Each year, the United States hosts millions of foreign visitors from all over the world. While the United States healthcare system is recognized as one of the best in the world, many visitors are concerned about the potential out-of-pocket expenses that could result from an injury or sickness during their visit to the United States of America. Healthcare costs are different in the United States than any other country around the world. That is why foreign national visiting the United States of America requires Visitors Medical Insurance™ to protect yourself and your family.
Visitors Medical Protection™ (VMP™) is a Short-term health insurance. If visiting the U.S.A., the Plan provides benefits to foreign nationals (Parents and relatives), including international visitors, or temporary residents, subject to the terms and conditions of the certificate of coverage. VMP™ is travel insurance for non-U.S. citizens traveling outside of their home country and for U.S. citizens traveling outside the United States.
Coverage can be obtained from a minimum of 5 days up to a maximum of 2 years. If the initial purchase is for one month or more, then plan is renewable (Without break in coverage) in one month increments up to a 24 continuous months
Visitors Medical Protection™ (VMP™) exclusively designed by Visitors Insurance.com™ – A division of Community Insurance Agency,™ Inc., in conjunction with the underwriting company, Sirius International Insurance Corporation, is acting by and through its managing general underwriter and the plan administrator, International Medical Group, Inc., (IMG).
Comprehensive coverage
PLAN AVMP™ MONTHLY RATES (5 days up to a maximum of 2 years) 90% / 10% in PPO Network up to the Policy Maximum after deductible met (Options 1, 2, 3, 4) (70%/30% out of PPO Network) Outside US & Canada: 100% (No coinsurance) |
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Option 1 - US$25,000 Policy Limit | ||||
Deductible | US$100 | US$250 | US$500 | US$1,000 |
---|---|---|---|---|
Under 18 | $23 | $21 | $19 | $17 |
18 - 29 | $36 | $33 | $30 | $26 |
30 - 39 | $46 | $42 | $38 | $34 |
40 - 49 | $71 | $65 | $57 | $52 |
50 - 59 | $101 | $92 | $84 | $73 |
60 - 64 | $127 | $116 | $106 | $94 |
65 - 69 | $146 | $133 | $120 | $107 |
70 - 79 | $196 | $178 | $159 | $143 |
80+* | $371 | $337 | $305 | $269 |
*$15,000 policy maximum |
PLAN AVMP™ DAILY RATES (5 days up to a maximum of 2 years) 90% / 10% in PPO Network up to the Policy Maximum after deductible met (Options 1, 2, 3, 4)(70%/30% out of PPO Network) Outside US & Canada: 100% (No coinsurance) |
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Option 1 - US$25,000 Policy Limit | ||||
Deductible | US$100 | US$250 | US$500 | US$1,000 |
---|---|---|---|---|
Under 18 | $0.77 | $0.70 | $0.64 | $0.58 |
18 - 29 | $1.20 | $1.09 | $1.00 | $0.88 |
30 - 39 | $1.53 | $1.40 | $1.27 | $1.12 |
40 - 49 | $2.37 | $2.15 | $1.91 | $1.73 |
50 - 59 | $3.37 | $3.06 | $2.79 | $2.43 |
60 - 64 | $4.24 | $3.85 | $3.52 | $3.12 |
65 - 69 | $4.87 | $4.43 | $4.00 | $3.58 |
70 - 79 | $6.54 | $5.95 | $5.31 | $4.76 |
80+* | $12.37 | $11.23 | $10.17 | $8.97 |
*$15,000 policy maximum |
