VU

Visit USA

Underwriter: Lloyd's of London
Policy info
Plan Administrator: TIS
Carrier: Lloyd's of London
AM Best Rating: A(Excellent)
Useful Links
Standard & Superior Plans: First Health PPO Network
Budget Plan: No Network

Visit USA-HealthCare is available to Non-U.S. residents while visiting the U.S. Coverage is available for the main insured party and spouse; unmarried adult dependent children; or for children traveling alone.
This plan is suitable for business and leisure travelers, international exchange students, tourists, holiday travelers and and church or missionary travelers.

Please review Visit USA-Healthcare Insurance Brochure brochure or Description of Coverage brochure (policy document) for complete and accurate coverage and exclusions.

Here is a complete list of benefits of Visit USA
Dr. / Physician Visit
Budget Plan
$50,00 policy max selected: $75/10 visits max
$150,000 policy max selected: $125/10 visits max

Standard/Superior Plans
In-network: after deductible plan pays 100% up to policy max Out of network: After deductible, reasonable & customary up to policy max
Surgical Treatment
Budget Plan
$50,00 policy max selected: $3,300
$150,000 policy max selected: $7,150

Standard/Superior Plans
In-network: after deductible plan pays 100% up to policy max Out of network: After deductible, reasonable & customary up to policy max
Prescription Drugs / Medicines
Budget Plan
$50,00 policy max selected: $150
$150,000 policy max selected: $300

Standard/Superior Plans
In-network: after deductible plan pays 100% up to policy max Out of network: After deductible, reasonable & customary up to policy max
Lab & X-rays
Budget Plan
$50,00 policy max selected: $500, plus $400 for one CAT Scan, MRI or PET
$150,000 policy max selected: $750, plus $650 for one CAT Scan, MRI or PET

Standard/Superior Plans
In-network: after deductible plan pays 100% up to policy max Out of network: After deductible, reasonable & customary up to policy max
Physical Therapy
Budget Plan (both policy maximum options)
$50 per visit, 1 visit per day, maximum 12 visits

Standard/Superior Plans
Usual Reasonable and Customary. Must be ordered by attending physician
Hospital Room
Budget Plan
$50,00 policy max selected: $1,500 per day - 30 days max
$150,000 policy max selected: $2,750 per day - 30 days max

Standard/Superior Plans
Usual Reasonable and Customary. Must be ordered by attending physician
Surgical Treatment
Budget Plan
$50,00 policy max selected: $4,000
$150,000 policy max selected: $8,000

Standard/Superior Plans
Usual Reasonable and Customary. Must be ordered by attending physician
Hospital Intensive Care Unit
Budget Plan
$50,00 policy max selected: $2,500 per day - 8 days max
$150,000 policy max selected: $4,000 per day - 8 days max

Standard/Superior Plans
Usual Reasonable and Customary. Must be ordered by attending physician
Ambulance Expenses
Budget Plan
Both policy maximum options: $500

Standard/Superior Plans
Usual Reasonable and Customary, when it leads to inpatient hospitalization
Emergency Room(ER)
Budget Plan
$50,00 policy max selected: $375
$150,000 policy max selected: $785

Standard/Superior Plans
Usual Reasonable and Customary. Additional $250 co-pay applies for illness that does not lead to inpatient hospitalization.
Acute, spontaneous and unexpected pain
Budget Plan: Not covered
Standard/Superior Plans: $100
Accidental emergency
Budget Plan: Not covered
Standard/Superior Plans: $1,000
Emergency Medical Evacuation / Repatriation
Budget Plan
Both policy maximum options: Overall maximum limit

Standard/Superior Plans
$100,000 lifetime maximum, except as provided under acute onset of pre-existing conditions.
Up to $500,000 lifetime maximum - not subject to deductible.
Return of Remains
Budget Plan
Both policy maximum options: $50,000

Standard/Superior Plans
Up to the overall maximum limit - not subject to deductible or coinsurance
Emergency Reunion
For all options: $15,000, subject to a maximum of 15 days - not subject to deductible.
Return of minor Child(ren)
Budget Plan: Not Covered
Standard/Superior Plans: $50,000
Trip Interruption
Budget Plan: Not Covered
Standard/Superior Plans: $5,000 not subject to deductible or co-insurance
Loss of checked Baggage
$250/Article, $500 Max
AD&D
Under 18: $5,000;
18-69: $50,000;
70-74: $20,000;
75 and above: $10,000.

Additional Accidental Death and Dismemberment available ( not available for those 70 and above)
Common Carrier Accidental Death
Budget Plan: Not Covered
Standard/Superior Plans: $50,000
Pre-Existing Conditions
For all Plan Options:
Ages 65 and above: $2,500
All others: $20,000 ($25,000 for Superior)
Maternity
Not Covered
General Physical full Checkup
Not Covered
Terrorism Coverage
Budget Plan: $25,000 for eligible medical coverage.
Standard/Superior Plans: Up to $50,000 lifetime maximum, eligible medical expenses only
24-Hrs Emergency Assistance
Yes. Contact Number and details can be found on the ID card.
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.
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