Visitor Secure Insurance

  • Low cost, Limited (Fixed) benefits plan
  • For visitors traveling outside home country (U.S.A. included)
  • Fixed benefit limits increase with Policy Maximum
  • Cancelable and Renewable
  • $100,000 if Policy Maximum is $100,000 or more, otherwise it is same as policy maximum for acute onset of pre-existing conditions for age under 70 years
  • Coverage is provided outside of home country including during travel
  • Deductible is per injury/sickness per person and Policy Maximum is per policy period
  • Must be purchased and effective with in 30 days of arrival to USA if age above 65
  • Coverage is available from 5 days to 364 days for ages 14 days to 99 years
  • Coventry Health Care PPO Network
  • Not available if mailing address and insured is physically located at the time of quote in Maryland(MD), New York(NY) & Washington(WA)
  • Administrator: HCC Medical Insurance Services
    Underwriter: Lloyd’s of London
  • Other Benefits:  • Common Carrier Accidental Death & Dismemberment  •Dental Accident  •Emergency medical evacuation (< 70)  •Local Ambulance  •Repatriation of Remains

Benefits

PLAN APLAN BPLAN CPLAN D
Deductible
Ages 14 days - 69 years$0, $50, or $100$0, $50, or $100$0, $50, or $100$0, $50, or $100
Ages 70 - 79$100 or $200$100 or $200N/AN/A
Ages 80 and above$100 or $200N/AN/AN/A
Overall Policy Maximum
Ages 14 days - 69 years5000075000100000130000
Ages 70 - 795000075000N/AN/A
Ages 80 and above10000N/AN/AN/A
Inpatient Treatment
Hospital room and board, including miscellaneous$1,450 per day, maximum 30 days$1,725 per day, maximum 30 days$2,000 per day, maximum 30 days$2,585 per day, maximum 30 days
Intensive care unit, including miscellaneous$2,110 per day, maximum 8 days$2,480 per day, maximum 8 days$2,850 per day, maximum 8 days$3,690 per day, maximum 8 days
Surgery$3,300 per session$4,400 per session$5,500 per session$7,150 per session
Consultant physician$450 maximum$475 maximum$500 maximum$650 maximum
Private duty nurse$550 maximum$550 maximum$550 maximum$700 maximum
Physician visits$60 maximum per visit, 30 visits maximum$75 maximum per visit, 30 visits maximum$90 maximum per visit, 30 visits maximum$115 maximum per visit, 30 visits maximum
Outpatient Treatment
Surgery$3,300 per session$4,400 per session$5,500 per session$7,150 per session
Outpatient surgical facility$1,000 maximum$1,050 maximum$1,100 maximum$1,400 maximum
Pre-admission testing$1,100 maximum$1,100 maximum$1,100 maximum$1,450 maximum
Diagnostic x-ray and labs$450 maximum, plus $250 for one CAT Scan, MRI or PET$475 maximum, plus$375 for one CAT Scan, MRI or PET$500 maximum, plus$500 for one CAT Scan, MRI or PET$650 maximum, plus$600 for one CAT Scan, MRI or PET
Emergency room (all expenses incurred therein)$355 maximum$465 maximum$575 maximum$750 maximum
Outpatient prescription drugs$100 maximum$125 maximum$150 maximum$200 maximum
Office visits, including urgent care$60 allowable per visit, 10 visitsmaximum$75 allowable per visit, 10 visitsmaximum$90 allowable per visit, 10 visitsmaximum$115 allowable per visit, 10 visitsmaximum
Miscellaneous Inpatient & Outpatient Treatment
Anesthesiologist825111013751775
Assistant surgeon825111013751775
Local ambulance$475 maximum$475 maximum$475 maximum$475 maximum
Dental accident$550 maximum$550 maximum$550 maximum$550 maximum
Physical therapy$40 maximum per visit, 1 visit per day, maximum 12 visits$40 maximum per visit, 1 visit per day, maximum 12 visits$40 maximum per visit, 1 visit per day, maximum 12 visits$40 maximum per visit, 1 visit per day, maximum 12 visits
Durable medical equipment$1,100 maximum$1,200 maximum$1,300 maximum$1,700 maximum
Other Benefits (not subject to deductible or overall policy maximum)
Emergency medical evacuation$50,000 lifetime maximum, except as provided under acute onset of pre-existing condition. Available only to members under age 70.$50,000 lifetime maximum, except as provided under acute onset of pre-existing condition. Available only to members under age 70.$50,000 lifetime maximum, except as provided under acute onset of pre-existing condition. Available only to members under age 70.$50,000 lifetime maximum, except as provided under acute onset of pre-existing condition. Available only to members under age 70.
Repatriation of remains$7,500 per member$7,500 per member$7,500 per member$7,500 per member
Common carrier accidental death & dismemberment$25,000 lifetime maximum principal sum per member Not subject to deductibleDeath or loss of two limbs - principal sum Loss of one limb - one-half the principal sum$25,000 lifetime maximum principal sum per member Not subject to deductibleDeath or loss of two limbs - principal sum Loss of one limb - one-half the principal sum$25,000 lifetime maximum principal sum per member Not subject to deductibleDeath or loss of two limbs - principal sum Loss of one limb - one-half the principal sum$25,000 lifetime maximum principal sum per member Not subject to deductibleDeath or loss of two limbs - principal sum Loss of one limb - one-half the principal sum
Acute onset of pre-exiting condition (only available to mem- bers under age 70)$50,000 lifetime maximum for eligible expenses. $25,000 lifetime maximum for emergency medical evacuation.$75,000 lifetime maximum for eligible expenses. $25,000 lifetime maximum for emergency medical evacuation.$100,000 lifetime maximum for eligible expenses. $25,000 lifetime maximum for emergency medical evacuation.$100,000 lifetime maximum for eligible expenses. $25,000 lifetime maximum for emergency medical evacuation.