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US Visitor/Immigrant Insurance > International Medical Group
Visitors Care Benefit Schedule
The plan offers benefit maximums of US$25,000, US$50,000 or US$100,000 for the life of the plan, and a choice of deductibles of US$0, US$50 or US$100 applied per period of coverage. When you incur eligible medical expenses, the plan will provide benefits for Usual, Reasonable and Customary charges up to the limits outlined in the Schedule of Benefits below, with no coinsurance. The four benefits below apply to all three plans.
INTERNATIONAL EMERGENCY CARE
| Emergency Evacuation | To US$50,000 when coordinated through IMG (not to exceed plan maximum) |
| The plan includes coverage for Emergency Medical Evacuations to the nearest qualified medical facility in life-threatening situations, and expenses for reasonable travel and accommodations resulting from the evacuation, which must be approved and coordinated in advance. | |
| Return of Mortal Remains | To US$7,500 when coordinated through IMG |
| If a covered illness/injury results in death, expenses for repatriation of bodily remains or ashes to the country of residence or citizenship will be covered, up to a maximum of US$7,500. | |
SPECIAL COVERAGES
| Home Country Coverage | As described below |
| Incidental Home Country Coverage - During the period of coverage, an insured person may return to his/her home country for incidental visits up to a cumulative two weeks total, and retain continuing coverage during such visit(s), so long as: a. The insured person must have previously left his/her home country for some portion of the period of coverage, and b. The return to the home country must not be undertaken for the purpose of receiving treatment for an illness or injury incurred while traveling or residing outside the home country. | |
| Common Carrier Accidental Death | US$25,000 to Beneficiary |
| If accidental death should occur while traveling on a commercial common carrier during the period of coverage, US$25,000 will be paid to the designated beneficiary. | |
MEDICAL BENEFITS - usual, reasonable and customary charges, subject to deductible and coinsurance
| Plan A - US$25,000 maximum benefit per life of plan | Plan B - US$50,000 maximum benefit per life of plan | Plan C - US$100,000 maximum benefit per life of plan | |
| Inpatient Treatment | |||
| Hospital room & board | Up to US US$825 per day, 30 day maximum per period of coverage | Up to US US$1,400 per day, 30 day maximum per period of coverage | Up to US US$1,950 per day, 30 day maximum per period of coverage |
| Intensive Care | Additional US$400 per day, 8 day maximum per period of coverage | Additional US$660 per day, 8 day maximum per period of coverage | Additional US$850 per day, 8 day maximum per period of coverage |
| Surgical Treatment | US$2,000 per surgical session | US$3,300 per surgical session | US$5,500 per surgical session |
| Consult physician | US$350 per period of coverage | US$450 per period of coverage | US$500 per period of coverage |
| Pre-admission tests | US$750 per period of coverage | US$1,100 per period of coverage | US$1,100 per period of coverage |
| Private duty nurse | US$400 per period of coverage | US$550 per period of coverage | US$550 per period of coverage |
| Physician visits | US$40 allowable charge per visit, 30 visits per period of coverage | US$55 allowable charge per visit, 30 visits per period of coverage | US$85 allowable charge per visit, 30 visits per period of coverage |
| Outpatient Treatment | |||
| Surgical treatment | US$2,000 per surgical session | US$3,300 per surgical session | US$5,500 per surgical session |
| Diagnostic x-ray & lab | US$650 per period of coverage, (US$325 allowable charge per procedure) | US$800 per period of coverage, (US$400 allowable charge per procedure) | US$950 per period of coverage, (US$475 allowable charge per procedure) |
| Hospital emergency room | US$200 allowable charge per visit | 75% of URC to US$330 | 75% of URC to US$550 |
| Prescription drugs | US$150 per period of coverage | US$250 per period of coverage | US$250 per period of coverage |
| Physician visits | US$50 allowable charge per visit, 10 visits per period of coverage | US$55 allowable charge per visit, 10 visits per period of coverage | US$85 allowable charge per visit, 10 visits per period of coverage |
| Miscellaneous Inpatient & Outpatient Services | |||
| Anesthetist | US$450 per surgical session | 25% of surgical benefit | 25% of surgical benefit |
| Assistant surgeon | US$450 per surgical session | 25% of surgical benefit | 25% of surgical benefit |
| Other Coverages | |||
| Ambulance | US$250 per period of coverage | US$450 per period of coverage | US$450 per period of coverage |
| Dental for accident to sound natural teeth | US$350 per period of coverage | US$550 per period of coverage | US$550 per period of coverage |
| Physiotherapy | US$25 per visit per day, 12 visits per period of coverage | US$40 per visit per day, 12 visits per period of coverage | US$40 per visit per day, 12 visits per period of coverage |
The period of coverage is the period of time for which premium has been timely paid. At each renewal, a new period of coverage will begin.
PLEASE NOTE: This web page contains only a consolidated and summary description of all current Visitors Care benefits, conditions, limitations and exclusions. A certificate of insurance containing the complete Policy Wording with all terms, conditions, limits and exclusions will be included with the fulfillment kit. Please review the Policy Wording carefully upon receipt and contact IMG if you have any questions concerning available coverages and benefits. The plan underwriter reserves the right to amend or modify the Policy Wording, and issue the most current Policy Wording for the Visitors Care plan, in the event an Application Form and/or this brochure has expired, is modified, or is replaced with a newer version. Current Policy Wordings are available upon request.