ChoiceAmerica

Limited Coverage

AM Best Rating: A (Excellent)

Carrier/Underwriter: IMG

Administrator: Sirius International

Medical Coverage During Travel

Renewable & Cancelable

Basic Coverage Plan

Coverage from 5 days to 365 days

PPO

First Health Network

Urgent Care

Cannot accept an address in Maryland (MD).

BUY

ChoiceAmerica is travel medical insurance for non-U.S. citizens traveling to the United States, Mexico or Canada.
ChoiceAmerica insurance is a basic travel medical insurance plan that has fixed pre defined limit for each medical service.
You visit any doctor or hospital of your choice.

Note: Choice America is not available for citizens or residents of the U.S.A. For Canadian and Mexican citizens and residents, the plan will not cover in their home country and country of citizenship.

The following benefit table shows how much insurance pays for the given covered medical service. If the actual bill is more, the difference will be your responsibility.
Please review ChoiceAmerica Insurance Brochure and Description of Coverage (policy document) for complete and accurate coverage and exclusions.

Applicant's Age 14 days - 79 years

CA $50,000 Policy Maximum	CA $100,000 Policy Maximum	CA $150,000 Policy Maximum
Out-Patient
Dr. / Physician Visit
$65/visit, 10 visits max	$90/visit, 10 visits max	$130/vist, 10 visits max
Urgent Care
$65/visit, 10 visits max	$90/visit, 10 visits max	$130/vist, 10 visits max
Surgical Treatment
$3,500	$4,500	$8,000
Prescription Drugs / Medicines
Up to Max $250 per certificate period	Up to Max $250 per certificate period	Up to Max $250 per certificate period
Lab & X-rays
$850	$1,000	$1,400
Physical Therapy
$40 per visit per day/ 12 visits max	$40 per visit per day/ 12 visits max	$40 per visit per day/ 12 visits max

In-Patient
Hospital Room
$1,400 per day/ 30 days max	$2,000 per day/ 30 days max	$3,000 per day/ 30 days max
Surgical Treatment
Up to $3,500	Up to $6,000	Up to $7,500
Hospital Intensive Care Unit
Up to $700 per day/ 8 Days max	Up to $1,000 per day/ 8 Days max	Up to $1,500 per day/ 8 Days max

Emergency Services
Ambulance Expenses
Up to $500	Up to $500	Up to $500
Emergency Room(ER)
Up to max $355	Up to max $575	Up to max$800

Dental
Acute, spontaneous and unexpected pain
Optional Coverage with additional premium 1 exam: Up to $75 Tooth Removal : Up to $150	Optional Coverage with additional premium 1 exam: Up to $75 Tooth Removal : Up to $150	Optional Coverage with additional premium 1 exam: Up to $75 Tooth Removal : Up to $150
Accidental emergency
Up to $600 per certificate period	Up to $600 per certificate period	Up to $600 per certificate period

Travel
Emergency Medical Evacuation / Repatriation
Up to $50,000	Up to $50,000	Up to $100,000
Return of Remains
Up to $7,500	Up to $7,500	Up to $7,500
Return of minor Child(ren)
Not Covered	Not Covered	Not Covered
Trip Interruption
Not Covered	Not Covered	Not Covered
Loss of checked Baggage
Not Covered	Not Covered	Not Covered

Life
AD&D
Not Covered	Not Covered	Not Covered
Common Carrier Accidental Death
Up to $5,000 per insured and Max $25,000 Max per family	Up to $5,000 per insured and Max $25,000 Max per family	Up to $5,000 per insured and Max $25,000 Max per family