Option 2 - US$50,000 Policy Limit | ||||
Deductible | US$100 | US$250 | US$500 | US$1,000 |
---|---|---|---|---|
Under 18 | $25 | $23 | $21 | $19 |
18 - 29 | $40 | $36 | $33 | $29 |
30 - 39 | $51 | $46 | $42 | $37 |
40 - 49 | $78 | $71 | $63 | $57 |
50 - 59 | $111 | $101 | $92 | $80 |
60 - 64 | $140 | $127 | $116 | $103 |
65 - 69 | $161 | $146 | $132 | $118 |
70 - 79 | $215 | $196 | $175 | $157 |
80+ | N/A | N/A | N/A | N/A |
Option 2 - US$50,000 Policy Limit | ||||
Deductible | US$100 | US$250 | US$500 | US$1,000 |
---|---|---|---|---|
Under 18 | $0.84 | $0.77 | $0.70 | $0.63 |
18 - 29 | $1.32 | $1.20 | $1.10 | $0.97 |
30 - 39 | $1.69 | $1.53 | $1.40 | $1.23 |
40 - 49 | $2.60 | $2.37 | $2.10 | $1.90 |
50 - 59 | $3.70 | $3.37 | $3.07 | $2.67 |
60 - 64 | $4.66 | $4.23 | $3.87 | $3.43 |
65 - 69 | $5.37 | $4.87 | $4.40 | $3.93 |
70 - 79 | $7.17 | $6.53 | $5.83 | $5.23 |
80+ | N/A | N/A | N/A | N/A |
Option 3 - US$100,000 Policy Limit | ||||
Deductible | US$100 | US$250 | US$500 | US$1,000 |
---|---|---|---|---|
Under 18 | $29 | $26 | $24 | $22 |
18 - 29 | $46 | $42 | $38 | $34 |
30 - 39 | $62 | $56 | $50 | $44 |
40 - 49 | $88 | $80 | $72 | $64 |
50 - 59 | $136 | $124 | $112 | $100 |
60 - 64 | $174 | $158 | $143 | $126 |
65 - 69 | $210 | $190 | $171 | $152 |
70+ | N/A | N/A | N/A | N/A |
Option 3 - US$100,000 Policy Limit | ||||
Deductible | US$100 | US$250 | US$500 | US$1,000 |
---|---|---|---|---|
Under 18 | $0.95 | $0.87 | $0.80 | $0.73 |
18 - 29 | $1.54 | $1.40 | $1.27 | $1.13 |
30 - 39 | $2.05 | $1.87 | $1.67 | $1.47 |
40 - 49 | $2.93 | $2.67 | $2.40 | $2.13 |
50 - 59 | $4.55 | $4.13 | $3.73 | $3.33 |
60 - 64 | $5.80 | $5.27 | $4.77 | $4.20 |
65 - 69 | $7.00 | $6.33 | $5.70 | $5.07 |
70+ | N/A | N/A | N/A | N/A |
Option 4 - US$250,000 Policy Limit | ||||
Deductible | US$100 | US$250 | US$500 | US$1,000 |
---|---|---|---|---|
Under 18 | $33 | $30 | $28 | $24 |
18 - 29 | $64 | $58 | $52 | $46 |
30 - 39 | $79 | $72 | $66 | $58 |
40 - 49 | $117 | $106 | $94 | $84 |
50 - 59 | $183 | $166 | $150 | $132 |
60 - 64 | $231 | $210 | $190 | $169 |
65 - 69 | $269 | $244 | $221 | $195 |
70+ | N/A | N/A | N/A | N/A |
Option 4 - US$250,000 Policy Limit | ||||
Deductible | US$100 | US$250 | US$500 | US$1,000 |
---|---|---|---|---|
Under 18 | $1.10 | $1.00 | $0.93 | $0.80 |
18 - 29 | $2.13 | $1.93 | $1.73 | $1.53 |
30 - 39 | $2.64 | $2.40 | $2.20 | $1.93 |
40 - 49 | $3.89 | $3.53 | $3.13 | $2.80 |
50 - 59 | $6.09 | $5.53 | $5.00 | $4.40 |
60 - 64 | $7.70 | $7.00 | $6.33 | $5.63 |
65 - 69 | $8.97 | $8.13 | $7.37 | $6.50 |
70+ | N/A | N/A | N/A | N/A |
PLAN B100% in PPO Network up to the Policy Maximum Limit after deductible met (Options 5,6,7,8)- ( 70% of next $5,000 and then 100% out of PPO Network) Outside US & Canada: 100% (No coinsurance) |
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Option 5 - US$25,000 Policy Limit | ||||
Deductible | US$100 | US$250 | US$500 | US$1,000 |
---|---|---|---|---|
Under 18 | $30 | $27 | $25 | $22 |
18 - 29 | $46 | $42 | $38 | $33 |
30 - 39 | $59 | $54 | $48 | $43 |
40 - 49 | $90 | $82 | $74 | $66 |
50 - 59 | $129 | $117 | $106 | $94 |
60 - 64 | $163 | $148 | $133 | $119 |
65 - 69 | $186 | $169 | $152 | $135 |
