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Rates: Plan A Rates / Plan B Rates / Plan C Rates / Plan D Rates
Visitor Medical Insurance > MultiNational Underwriters > Plan Benefits
ImmigrantSecure Benefit Schedule
All benefits, except Common Carrier Accidental Death and Dismemberment, are subject to Deductible and are per Certificate Period unless stated otherwise. Coinsurance does not apply.
| Plan A | Plan B | Plan C | Plan D | |
| Deductible Ages 70 and above |
$200 per Injury or Illness | Not available | ||
| All others | $0, $50, or $100 per Injury or Illness | $0, $50, or $100 per Injury or Illness | ||
| Overall Policy Maximum Ages 80 and above |
$10,000 | Not available | Not available | Not available |
| Ages 70-79 | $25,000 | $50,000 | Not available | Not available |
| Maximum per Injury / Illness Ages 14 days through 69 |
$50,000 | $75,000 | $100,000 | $130,000 |
| Penalty for failure to Pre-certify | 50% of Eligible Medical Expenses | |||
Inpatient Treatment |
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| Hospital Room & Board including miscellaneous | Up to $1,400/day, 30 day max | Up to $1,675/day, 30 day max | Up to $1,950/day, 30 day max | Up to $2,535/day, 30 day max |
| Hospital Intensive Care Unit | $2,060/day, 8 day max | $2,430/day, 8 day max | $2,8000/day, 8 day max | $3,640/day, 8 day max |
| Surgery | $3,300 per session | $4,400 per session | $5,500 per session | $7,150 per session |
| Anesthetist | Up to $825 | Up to $1,100 | Up to $1,375 | Up to $1,775 |
| Assistant Surgeon | Up to $825 | Up to $1,100 | Up to $1,375 | Up to $1,775 |
| 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 $1,100 | Up to $1,100 | Up to $1,100 | Up to $1,450 |
| Outpatient Treatment |
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| Surgical Treatment | Up to $3,300 | Up to $4,400 | Up to $5,500 | Up to $7,150 |
| 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 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 $1,000 | Up to $1,050 | Up to $1,100 | Up to $1,400 |
Miscellaneous Inpatient & Outpatient Treatment |
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| Anesthesiologist | 25% of Surgeon benefit | |||
| Assistant Surgeon | 25% of Surgeon benefit | |||
| Ambulance Services | $450 maximum | |||
| Dental Accident | $550 maximum | |||
| Physical Therapy | $40 maximum/visit, 1 visit/day, 12 visits max | |||
| Durable Medical Equipment | $1,100 maximum | $1,200 maximum | $1,300 maximum | $1,700 maximum |
| Chemotherapy and Radiation | $1,100 maximum | $1,225 maximum | $1,350 maximum | $1,750 maximum |
| Other Benefits |
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| Emergency Evacuation | $50,000 Lifetime Maximum. Available only to Members under age 70. Accrues toward Maximum per Injury / Illness | |||
| Repatriation of Remains | $7,500 per Member | |||
| Common Carrier Accidental Death & Dismemberment | $25,000 Lifetime Maximum Principal Sum per Member Not Subject to Deductible Death or Loss of Two Limbs – Principal Sum Loss of One Limb – One-half the Principal Sum |
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Covered Expenses
Medical
Subject to the coverage outlined in the Schedule of Benefits and Limits, ImmigrantSecureSM will provide benefits for the
following:
- Inpatient and Outpatient charges made by a Hospital
- Charges made by a Physician, surgeon, radiologist, anesthesiologist, and any other medical specialist to whom the Physician has referred the case
- Charges made for dressings, sutures, casts or other supplies prescribed by the attending Physician or specialist, but excluding nebulizers, oxygen tanks, diabetic supplies and all devices for repeat use at home
- Charges for diagnostic testing using radiology, ultrasonographic or laboratory services
- Charges for oxygen and other gases and anesthetics and their administration
- Charges for prescription drugs for treatment of a covered Injury or Illness, but not for the replacement of lost, stolen, damaged, expired or otherwise compromised drugs
- Charges made by a licensed Extended Care Facility upon direct transfer from an acute care Hospital
- Emergency local ambulance transport incurred in connection with Injury or Illness resulting in Inpatient hospitalization
Emergency Medical Evacuation Expenses
If recommended by your attending Physician, who certifies that Evacuation is necessary to safeguard your life and that Medically Necessary treatment is not available locally, and if approved in advance and coordinated by MultiNational Underwriters®, ImmigrantSecureSM will provide the following benefits: Emergency air and/or ground transportation to the nearest Hospital that is qualified to provide the Medically Necessary treatment.
Repatriation of Mortal Remains Expenses
In the event of a covered Injury or Illness resulting in your death, ImmigrantSecureSM will provide the following benefit: Air and/or ground transportation of bodily remains or ashes to the area of your Principal Residence, and reasonable costs of preparation of your remains necessary for transportation.
Common Carrier Accidental Death & Dismemberment (AD&D)
In the event of your Accidental Death while traveling on board a commercial common carrier (airplane or cruiseline), ImmigrantSecureSM will provide the following benefit, subject to a maximum of $125,000 per family:
- Accidental Death – $25,000 to the Beneficiary designated on your Application
- Loss of 2 eyes or 2 or more limbs – $25,000 to you
- Loss of 1 eye or 1 limb – $12,500 to you