Other
Pre-Existing Conditions
Optional Coverage with Additional Premium Additional Deductible: $50 per incident Physician Visit: $100 per vist/ 2 visits max Lab work & X-ray: $500 Emergency Room & Hospitalization: $1,000 Prescription : $50	Optional Coverage with Additional Premium Additional Deductible: $50 per incident Physician Visit: $100 per vist/ 2 visits max Lab work & X-ray: $500 Emergency Room & Hospitalization: $1,000 Prescription : $50	Optional Coverage with Additional Premium Additional Deductible: $50 per incident Physician Visit: $100 per vist/ 2 visits max Lab work & X-ray: $500 Emergency Room & Hospitalization: $1,000 Prescription : $50
Local Burial or Cremation
Up to $5,000	Up to $5,000	Up to $5,000
Maternity
Not Covered	Not Covered	Not Covered
Incidental Home Country Coverage
Not Covered	Not Covered	Not Covered
General Physical full Checkup
Up to $50,000 per certificate period	Up to $50,000 per certificate period	Up to $50,000 per certificate period
Terrorism Coverage
$50,000 per coverage period	$50,000 per coverage period	$50,000 per coverage period

Support
24-Hrs Emergency Assistance
Yes. Contact number and details can be found on the ID card.	Yes. Contact number and details can be found on the ID card.	Yes. Contact number and details can be found on the ID card.

Plan Administrator Company

IMG

Carrier / Underwriter

Sirius International

Eligibility

1) Can be purchased by non-US citizens and non-US Resident.
2) Available ages 15 days to 79 years.
3) For people 65 and over, the plan has to be purchased within 30 days, after arriving in the USA.

Policy Content

What is Policy Maximum?

Policy Maximum is the maximum amount that an insurance policy will pay for covered expenses. If you choose a policy with maximum coverage of say $50,000, and your actual bills are $120,000, the insurance will pay only up to $50,000 for the covered expenses as per the policy.

Note: Policy maximum is the outer limit of the insurance company's liability for the covered expenses only. Do not assume that insurance pays for everything up to policy maximum. All applicable limits and exclusions will apply.

What policy maximum should I choose?

This type of plan pays based on fixed pre-defined benefits. Higher the policy maximum, better are the benefits. It is a good idea to select a higher policy maximum such as $100,000 or more for better benefits.

Note: These suggestions are based on generic guidelines of how the insurance policy works and what can be the best possible combination for maximum benefit from this type of policy.

Deductible Content

Deductible Per Incident

What is Deductible?

Deductible is the amount that you are responsible for, before insurance company starts paying for any covered expenses. Deductible for this type of plan is applicable once per incident.

For example: If you visit a doctor for a medical problem, and after consultation, the doctor prescribes Medicines, X-rays, and Lab tests, then since all these services are part of one incident, your deductible will be applicable for these services only once. If you visit a doctor again after a few days for a new problem, the deductible will be applicable again for that new incident.

What deductible to choose with this Plan?

Since deductible is per incident for these type of plans. It is a good idea to select a lower deductible such as “0“.

Note : For Age 70 and above, lower deductible like Zero “0“ is not available.

Plan Type

Limited Coverage Plan
Plan pays by a pre-defined fixed benefit table.

AM Best Rating

A (Excellent)

Coverage in U.S.A.

Covered

Coverage outside U.S.A.

Only Canada and Mexico

Co-Pay

No Co-pay
(You pay the difference of the fixed benefits defined by the benefit table)

Co-Insurance

No Co-Insurance
(You pay the difference of the fixed benefits defined by the benefit table)

How the Benefits are Paid

After the deductible, plan pays fixed amount based on a pre-defined benefit table for each type of service or treatment.

Coverage Type

Per Life of Plan

Deductible Type

Per Period of Coverage

Renewability

Can be renewed only before policy expires. $5 renewal fee applies for every renewal. Can be renewed for up to 12 months

Cancellation

1) No refund available if you need to visit doctors with the policy.
2) Full refund available if cancelled before start date.
3) Pro-rated refund available after start date only if no claims is submitted by you or the service provider.
4) $20 Cancellation Fee Applicable.
5) Written request or e-mail is required for any cancellation and refund

PPO Network

First Health Network

Coverage Length

Minimum 5 days to Maximum 12 months

Available Deductibles

Choose From: $0, $50, $100

Available Coverage

Plan A: $50,000
Plan B: $100,000
PlanC: $150,000

Provider Directory

By Provider, Phone Nos. : 800-628-4664 or 317-655-4500

Plan Brochure

Choice America Insurance Brochure

Home Country Definition

For United States citizens, the Home Country is the United States. For non-United States citizens, the Home Country is the country of which the Insured Person is a citizen or national; including any country where the Insured Person maintains his/her primary residence or usual place of abode and any country of which the Insured Person pays income taxes or is the possessor of a validly issued passport. In the event there is more than one Home Country under the above-listed criteria or the person has dual citizenship, the Home Country is the country meeting the above-listed criteria and listed by the Insured Person as his or her Home Country on the Application.