70 - 79 | $252 | $229 | $206 | $183 |
80+* | $480 | $436 | $392 | $349 |
*$15,000 policy maximum |
PLAN B100% in PPO Network up to the Policy Maximum Limit after deductible met (Options 5,6,7,8)- ( 70% of next $5,000 and then 100% out of PPO Network) Outside US & Canada: 100% (No coinsurance) |
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Option 5 - US$25,000 Policy Limit | ||||
Deductible | US$100 | US$250 | US$500 | US$1,000 |
---|---|---|---|---|
Under 18 | $1.00 | $0.91 | $0.82 | $0.73 |
18 - 29 | $1.53 | $1.40 | $1.26 | $1.12 |
30 - 39 | $1.97 | $1.79 | $1.61 | $1.43 |
40 - 49 | $3.00 | $2.73 | $2.46 | $2.18 |
50 - 59 | $4.30 | $3.91 | $3.52 | $3.13 |
60 - 64 | $5.44 | $4.94 | $4.45 | $3.96 |
65 - 69 | $6.21 | $5.64 | $5.08 | $4.51 |
70 - 79 | $8.41 | $7.64 | $6.88 | $6.12 |
80+* | $16.00 | $14.53 | $13.08 | $11.63 |
*$15,000 policy maximum |
Option 6 - US$50,000 Policy Limit | ||||
Deductible | US$100 | US$250 | US$500 | US$1,000 |
---|---|---|---|---|
Under 18 | $33 | $30 | $27 | $24 |
18 - 29 | $51 | $46 | $41 | $37 |
30 - 39 | $65 | $59 | $53 | $47 |
40 - 49 | $99 | $90 | $81 | $72 |
50 - 59 | $142 | $129 | $116 | $103 |
60 - 64 | $179 | $163 | $147 | $130 |
65 - 69 | $205 | $186 | $167 | $149 |
70 - 79 | $277 | $252 | $227 | $202 |
80+ | N/A | N/A | N/A | N/A |
Option 6 - US$50,000 Policy Limit | ||||
Deductible | US$100 | US$250 | US$500 | US$1,000 |
---|---|---|---|---|
Under 18 | $1.10 | $1.00 | $0.90 | $0.80 |
18 - 29 | $1.69 | $1.53 | $1.38 | $1.23 |
30 - 39 | $2.16 | $1.97 | $1.77 | $1.57 |
40 - 49 | $3.30 | $3.00 | $2.70 | $2.40 |
50 - 59 | $4.73 | $4.30 | $3.87 | $3.44 |
60 - 64 | $5.98 | $5.43 | $4.89 | $4.35 |
65 - 69 | $6.82 | $6.20 | $5.58 | $4.96 |
70 - 79 | $9.24 | $8.40 | $7.56 | $6.72 |
80+ | N/A | N/A | N/A | N/A |
Option 7 - US$100,000 Policy Limit | ||||
Deductible | US$100 | US$250 | US$500 | US$1,000 |
---|---|---|---|---|
Under 18 | $36 | $33 | $30 | $26 |
18 - 29 | $58 | $53 | $48 | $42 |
30 - 39 | $76 | $69 | $62 | $55 |
40 - 49 | $111 | $101 | $91 | $81 |
50 - 59 | $172 | $156 | $140 | $125 |
60 - 64 | $218 | $198 | $178 | $158 |
65 - 69 | $262 | $238 | $214 | $190 |
70+ | N/A | N/A | N/A | N/A |
Option 7 - US$100,000 Policy Limit | ||||
Deductible | US$100 | US$250 | US$500 | US$1,000 |
---|---|---|---|---|
Under 18 | $1.21 | $1.10 | $0.99 | $0.88 |
18 - 29 | $1.94 | $1.77 | $1.59 | $1.41 |
30 - 39 | $2.53 | $2.30 | $2.07 | $1.84 |
40 - 49 | $3.70 | $3.37 | $3.03 | $2.69 |
50 - 59 | $5.72 | $5.20 | $4.68 | $4.16 |
60 - 64 | $7.26 | $6.60 | $5.94 | $5.28 |
65 - 69 | $8.73 | $7.93 | $7.14 | $6.35 |
70+ | N/A | N/A | N/A | N/A |
Option 8 - US$250,000 Policy Limit | ||||
Deductible | US$100 | US$250 | US$500 | US$1,000 |
---|---|---|---|---|
Under 18 | $43 | $39 | $35 | $31 |
18 - 29 | $80 | $73 | $66 | $58 |
30 - 39 | $101 | $92 | $83 | $74 |
40 - 49 | $147 | $134 | $121 | $107 |
50 - 59 | $232 | $211 | $190 | $169 |
60 - 64 | $295 | $268 | $241 | $214 |
65 - 69 | $344 | $313 | $282 | $250 |
70+ | N/A | N/A | N/A | N/A |
Option 8 - US$250,000 Policy Limit | ||||
Deductible | US$100 | US$250 | US$500 | US$1,000 |
---|---|---|---|---|
Under 18 | $1.43 | $1.30 | $1.17 | $1.04 |
