Insurance Program
Why you need this program.
The United States offers the most comprehensive medical care,
but is often complicated as well as very expensive. For a visitor
to the United States or a recent immigrant, finding an insurance
program that is easy to understand and reasonably priced is often difficult.
As a solution, Inbound USA was developed to provide a simple program to visitors and immigrants.
This is a brief description of the Inbound USA program. Detailed
wording is outlined in the Program Summary, which will be
mailed to you once you have enrolled in Inbound USA.
Eligibility
This program is available to non-United States citizens
who come to the U.S. for business, pleasure, to study, or to
immigrate. The program must become effective within 12 months of arrival in the United States.
period of coverage
You may initially enroll in Inbound USA for as little as 5 days and
up to maximum of 12 months. If you initially purchase at least
3 months, you may continue to renew coverage for a minimum of 3 months at a time, at the premium rate in force at the time of renewal. Total period of coverage for Inbound USA cannot exceed 12 months (in order to reapply after the 12 months, you
must first return to your home country).
effective date -Your coverage will begin on the latest of the following:
1. Your departure from your Home Country; or
2. The date your Application and premium are received by Seven Corners; or
3. The date your Application and premium are accepted by Seven Corners; or
4. The date you request on the Application.
expiration date -Your coverage will end on the earlier of the following:
1. The date shown on the Insurance Confirmation Card, for
which premium has been paid; or
2. The date you return to your Home Country; or
3. 12 months after your original Effective Date; or
4. The day an insured becomes a U.S. citizen or is considered a U.S. resident by the state where they are residing; or
5. The date of entry into active military service.
Upon each renewal, the rates, benefits, and program in general are subject to change.
renewal.
If Inbound USA is initially purchased for at least three months, one month before the expiration date, Seven Corners will send a renewal notice to the Address of Correspondence listed on the application. If you renew the coverage for 3 or more months (up to 12 months in total), Seven Corners will continue to send renewal notices to you. If you initially apply online, you will have the option to renew in whatever increment you choose (Minimum 5 day purchase). There is a $5 admin fee each time you renew. If you renew the coverage for only 1 or 2 months, Seven Corners will assume that you no longer require the coverage and will not send another renewal notice. Again, the total period of coverage for Inbound USA cannot exceed 12 months.
schedule of benefits
If your covered Injury or Sickness requires treatment by a physician, this program will provide benefits for the Usual and Customary (U&C) charges scheduled below which exceed the chosen Per Person Deductible ($0, $50 or $100, or a $200 deductible for age 70 and over) for each Injury and each Sickness and which are incurred within the 26 weeks following the Injury or Sickness. Payment for any covered service will not exceed the Benefit Maximum shown. The maximum amount payable for all benefits will be no more than $50,000, $75,000, $100,000, or $130,000 for each Injury and each Sickness.
For persons age 70 and over, the maximum benefit limit is $50,000 or $70,000 for each Injury or Sickness. The period in which covered expenses must be incurred is 26 weeks following the Injury or Sickness, and a separate schedule applies.
