Plan Administrator: USI Affinity Travel Insurance Services | AM Best Rating: A+ "Superior" | Underwriter: Lloyd's of London
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Overall Maximum Limit |
$500,000, $1,000,000, or $2,000,000 |
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Coinsurance – Claims incurred outside U.S. |
We will pay 100% of eligible expenses after the deductible up to the overall maximum limit. |
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Coinsurance – Claims incurred in U.S. |
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In-Network Payment |
Within the PPO: We will pay 100% of eligible expenses, after the deductible, to the overall maximum limit. |
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Out-of-Network Payment |
Outside the PPO: Usual, reasonable, and customary. You may be responsible for any charges exceeding the payable amount |
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Intensive Care Unit |
Up to the overall maximum limit |
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Local Ambulance |
Usual, reasonable and customary charges, when covered illness or injury results in hospitalization as inpatient. |
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Lost Checked Luggage |
Up to $500 - not subject to deductible or coinsurance |
Complete details are given in certificate of insurance.
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Acute Onset of Pre-existing Condition (excludes chronic and congenital conditions) |
Age 60-69: $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.
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:
Premiums may be refunded after the Certificate Effective Date subject to the following provisions: a. a $25 cancellation fee will apply; and b. only the unused portion of the plan cost will be refunded; and c. only Members who have no claims are eligible for premium refund.
A completed and signed Claimant’s Statement and Authorization form, together with any/all required attachments, original itemized bills from Physicians, Hospitals and other medical providers, original receipts for any expenses which have already been paid by or on behalf of the Member, and any other documentation that is deemed necessary by the Underwriters.