18 - 29 | $2.68 | $2.43 | $2.19 | $1.95 |
30 - 39 | $3.37 | $3.07 | $2.76 | $2.45 |
40 - 49 | $4.91 | $4.47 | $4.02 | $3.57 |
50 - 59 | $7.74 | $7.03 | $6.33 | $5.63 |
60 - 64 | $9.83 | $8.93 | $8.04 | $7.15 |
65 - 69 | $11.48 | $10.43 | $9.39 | $8.35 |
70+ | N/A | N/A | N/A | N/A |
Visitors Medical Protection™ (VMP), exclusively designed by Visitors Insurance.com - A division of Community Insurance Agency, Inc.
Visitors Medical Protection™ (VMP™) is a Short-term health insurance for Foreign Nationals Traveling Worldwide (Including USA) or U.S citizens traveling abroad. Coverage includes Emergency evacuation, repatriation, and your choice of deductibles and policy limits. Coverage can be obtained from a minimum of 5 days up to a maximum of 2 years. If the initial purchase is for one month or more, then plan is renewable (Without break in coverage) in one month increments up to a 24 continuous months
Deductible - Your choice of US$100, $250, $500, $1,000 or $2,500 deductible per insured person, per coverage period
$50 Dr Office co-pay benefits - (not subject to deductible) in PPO or out of network
Medical Maximum benefits - $25,000, $50,000, $100,000 & $250,000 ( Age 80+ $15,000 policy Maximum)
Co-insurance (After deductible paid by insured)-(See locating PPO Provider on the web sites)
Plan - A In PPO Network: The plan Pays 90% of eligible expenses up to the Policy Maximum limits. Plan - A Out of PPO Network: Pays 70% of eligible expenses up to the Policy Maximum limits.
New Improved 100% PPO Benefits!
Plan - B In PPO Network: The plan Pays 100% of eligible expenses up to the Policy Maximum limits... Plan - B Out of PPO Network: The plan Pays 70% of the next US$5,000 then 100% of eligible expenses up to the Max. limits. Outside US & Canada: 100% (No coinsurance)
Benefit Period
If a covered injury or illness requires continuing treatment after the Period of Coverage expires, the six-month Benefit Period may provide continued coverage. When the certificate expires, the Company will review the date of initial treatment for the covered injury or illness. If treatment began less than six months before the Period of Coverage expired, benefits for the covered injury or illness will continue subject to the Policy Limits and the other terms of the plan until there have been six months of continuous coverage for the covered injury or illness.
Period of Coverage - Minimum 5 days and maximum 24 consecutive months for any one policy period
Emergency Evacuation
Up to US$100,000 when coordinated through the Plan Administrator. This Plan includes coverage for Emergency Medical Evacuations to the nearest qualified medical facility; expenses for reasonable travel and accommodations resulting from the evacuation; and the cost of returning to either the country of residence or the country where the evacuation occurred.
Repatriation
Up to US$20,000 per adult, US$5,000 per child when coordinated through the Plan Administrator. If a covered illness/injury results in death, expenses for Repatriation of bodily remains or ashes to the country of residence will be covered up to a maximum of US$20,000 per adult and US$5,000 per child.