US States Restrictions

Maryland

ChoiceAmerica Insurance FAQs

Q1: Am I eligible for the ChoiceAmerica plan?

ChoiceAmerica is travel medical insurance for non-U.S. citizens traveling to the United States, Mexico or Canada. To qualify for coverage you must not be a citizen of the host country you are traveling to, which are the United States, Mexico or Canada. ChoiceAmerica is not available to those whose applications list a U.S state address as the mailing address.

Q2: Can I renew the ChoiceAmerica plan?

Your ChoiceAmerica policy may be extended in increments with minimum of five days up to the maximum coverage period of 12 continuous months..

Q3: Can I cancel the ChoiceAmerica plan?

Yes, you can cancel this plan. If you submit a written request to International Medical Group (IMG) prior to your start date, you will receive a complete refund. After the policy's start date, you may submit a written request for cancellation as long as no claims have been submitted, but the following conditions will apply:
1) You will be required to pay a $20 cancellation fee and
2) Your refund will be pro-rated based on the amount of days left on the policy. If you have filed claims, your premium is non-refundable.

Q4: What does the ChoiceAmerica plan cover? Why is it so much cheaper than the comprehensive plans?

The ChoiceAmerica plan is a limited coverage plan and pays its benefits according to a fixed schedule of benefits. This plan is less expensive than comprehensive plans because the plan provides only basic coverage and has limited or restricted benefits.

Q5: How does the deductible work in the Choice America Policy?

The deductible is the first amount of the covered bill that is the insured person's responsibility, before the insurance starts paying. For the Choice America Policy, you can choose a deductible of $0, $50 and $100. In case of a limited coverage plan like Choice America, it is better to choose the lowest deductible available. As it is, the plan pays a very limited fixed amount for every service and treatment. The deductible for limited plans are deducted for these fixed benefit amounts, amounts, and not the amount that the doctors charge. If you choose a higher deductible, the amount that the insurance covers would be reduced further.
For example: You choose a $50,000 policy maximum, with a $50 deductible, and you need a doctor's consolation. You can see in the Schedule of benefits that the insurance would pay $65 for a doctor's visit. Now the deductible of $50 would apply to the fixed benefit amounts. So in this case the plan would pay ($65-$50) = $15 towards your doctor's visit. Whatever amount the doctor might charge, the insurance would pay only $15. If you go back again for the same situation for another consultation, then the plan would pay $65.
For the Choice America Plan, the deductible is only one time in the policy period.

Q6: Is pre-existing condition covered in this policy?

Pre-existing condition is usually not covered in travel insurance policies. The Choice America plan offers a limited coverage for pre-existing conditions, only if you choose optional coverage for pre-existing condition. This can be purchased with additional premium. The pre-existing rider has to be purchased before leaving from the home country. The policy has to be purchased for a minimum of 30 days.
If you choose the optional pre-existing condition rider, after an additional deductible of $50 per incident, the plan will pay for the following:

1) Physician visit: $100 per visit, 2 visits maximum.
2) Lab & x-ray: $500.
3) Emergency room & hospitalization: $1,000.
4) Prescription: $50
For more information on the optional rider, please check the description of coverage. ChoiceAmerica Pre-existing Rider

Q7: Is dental treatment covered in the policy?

Dental is usually not covered in travel insurance policies. The Choice America plan offers a limited coverage for dental, only if you choose optional coverage for dental and vision. This can be purchased with additional premium. If you choose the optional dental and vision rider, the plan will pay for the following dental treatments:

$75 for only one dental exam, and
Maximum of $150 for tooth extraction.