Covered Services injury and sickness benefit maximums
| Age 14 days to Age 69 |
Plan A
$50,000 Max per Injury/Sickness |
Plan B
$75,000 Max per Injury/Sickness |
Plan C
$100,000 Max per Injury/Sickness |
Plan D
$130,000 Max per Injury/Sickness |
| INPATIENT |
|
|
|
|
Hospital Room & Board
including miscellaneous |
Up to $1400/day, 30 day max |
Up to $1675/day, 30 day max |
Up to $1950/day, 30 day max |
Up to $2535/day, 30 day max |
| Hospital Intensive Care Unit |
Additional $660/day,
8 day max |
Additional $755/day,
8 day max |
Additional $850/day,
8 day max |
Additional $1105/day,
8 day max |
| Surgical Treatment |
Up to $3300 |
Up to $4400 |
Up to $5500 |
Up to $7150 |
| Anesthetist |
Up to $825 |
Up to $1100 |
Up to $1375 |
Up to $1775 |
| Assistant Surgeon |
Up to $825 |
Up to $1100 |
Up to $1375 |
Up to $1775 |
| Physician’s Non-Surgical Visits |
Up to $55/visit,
1/day, 30 visits max |
Up to $70/visit,
1/day, 30 visits max |
Up to $85/visit,
1/day, 30 visits max |
Up to $110/visit,
1/day, 30 visits max |
A Consulting Physician,
when requested by attending Physician |
Up to $450 |
Up to $475 |
Up to $500 |
Up to $650 |
| Private Duty Nurse |
Up to $550 |
Up to $550 |
Up to $550 |
Up to $700 |
| Pre-Admission Tests w/in 7 days before Hospital admission |
Up to $1100 |
Up to $1100 |
Up to $1100 |
Up to $1450 |
| OUTPATIENT |
| Surgical Treatment |
Up to $3300 |
Up to $4400 |
Up to $5500 |
Up to $7150 |
| Anesthetist |
Up to $825 |
Up to $1100 |
Up to $1375 |
Up to $1775 |
| Assistant Surgeon |
Up to $825 |
Up to $1100 |
Up to $1375 |
Up to $1775 |
| Physician’s Non-Surgical / Urgent Care Visits |
Up to $55/visit,
1/day, 10 visits max |
Up to $70/visit,
1/day, 10 visits max |
Up to $85/visit,
1/day, 10 visits max |
Up to $110/visit,
1/day, 10 visits max |
| Diagnostic X-rays & Lab Services |
Up to $450 - Additional $250
- One Cat scan, PET scan or MRI |
Up to $475 – additional $375
- One Cat scan, PET scan or MRI |
Up to $500 - Additional $500
- One Cat scan, PET scan or MRI |
Up to $650 - Additional $600
- One Cat scan, PET scan or MRI |
Hospital Emergency Room
(all expenses incurred therein) |
75% of U&C to a maximum of $330 |
75% of U&C to a maximum of $440 |
75% of U&C to a maximum of $550 |
75% of U&C to a maximum of $700 |
| Prescription Drugs |
Up to $100 |
Up to $125 |
Up to $150 |
Up to $200 |
| Outpatient Surgical Facility |
Up to $1000 |
Up to $1050 |
Up to $1100 |
Up to $1400 |
| OTHER TREATMENT AND SERVICES |
| Ambulance Services |
Up to $450 |
Up to $450 |
Up to $450 |
Up to $450 |
| Initial Orthopedic Prosthesis/brace |
Up to $1100 |
Up to $1200 |
Up to $1300 |
Up to $1700 |
| Chemotherapy and/or radiation therapy |
Up to $1100 |
Up to $1225 |
Up to $1350 |
Up to $1750 |
| Dental Treatment for Injury to |
Up to $550 |
Up to $550 |
Up to $550 |
Up to $550 |
| Sound, Natural Teeth |
| Mental & Nervous Disorder & Substance Abuse |
Same as any Sickness |
Same as any Sickness |
Same as any Sickness |
Same as any Sickness |
| Physiotherapy |
Up to $40/visit,
1/day, 12 visits max |
Up to $40/visit,
1/day, 12 visits max |
Up to $40/visit,
1/day, 12 visits max |
Up to $40/visit,
1/day, 12 visits max |
| Emergency Evacuation |
$50,000 |
$50,000 |
$50,000 |
$50,000 |
| Repatriation of Remains |
$7,500 |
$7,500 |
$7,500 |
$7,500 |
| AD&D Principal Sum |
$25,000 Common Carrier |
$25,000 Common Carrier |
$25,000 Common Carrier |
$25,000 Common Carrier |
If an insured person turn 70 years old during the purchased coverage period, the 70 and over benefit schedule becomes effective upon the day the
insured turns 70. Individuals with the $100,000 or $130,000 per injury or sickness policy maximum will receive the $70,000 per injury or sickness schedule
for age 70 and older. Individuals with the $75,000 or $50,000 per injury or sickness policy maximum will receive the $50,000 per injury or sickness
schedule for age 70 and older.