Return of Mortal Remains or Cremation/Burial
If a covered illness/injury results in death, expenses for Repatriation of bodily remains or ashes to the country of residence will be covered up to a maximum of US$20,000 per adult and US$5,000 per child; or up to $5,000 for the preparation, local burial or cremation of your mortal remains at the place of death, when coordinated through the Plan Administrator.
Emergency Reunion
Up to US$15,000 when coordinated through the Plan Administrator. This Plan provides emergency reunion coverage, up to US$15,000 for a maximum of 15 days, for the reasonable travel and lodging expenses of a relative or friend during an Emergency Medical Evacuation: either the cost of accompanying the insured during the evacuation or traveling from the country of residence to be reunited with the insured.
Local Ambulance - To Policy Maximum
Accidental Death and Dismemberment
US$25,000 principal sum. The Plan includes US$25,000 principal sum benefit for Accidental Death and Dismemberment occurring during the Period of Coverage: Accidental Loss of life – principal sum· Accidental Loss of two Members – principal sum· – Accidental Loss of one Member – 50% of principal sum. 'Member'? means hand, foot or eye. For additional information please see the Conditions of Coverage section.
Hospital Room and Board - Average semi-private room rate up to the Policy Maximum
Intensive Care - Two times the average semi-private room rate up to the Policy Maximum
Medical Expenses Usual, reasonable and customary up to the Policy Maximum
Outpatient Medical - Usual, reasonable and customary up to the Policy Maximum
Emergency Room
Charges incurred for the use of the Emergency Room due to an accident are covered up to the Policy Maximum. Charges incurred for the use of the Emergency Room for the treatment of an illness are subject to an additional (extra) US$250 deductible if treatment does not require admission to the hospital.
Dental – Injury due to an accident:
The Plan covers the cost of emergency dental treatment and dental procedures necessary to restore sound natural teeth lost or damaged in an accident up to the Policy Maximum. Sudden dental emergency: The Plan will pay up to US$100 for the necessary treatment of sudden, unexpected pain to sound natural teeth.
Returning Minor Children
To US$5,000 when coordinated through the Plan Administrator. If a covered illness/injury results in a hospitalization and/or death of the insured person, and he/she is traveling alone with child(ren) 19 or under that otherwise would be left unattended, the Plan will pay up to US$5,000 for one way economy fare to their home country, including a chaperone, if necessary, for the safety of the child(ren).
Special Coverages
Incidental Home Country Coverage
During the Period of Coverage an insured person may return to his/her country of residence for incidental visits up to a cumulative two weeks total, subject to: a. The insured person must have left their country of residence, b. The total Period of Coverage must be for a minimum of 30 days, and c. The return to the country of residence may not be taken to receive treatment for an illness or injury incurred while traveling.
End of Trip Home Country Coverage
For every five months of continuous coverage you purchase, you can purchase one additional month of home country coverage as an accommodation and supplemental travel benefit, up to a maximum of two months. To purchase this special home country extension coverage, please check the appropriate box on the Application Form, and calculate your premium to include the additional month(s).
Trip Interruption
To US$5,000. If, during a covered trip, there is an unexpected death of an immediate family member (spouse, child, parent or sibling), a break-in at the insured's principle residence, or the substantial destruction of the insured-s principal residence due to a fire or natural disaster, the Plan will pay to return the insured to the area of principal residence. The Plan will pay for a one way air or ground transportation ticket of the same class as the unused travel ticket, less the value of the unused return ticket.
Lost Luggage
To US$50 per item of personal property; maximum of US$250 per Period of Coverage. This benefit will be paid in the event that the Common Carrier permanently loses an insured person-s checked luggage while in transit. This coverage is secondary to any other available coverage reimbursement, including the Carrier-s.
Common Carrier Accidental Death
US$50,000 to Beneficiary; maximum of US$250,000 per family. If accidental death should occur while traveling on a commercial Common Carrier, US$50,000 will be paid to the designated beneficiary, to a maximum of US$250,000 per family.
