WorldMed - Inbound

Detail

Plan Administrator: USI Affinity Travel Insurance Services | AM Best Rating: A"Excellent" | Underwriter: Lloyd's of London

  • Coverage Area: Non-US citizens (age 0-64) traveling outside their home country.
  • Coverage Length: Min 5 days to max 364 days.
  • Acute Onset of Pre-existing Condition: $200,000 for under age 60. $20,000 for age 60 to 64. Excludes chronic and congenital conditions.
  • Co-Insurance: Inside US within PPO –  After ded, 100% up to policy max. Inside US but outside PPO – After ded, URC up to policy max . Outside US – After ded, 100% up to policy max.
  • PPO Network: United Healthcare
  • ID Card: Comes in email to download.

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  • Doctor visit: After deductible & co-insurance, up to policy max.
  • Urgent Care: $25 co-pay/visit after which co-insurance will apply.
  • Hospital Room and Board: Up to policy max after deductible ad co-insurance.
  • Ambulance: URC when covered illness/injury results in hospitalization as inpatient.

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  • Pre-existing Conditions, except charges resulting directly from an Acute Onset of Pre-existing Condition, as herein defined, subject to the limits set forth in the Schedule of Benefits and Limits.
  • All forms of cancer / neoplasm.
  • Sleep apnea or other sleep disorders.
  • Charges exceeding usual, reasonable and customary.

Complete details are given in certificate of insurance.

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Acute Onset of Pre-existing Condition (excludes chronic and congenital conditions)

Age 60-64: $20,000

Under age 60: $200,000

ACUTE ONSET OF PRE-EXISTING CONDITION

Acute Onset of Pre-existing Condition means a sudden and unexpected outbreak or recurrence of a pre-existing condition(s) which occurs spontaneously and without advance warning either in the form of physician recommendations or symptoms, is of short duration, is rapidly progressive, and requires urgent care. The Acute Onset of a Pre-existing Condition(s) must occur after the certificate effective date. Treatment must be obtained within 24 hours of the sudden and unexpected outbreak or recurrence. A pre-existing condition that is a chronic or congenital condition or that gradually becomes worse over time will not be considered Acute Onset. This benefit does not include coverage for known, scheduled, required, or expected medical care, drugs or treatments existent or necessary prior to the certificate effective date.

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To comply with the United States Preferred Provider Organization requirements, the Member must receive medical treatment from PPO providers while in the United States. If the Member chooses to comply with the PPO requirements, and the expenses are incurred in a PPO provider, Underwriters will waive the Coinsurance applicable to the expenses.Members may review a listing of Hospitals, Physicians and other medical service providers included in the PPO Network for the area where the Member will be receiving treatment by accessing the Internet website for HCC Medical Insurance Services at:

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Premiums may be refunded after the certificate effective date subject to the following provisions:

  1. A $25 cancellation fee will apply for administrative costs incurred by us; and
  2. Only the unused portion of the plan cost will be refunded; and
  3. You cannot have filed any claims to be eligible for a premium refund.

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This insurance policy has in it a Claims Procedure which tells you what steps you must take to file a claim, and explains our obligations to you. Beginning on the last day of your certificate period, you shall have 60 days to provide us proof of claim.

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