| Age 70 to Age 99 |
Plan J
$50,000 Max per Injury/Sickness |
Plan K
$70,000 Max per Injury/Sickness |
| INPATIENT |
|
|
| Hospital Room & Board including miscellaneous |
Up to $1050/day, 30 day max |
Up to $1470/day, 30 day max |
| Hospital Intensive Care Unit |
Additional $460/day, 8 day max |
Additional $640/day, 8 day max |
| Surgical Treatment |
Up to $2750 |
Up to $3850 |
| Anesthetist |
Up to $685 |
Up to $960 |
| Assistant Surgeon |
Up to $685 |
Up to $960 |
| Physician’s Non-Surgical Visits |
Up to $55/visit, 1/day, 30 visits max |
Up to $75/visit, 1/day, 30 visits max |
| A Consulting Physician, when requested by attending Physician |
Up to $400 |
Up to $560 |
| Private Duty Nurse |
Up to $450 |
Up to $450 |
| Pre-Admission Tests w/in 7 days before Hospital admission |
Up to $775 |
Up to $1085 |
| OUTPATIENT |
| Surgical Treatment |
Up to $2750 |
Up to $3850 |
| Anesthetist |
Up to $685 |
Up to $960 |
| Assistant Surgeon |
Up to $685 |
Up to $960 |
| Physician’s Non-Surgical / Urgent Care Visits |
Up to $55/visit, 1/day, 10 visits max |
Up to $75/visit, 1/day, 10 visits max |
| Diagnostic X-rays & Lab Services |
Up to $400 - Additional $250
One Cat scan, PET scan or MRI |
Up to $560 – additional $300
One Cat scan, PET scan or MRI |
| Hospital Emergency Room (all expenses incurred therein) |
75% of U&C to a maximum of $250 |
75% of U&C to a maximum of $350 |
| Prescription Drugs |
Up to $80 |
Up to $110 |
| Outpatient Surgical Facility |
Up to $850 |
Up to $1190 |
| OTHER TREATMENT AND SERVICES |
| Ambulance Services |
Up to $450 |
Up to $450 |
| Initial Orthopedic Prosthesis/brace |
Up to $850 |
Up to $1190 |
| Chemotherapy and/or radiation therapy |
Up to $850 |
Up to $1190 |
| Dental Treatment for Injury to Sound, Natural Teeth |
Up to $550 |
Up to $550 |
| Mental & Nervous Disorder & Substance Abuse |
Same as any Sickness |
Same as any Sickness |
| Physiotherapy |
Up to $40/visit, 1/day, 12 visits max |
Up to $40/visit, 1/day, 12 visits max |
| Emergency Evacuation |
$50,000 |
$50,000 |
| Repatriation of Remains |
$7,500 |
$7,500 |
| AD&D Principal Sum |
$25,000 Common Carrier |
$25,000 Common Carrier |
Emergency Medical Evacuation Expenses
The program will pay up to $50,000 in Covered Expenses
incurred if any covered Injury or Sickness originating during
the Period of Coverage results in the Medically Necessary
Emergency Medical Evacuation or Repatriation of the Insured
Person (the Insured Person’s medical condition warrants
immediate transportation from the medical facility where the
Insured Person is located to the nearest adequate medical
facility where medical treatment can be obtained). The benefit
must be ordered by the Assistance Company in consultation
with the Insured Person’s local attending Physician. *
Repatriation of Mortal Remains Expenses
The program will pay the reasonable Covered Expenses
incurred, up to a maximum of $7,500, to return the Insured Person’s remains to his/her Home Country if he or she dies.*
Common Carrier Accidental Death and Dismemberment
(AD&D)
Accidental Death and Dismemberment shall apply to covered
accidents sustained by an insured person while riding as a
passenger in or on any land, water or air conveyance operated
under a license for the transportation of passengers for hire.
