Plan Administrator: USI Affinity Travel Insurance Services | AM Best Rating: A+ "Superior" | Underwriter: United States Fire Insurance Company

  • Eligibility: U.S. Citizens and Non US citizen age 0-99 are eligible for visiting outside their home country excluding USA
  • Coverage Length:Min 5 days up to max 364 days.
  • Renew Online:No Coverage.
  • Acute Onset of Pre-existing Condition: Age 80 or older: $5,000,Ages 60 to 79: $20,000 Under age 60: Up to the overall maximum limit .
  • Co-Insurance:
    In Network: After deductible is paid by insured, plan pays 100% up to policy maximum
    Out-of-Network: After the deductible is paid by insured, Usual, reasonable, and customary. You may be responsible for any charges exceeding the payable amount.
  • PPO Network: Provides Equian International PPO Network
  • ID Card & Visa Letter comes in email instantly.

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  • Doctor Visit: Up to policy max
  • Hospital Room and Board: Up to policy max.
  • Urgent Care: For each visit, the Member shall be responsible for a $50 co-payment, after which Coinsurance will apply
  • Ambulance: Up to policy max.
  • Medical Expenses : $100,000
  • Emergency Room: Up to policy max.
  • Loss of Checked Baggage: $250 limit per bag; $500 per Certificate Period

Complete details are given in certificate of insurance.

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  • Routine pre-natal care, Pregnancy, child birth, and post natal care.
  • Diagnosis, testing, or treatment related to birth defects and congenital illnesses.  Birth defects are deemed to include hereditary conditions.
  • Diagnosis, testing, or treatment for HIV+, AIDS or ARC, and all diseases caused by and/or related to HIV.
  • Routine Physical Check Up.
  • Organ or Tissue Transplants or related services.
  • Diagnosis, testing, or treatment of all forms of cancer / neoplasm
  • Diagnostic testing or procedures, services, supplies, and treatment for hair loss including wigs, hair transplants or any drug that promises hair growth.
  • Dental Treatment, except for Emergency Dental Treatment necessary to replace sound natural teeth lost or damaged in an Accident covered hereunder or for the Emergency relief of Acute Onset of Pain.

Complete details are given in certificate of insurance.

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Age 0-64,$10,000;formembers Age 65 and over, $2,500

The term “Acute Onset of a Pre-Existing Condition(s)” shall mean a sudden and unexpected outbreak or recurrence of a Pre-existing Condition(s) which occurs spontaneously and without advance warning 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 effective date of the policy. 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 Effective Date of coverage.

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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, LLC at:

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Renew

Non Renewable.

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Premiums will be refunded in full if cancellation request is received prior to the certificate effective date. Premiums may be refunded after the certificate effective date subject to the following provisions:

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

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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.

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