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

  • Eligibility: Non US Citizen Age 14-64 travelling to USA.
  • Coverage length: Min 5 days to 364 days.
  • Coinsurance:Claims Incurred in the U.S.
  • In-Network Payment:Within the PPO: We will pay 80% of eligible expenses, after the deductible, up to the overall maximum limit
  • Out-Of-Network Payment:Outside the PPO: Usual, reasonable, and customary. You may be responsible for any charges exceeding the payable amount.
  • Renew Online: Any extension or renewal is based upon the eligibility rules in force at the time of renewal and is solely at the  discretion of Underwriter.
  • ID card & Visa Letter comes in email instantly.

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Age and Policy Maximum

Age 0-65 :2,00,000

Doctor Visit Up to the overall maximum limit
Surgical Treatment Up to the overall maximum limit
Hospital Room and Board Average semi-private room rate, including nursing services.
Ambulance Up to $300 per injury or illness, when covered illness or injury results in hospitalization as inpatient. - not subject to coinsurance
Prescription 50% of actual charges- not subject to coinsurance

Complete details are given in certificate of insurance.

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  • Pre-existing Conditions – Charges resulting directly or indirectly from any Pre-existing Condition, as herein defined, are excluded from this insurance during the first 180 days of coverage.
  • Routine pre-natal care, Pregnancy, child birth, post natal care, and routine nursery care of a newborn, unless directly related to a Covered Pregnancy as defined.
  • Diagnosis, testing, treatment, services or supplies which are not Medically Necessary.
  • Routine check-ups
  • Diagnosis, testing, or treatment of Members who are HIV+ or have AIDS or ARC.
  • Eye surgery, such as radial keratotomy, when the primary purpose is to correct nearsightedness.
  • Diagnosis, testing, or treatment of sleep disorders.
  • Willfully self-inflicted Injury or Illness.
  • Complete details are given in certificate of insurance.

Complete details are given in certificate of insurance.

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Acute Pre-Ex Coverage

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

Up to $25,000 lifetime maximum for eligible medical expenses

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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.

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When Underwriters receive notice of claim, they will provide the Member with forms for filing Proof of Claim.  The following is considered to be Proof of Claim:

  • A completed and signed Claimant’s Statement and Authorization form, together with any/all required attachments; and
  • Original itemized bills from Physicians, Hospitals and other medical providers; and
  • Original receipts for any expenses which have already been paid by or on behalf of the Member.

The Member shall have 60 days beginning on the last day of the Certificate Period to submit Proof of Claim to Underwriters, unless medical services were rendered after the Certificate Termination Date, in which case the Member shall have 60 days from the date the claim is incurred to submit Proof of Claim to Underwriters.

Time Limit – In the event Underwriters deny all or part of a claim under this insurance, the Member shall have 90 days from the date notice

Appeal Procedure – Within 60 days of Underwriters’ receipt of the appeal, Underwriters’ will review the claim.  A written response will be forwarded to the Member.

Offline Form

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