A loss must occur within 365 days after the date of accident
causing the loss:
*NOTE: If event of an Emergency Medical Evacuation or
Repatriation of Mortal Remains benefit is needed or utilized,
arrangements must be made by the Assistance Service
Provider.
Definitions
| For loss of: |
Indemnity |
| Life |
Principal Sum |
| Both Hands or Both Feet or |
| Sight of Both Eyes |
Principal Sum |
| One Hand and One Foot |
Principal Sum |
| Either Hand or Foot and |
| Sight of One Eye |
Principal Sum |
| Either Hand or Foot |
One-Half the Principal Sum |
| Sight of One Eye |
One-Half the Principal Sum |
The term “Injury” shall mean bodily Injury listed in the most
recent edition of the International Classification of Diseases and
caused solely and directly by Accidental, external, and visible
means occurring while this Certificate is in force and resulting
directly and independently of all other causes resulting in a
Covered Event under this Program.
The term “Sickness” shall mean Illness or Disease of any
kind listed in the most recent edition of the International
Classification of Diseases. All related conditions and recurrent
symptoms of the same or a similar condition will be considered
one Sickness.
The term “Pre-Existing Condition” shall mean 1) A condition that
would have caused a person to seek medical advice, diagnosis,
care or Treatment within the 6 months (or 12 months for
persons 70 and older) prior to the Individual Effective Date of
Coverage under this program; 2) A condition for which medical
advice, diagnosis, care or Treatment, including Medication, was
sought, recommended or received within the 6 months (or 12
months for persons age 70 and older) prior to the Individual
Effective Date of Coverage under this program; 3) The
symptoms which occurred within the 6 months (or 12 months
for persons 70 and older) prior to the Individual Effective Date
of the Coverage under this Certificate would have allowed
a person trained in medicine to make a diagnosis of the
condition producing the symptoms: 4) A condition which
manifested itself within the 6 months (or 12 months for persons
70 and older) prior to the Individual Effective Date of Coverage
under this Certificate;
Exclusions and Limitations
exclusions
No benefits will be paid for loss or expense caused by,
contributed to, or resulting from:
1. Pre-existing Conditions;
2. Any expenses incurred when travel was undertaken
solely for the purpose of obtaining medical treatment or
while traveling against the advice of a Physician;
3. Expense incurred within the Insured Person’s Home
Country or country of regular domicile;
4. Routine physicals, inoculations, or other examinations
where there are no objective indications of impairment of
normal health, or well baby care, new-born baby care;
well-baby nursery and related Physician charges;
5. Prescriptions or fitting of eyeglasses and contact lenses;
eye examinations; or other treatment for visual defects
and problems. “Visual defects: means any physical defect
of the eye which does or can impair normal vision;
6. Hearing examinations or hearing aids; or other treatment
for hearing defects and problems. “Hearing defects: means
any physical defect of the ear which does or can impair
normal hearing:
7. Dental treatment, except as the result of injury to sound,
natural teeth;
8. Services or supplies performed or provided by a Member
of the Insured Person’s family, or anyone who lives with
the Insured Person;
9. Expenses which were not recommended, approved and
certified as Medically Necessary and reasonable by a
Physician;
10. Weak, strained or flat feet, corns, calluses, or toenails;
11. Cosmetic surgery, or treatment for congenital anomalies
(except as specifically provided), except reconstructive
surgery as the result of a covered Injury or Sickness.