For more information on the optional rider, please check the description of coverage. ChoiceAmerica Dental and Vision Rider

Q8: Is vision covered in the policy?

Vision is usually not covered in travel insurance policies. The Choice America plan offers a limited coverage for dental, only if you choose optional coverage for dental and vision. This can be purchased with additional premium. If you choose the optional dental and vision rider, the plan will pay up to a maximum of $100 for only one vision exam.
For more information on the optional rider, please check the description of coverage.ChoiceAmerica Dental and Vision Rider

Q9: What is Border Security Coverage?

Border security coverage is a unique feature of the Choice America Plan. It is available for people travelling to the USA on B2 or tourism visa. For some reason if the entry to the USA is denied at the border, the insurance would cover up to $2500 for an economy class air fare, back to the insured person’s home country. Please check the description of coverage for more information and additional conditions. ChoiceAmerica Border Entry Protection

Q10: Is Adventure Sports covered by the Choice America Plan?

Adventure sports are usually not covered in travel insurance policies. The Choice America plan offers a limited coverage for Adventure Sports, if you choose the Adventure Sports Rider Option. This can be purchased with additional premium. To check out which adventure sports are covered, you can check the Description of Coverage to see which sports are covered under the Sports Rider option. ChoiceAmerica Adventure Sports Rider

Q11: After I received my confirmation, I realized there may have been some errors in my application. What should I do?

Send any correction to us in writing by email to: support@visitorscoverage.com. When sending correspondence, please include your policy number. You can also contact IMG directly. Contact information: Email: chs.service@imglobal.com. If the correction results in an increase in premium, please authorize payment to your card on file.

Q12: Which doctor or hospital can I go to?

You can go to any doctor or hospital of your choice. If you would like, you can choose to go in the PPO network for ChoiceAmerica, which is the FirstHealth PPO Network.

You can search for doctors or hospitals in the Provider Directory.

Q13: What information do I need to purchase this insurance?

Name(s), date of birth, and passport number of the visitor(s).

Q14: I want to purchase insurance for more than one visitor. Should I purchase two separate policies for them or have a combined policy?

The benefits and cost does not differ if you buy individually or combined policies. If the visitors have different travel plans (might be coming together but leaving on different dates, etc.) it is recommended to buy separate policies. Having separate policies gives you more flexibility in renewals and cancellations.

Q15: When will I receive my ID card?

ChoiceAmerica plan is an online insurance policy. Once you purchase the policy online you will receive a printable policy in your e-mail. You can print and cut the paper ID card for your record and use it in the event you go to Doctor or hospital.

Q16: How do I use this insurance?

Please refer to the following article about the policy usage: how to use Visitor Insurance?

Q17: Where can I find the claim information?

Please refer to the following article for the claim process: Visitor Insurance Claim Process

Q18: Where can I find answers to other questions I have?

Learn more from informative articles at Visitor Insurance Information section.

If you still have questions, please email us at support@visitorscoverage.com or call our support line toll free: 1.866.384.9104. Business Hours: Mon - Fri 8:30am- 5:30pm PST.

Q19: What is pre-certification?

Pre-certification is the process of letting the insurance company know, before taking any major medical services like Hospitalization, surgery etc. In case of an emergency admission, the precertification call must be made within 48 hours of admission, or as soon as reasonably possible. If a hospital admission, a surgery or anything else requiring precertification is not pre-certified, eligible claims and expenses will be reduced by 50%. See complete pre-certification details in your policy brochure and description of coverage.

Disclaimer

Plan features listed here are high level, provided for your convenience and information purpose only. Please review the Evidence of Coverage and Plan Contract (Policy) for a detailed description of Coverage Benefits, Limitations and Exclusions. Must read the Policy Brochure and Plan Details for complete and accurate details. Only the Terms and Conditions of Coverage Benefits listed in the policy are binding.

Primary Traveler

Are any of the travelers a US citizen?