Sports & Activities Coverage
VMP™ covers injuries incurred during athletic activities which are non-organized, non-contact and engaged in by the insured person solely for leisure, recreation, entertainment or fitness purposes. Some of these sports and activities include, but are not limited to, motor cycle/motorscooter riding, recreational downhill and/or cross country snow skiing, horseback riding, sub-aquatic activities (to 10m), wakeboarding, and water skiing. However, activities not covered include amateur or professional sports or other athletic activity which is organized and/or sanctioned by the National Collegiate Athletic Association (and/or any other collegiate sanctioning or government body), or the International Olympic Committee, and or Adventure Sports. Please note this is only a summary of sports and activities and exclusions. For additional information, please refer to the Certificate of Insurance.
The following hazardous activities are excluded unless the Adventure Sports Rider is purchased: abseiling, BMX, bobsleigh, bungee jumping, canyoning, caving, hang gliding, heli-skiing, high diving, horseback riding, hot air ballooning, inline skating, jet skiing, jungle zip lining, kayaking, mountain biking, paragliding, parascending, piloting a non-commercial aircraft, rappelling, rock climbing or mountaineering (ropes and guides to 4500m from ground level), scuba diving (to 50m), skydiving, snow boarding, snowmobiling, snow skiing, spelunking, surfing, trekking, whitewater rafting (to Class V), and wildlife safaris. To be covered under the Adventure Sports Rider, these adventure activities must be engaged in solely for leisure, recreation, or entertainment purposes.
Injury sustained while participating in contact sports of any kind, racing of any kind, BASE jumping, kiteboarding, mountaineering or climbing or trekking above elevation 4500 meters above ground level or without proper ropes or guides; luge, motocross, Moto-X, rodeo activity, ski jumping, whitewater rafting exceeding Class V difficulty, scuba below 50 meters; and/or adventure sports not expressly covered hereunder are excluded regardless of which plan or rider is selected.
Charges for or arising from the following services, treatments, events and/or conditions are excluded from coverage under the plan.
This web page contains only a consolidated and summary description of all current VMP™ benefits, conditions, limitations and exclusions. A certificate containing the complete Certificate Wordings with all terms, conditions and exclusions will be included with the fulfillment kit. IMG reserves the right to issue the most current Certificate Wordings for this insurance plan in the event this application and/or brochure has expired, is modified, or is replaced with a newer version. Current Certificate Wordings are available upon request.
IMPORTANT NOTICE REGARDING PATIENT PROTECTION AND AFFORDABLE CARE ACT (PPACA): This insurance is not subject to, and does not provide benefits required by, PPACA. On January 1, 2014, PPACA will require U.S. citizens and certain U.S. residents to obtain PPACA compliant insurance coverage unless they are exempt from PPACA. Penalties may be imposed on U.S. citizens and U.S. residents who are required to maintain PPACA compliant coverage but do not do so. Please note that it is solely your responsibility to determine if PPACA is applicable to you
You may seek treatment under Patriot Travel Medical Insurance Plan worldwide, including in the United States , with the hospital or doctor of your choice. When seeking treatment in the U.S., you may use the independent Preferred Provider Organization (PPO) contracted by IMG, a separately organized network (First Health Group) of approximately 500,000 physicians and 4,700 privately owned and operated hospitals. * This PPO network includes a large number of hospitals including some of the most well recognized university medical centers and transplant facilities.
Using this provider network could significantly reduce your out-of-pocket expenses.
PRECERTIFICATION: Each proposed hospital admission, inpatient or outpatient surgery, and certain other medical procedures must be Pre-certified for medical necessity. This means the insured person or their attending physician must call the number listed on the IMG identification card prior to admittance to a hospital or performance of a surgery, or medical procedure. In the case of an emergency hospital admission, the Pre-certification call must be made within 48 hours of the admission, or as soon as reasonably possible. For a complete list of procedures requiring Pre-certification, please refer to your certificate wording. If Pre-certification guidelines are not followed, eligible claims and expenses will be reduced by 50%
1980 - 2015 © 2015 | 425 Huehl Road, Suite #22A, Northbrook IL 60062, USA | Email : [email protected] | Privacy Policy
1980 - 2015 © 2015
425 Huehl Road, Suite #22A, Northbrook
IL 60062, USA
Email : [email protected]
Privacy Policy