Correction of a deviated nasal septum is considered
cosmetic surgery unless it results from a covered Injury or
covered Sickness;
12. Elective Surgery and Elective Treatment;
13. Drug, treatment or procedure that either promotes or
prevents conception, or prevents childbirth;
14. Injury sustained while participating in professional,
sponsored and/or organized Amateur or Interscholastic
Athletics;
15. Organ transplants;16. Any consequence, whether directly or indirectly,
proximately or remotely occasioned by, contributed to by,
or traceable to, or arising in connection with war, invasion,
act of foreign enemy hostilities, warlike operations
(whether war be declared or not), or civil war; terrorist
activity; nuclear, chemical, biological; (details in program
summary)
17. Participation in a riot or civil disorder, commission of
or attempt to commit a felony in the country in which it
was attempted or committed;
18. Suicide or attempted suicide (including drug overdose),
while sane or insane (while sane in Missouri), or an
intentionally self-inflected Injury;
19. Expenses of an institution, health service, or infirmary
for whose service payment is not required in the absence
of insurance;
20. Treatment of nervous or mental disorders, except as
stated in the Schedule of Benefits, or treatment of
alcoholism or drug abuse, except as provided for
treatment of mental or nervous disorders, according to the
Schedule of Benefits;
21. Loss incurred from riding in any aircraft, other than as
a passenger in an aircraft licensed for the transportation of
passengers;
22. Treatment services, supplies or facilities in a hospital
owned or operated by: a) The Veteran’s Administration; or
b) A national government or any of its agencies. (This
exclusion does not apply to treatment when a charge is
made which the Insured is required by law to pay);
23. Duplicate services actually provided by both a certified
nurse-midwife and Physician;
24. Expenses incurred during a hospital emergency room
visit which is not of an emergency nature;
25. Expenses incurred for outpatient treatment in
connection with the detection or correction by
manual or mechanical means of structural imbalance,
distortion or sublimation in the human body for purposes
of removing nerve interference and the effects thereof,
where such interference is the result of or related to
distortion, misalignment or subluxation of or in the
vertebral column;
26. Injury sustained while taking part in mountaineering
where ropes or guides are normally used, hang gliding,
parachuting, bungee jumping, racing by horse or motor
vehicle or motorcycle, motorcycle/motor scooter riding,
scuba diving involving underwater breathing apparatus
(unless PADI or NAUI certified), water skiing, snow skiing,
snow boarding and snowmobiling;
27. Treatment paid for or furnished under any other
individual, government, or group policy; previous policy;
payable under any Worker’s Compensation or
Occupational Disease Law or Act; or charges provided at
no cost to the Insured Person;
28. Expense incurred after the Expiration Date for an Insured
Person except as may be specifically provided;
29. Expenses for treatment in connection with alcoholism
and drug addiction, or use of any drug or narcotic agent
or for Injury or Sickness due wholly or partly to the effects
of intoxicating liquor or drugs, unless prescribed by a
Physician;
30. Sexually transmitted diseases, including AIDS.
31. Pregnancy expenses or Sickness resulting from
pregnancy, childbirth, or miscarriage; or for miscarriage
resulting from Injury; or voluntary or elective abortion;
32. Treatment while confined primarily to receive custodial
care, educational or rehabilitative care and nursing
services in a long term facility, spa, hydroclinic, weight loss
clinic, sanatorium, nursing home or similar facilities;
33. Expenses for Speech therapy, Occupational therapy or
Vocational Rehabilitation.
