semi private room rate
ICU Room and Board Charges:three times the average semi private room rate
Outpatient Medical:Usual customary charge to the selected Medical Maximum
Emergency Medical Treatment of Pregnancy:$1,000 per Policy Period
Mental or Nervous Disorders:$2,500 per Policy Period
Physiotherapy/Physical Medicine/ Chiropractic:$50 per visit per day; up to 10 visits per Policy Period
Dental Treatment (Injury and emergency alleviation of pain):$250 per Policy Period
Doctor Visits, X-rays and Prescriptions, Ambulance:Usual customary charge to the selected Medical Maximum
Unexpected Recurrence of a Pre-existing Condition:The first $1,000 of Covered Expenses


The pre-existing condition exclusion is waived for the first $1,000 of Covered Expenses resulting from a sudden, unexpected recurrence of a Preexisting Condition while traveling in the United States. This benefit does not include coverage for known, scheduled, required, or expected medical care, drugs or treatments existent or necessary prior to the Effective Date of coverage.

Benefit Period:1 year from the date of the Covered Accident or Sickness
Additional Benefits (not subject to Policy Maximum, Deductible or Co-Insurance)
Accidental Death & Dismemberment Principal Sum:$25,000
Coma Benefit:$10,000
Felonious Assault and Violent Crime:100% up to $50,000
Adaptive Home and Vehicle:$5,000
Seatbelt Benefit:10% up to $50,000
Airbag Benefit:10% up to $50,000
Hijacking and Air or Water Piracy:Covered
Emergency Medical Evacuation:100% up to $2,000,000
Political/Natural Disaster Evacuation:$25,000
Repatriation of Remains:100% up to $1,000,000
Emergency Reunion:$15,000
Return of Minor Child(ren) or Travel Companion:$5,000
Hospital Confinement:$50 per day 10 day Maximum
Basic Lost Baggage:$1,000 per Policy Period
Trip Interruption:$5,000 per Policy Period
Optional Benefits
Enhanced BaggageUp to $3,500
Upgrade AD&DUp to $1,000,000
Home Country Coverage/Follow Me Home CoverageSee benefit page 11 in brochure
Athletic Sports CoverageSee benefit page 12 in brochure
Hazardous ActivitiesSee benefit page 12 in brochure