Visit USA HealthCare - Standard

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

  • Coverage Area: Non-US citizens (age 0-99) traveling outside home country.
  • Coverage Length: up to 364 days.
  • Acute Onset of Pre-existing Condition: $20,000 up to age 64. $2,500 for age 65 and above. Excludes chronic and congenital conditions.
  • Co-Insurance: Within PPO network in USA, after deductible plan pays 100% up to policy maximum. Outside PPO network in USA, plan pays Usual, Reasonable, and customary (URC). You will pay charges exceeding the payable amount. Outside USA, after deductible plan pays 100% up to policy maximum.
  • PPO Network: United Healthcare network.
  • ID Card: comes in email to download.

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  • Doctor visit: After deductible and coinsurance, plan will pay up to policy maximum.
  • Urgent care: Inside USA: $50 per visit co-payment after which coinsurance will apply. Copayment is waived for members with $0 deductible. Not subject to deductible. Outside USA: No co-payment.
  • Hospital Room & Board: Inpatient: Average semi-private room rate, including nursing services.
  • Ambulance: Usual, reasonable and customary charges, when covered illness or injury results in hospitalization as inpatient.
  • Prescription: After deductible, Usual, reasonable, and customary (URC). You may be responsible for any charges exceeding the payable amount.

Complete details are given in certificate of insurance.

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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.
  • Pregnancy except as covered under Complications of Pregnancy, as herein defined, termination of pregnancy except in connection with covered Complications of Pregnancy, all charges related to pregnancy after the 26th week of pregnancy, routine prenatal care, child birth, postnatal care, and charges incurred by a child under the age of 14 days.
  • Charges exceeding usual, reasonable and customary.
  • Not medically necessary.

Complete details are given in certificate of insurance.

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Acute Onset of Pre-existing Condition (excludes chronic and congenital conditions) Ages 65 and above: $2,500
All others: $20,000

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PPO Network

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: www.hccmis.com.

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Not Renewable.

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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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