Plan Rates
| $0 Per Injury / Sickness Deductible Per Person |
|
Plan A
$50,000 Maximum
Monthly Rate / Daily Rate |
Plan B
$75,000 Maximum
Monthly Rate / Daily Rate |
Plan C
$100,000 Maximum
Monthly Rate / Daily Rate |
Plan D
$130,000 Maximum
Monthly Rate / Daily Rate |
| Age 2 weeks - 49 |
$47.00 / $1.56 |
$55.00 / $1.83 |
$63.00 / $2.10 |
$82.00 / $2.73 |
| Age 50 – 59 |
$64.00 / $2.12 |
$74.00 / $2.46 |
$84.00 / $2.81 |
$110.00 / $3.65 |
| Age 60 – 69 |
$71.00 / $2.36 |
$82.00 / $2.74 |
$94.00 / $3.12 |
$122.00 / $4.06 |
Dependent Child
(Age 2 weeks - 18)* |
$36.00 / $1.20 |
$45.00 / $1.49 |
$53.00 / $1.77 |
$69.00 / $2.30 |
| $50 Per Injury / Sickness Deductible Per Person |
|
Plan A
$50,000 Maximum
Monthly Rate / Daily Rate |
Plan B
$75,000 Maximum
Monthly Rate / Daily Rate |
Plan C
$100,000 Maximum
Monthly Rate / Daily Rate |
Plan D
$130,000 Maximum
Monthly Rate / Daily Rate |
| Age 2 weeks - 49 |
$39.00 / $1.30 |
$46.00 / $1.52 |
$52.00 / $1.74 |
$68.00 / $2.26 |
| Age 50 – 59 |
$53.00 / $1.77 |
$62.00 / $2.06 |
$70.00 / $2.35 |
$92.00 / $3.05 |
| Age 60 – 69 |
$59.00 / $1.97 |
$69.00 / $2.29 |
$78.00 / $2.61 |
$102.00 / $3.39 |
Dependent Child
(Age 2 weeks - 18)* |
$30.00 / $1.00 |
$37.00 / $1.23 |
$44.00 / $1.47 |
$57.00 / $1.91 |
| $100 Per Injury / Sickness Deductible Per Person |
|
Plan A
$50,000 Maximum
Monthly Rate / Daily Rate |
Plan B
$75,000 Maximum
Monthly Rate / Daily Rate |
Plan C
$100,000 Maximum
Monthly Rate / Daily Rate |
Plan D
$130,000 Maximum
Monthly Rate / Daily Rate |
| Age 2 weeks – 49 |
$36.00 / $1.20 |
$42.00 / $1.41 |
$49.00 / $1.62 |
$63.00 / $2.11 |
| Age 50 – 59 |
$49.00 / $1.64 |
$59.00 / $1.96 |
$69.00 / $2.29 |
$89.00 / $2.97 |
| Age 60 – 69 |
$55.00 / $1.83 |
$66.00 / $2.19 |
$77.00 / $2.55 |
$99.00 / $3.31 |
Dependent Child
(Age 2 weeks - 18)* |
$28.00 / $0.93 |
$34.00 / $1.14 |
$40.00 / $1.35 |
$53.00 / $1.76 |
* Dependent Child rate is applicable when at least one parent will also be covered under Inbound USA.
| $200 Per Injury / Sickness Deductible Per Person |
| |
Plan J
$50,000 Maximum
Monthly Rate / Daily Rate |
Plan K
$70,000 Maximum
Monthly Rate / Daily Rate |
| Age 70 – 74 |
$74.00 / $2.48 |
$104.00 / $3.47 |
| Age 75 – 79 |
$82.00 / $2.73 |
$115.00 / $3.82 |
| Age 80 – 84 |
$110.00 / $3.67 |
$154.00 / $5.14 |
| Age 85 – 89 |
$125.00 / $4.15 |
$174.00 / $5.81 |
| Age 90 – 94 |
$143.00 / $4.77 |
$200.00 / $6.68 |
| Age 95 – 99 |
$164.00 / $5.48 |
$230.00 / $7.67 |
Please be aware that this is not a general health insurance policy, but an interim program intended for temporary use. Inbound
USA does not guarantee payment to a facility or individual for medical expenses until the Company determines that it is an
eligible expense.
What You Will Receive
Upon successful enrollment in Inbound USA, you will receive an information packet from Seven Corners. This packet will include
your ID Card and Program Summary. The Program Summary describes all the benefits of Inbound USA in complete detail. In addition,
the Program Summary explains the procedure for submitting claims.
Refund of Premium
Refund of premium shall be considered only if written request is received by Seven Corners prior to the Effective Date of Coverage.
After the Effective Date of Coverage, the premium is considered fully earned and non-refundable.
The Insurance Company
Inbound USA is underwritten by Certain Underwriters at Lloyd’s, London and is rated A “Excellent” by A.M. Best. In addition to
being one of the largest insurance entities in the world, Lloyd’s has over 300 years of experience in the international insurance
business. |