Visitor insurance types - Comprehensive vs Fixed benefit coverage

Visitor medical insurance plans can be classified as either fixed (limited) benefits or comprehensive plans. There are significant differences in the coverage, price, benefit limits... between the two types of Visitor Insurance. Listed here are details to highlight the differences between Fixed benefit and Comprehensive visitor medical insurance.

Types of visitor insurance, Difference between US travel health insurance

Fixed benefit insurance

Affordable but limited coverage
  • Definition
    Fixed benefits plans have specific benefit limits for different covered medical expenses.
    These benefit limits are not the same as the plan medical maximum.
  • Coverage details
    Clearly defined coverage limits. More affordable when compared to comprehensive plans, but with correspondingly less coverage. This works for small ailments, but can be inadequate for major expenses.
  • Cost of fixed benefit US travel insurance
    Cheapest options in the market definitely more affordable.
  • How do fixed benefits plans work?
    The customer is required to pay an initial deductible for each injury or sickness and the plan pays for the rest of the covered expenses.
  • Preferred provider organization (PPO) network:
    You can visit any hospital or doctor, since there will be no discounted rates, the plan will only pay up to the clearly defined limits for different expenses.
  • Trip expenses
    Usually not covered
  • Any limitation on hospitals and doctors?
    No limitation, you can go to any doctor or hospital, however the plan will have clearly defined payments for different treatments.
  • Popular fixed benefit visitor insurance plans
    Visitors Care | Inbound USA Choice | Inbound USA Basic | Inbound USA Elite | Visitors Secure | Safe Travels visitors to USA | INF Premier Plan Insurance | INF Standard Plan Insurance | INF Choice Plan Insurance
  • Popular fixed benefit global insurance plans
    Global Medical Silver

Comprehensive insurance

Expensive but exhaustive coverage
  • Definition
    These plans do not have benefit limits based on the type of medical expense. Benefits for covered medical expenses go all the way up to the plan maximum (less deductible and co-insurance)
  • Coverage details
    The plan pays for all expenses after the deductible and co-insurance component. These plans are recommended given the high costs of health care in the US. These plans are worth every penny of premium paid in the event of catastrophic medical emergencies.
  • Cost of comprehensive US travel insurance
    More expensive.
  • How do comprehensive plans work?
    The insured has to pay the deductible and an additional 20% co insurance for the first $5000 of the medical expense incurred. After $5000, the plan pays 100% of the eligible medical expenses up to the plan maximum. There are other variances of the co-insurance, some where the plan pays 90% up to first $5,000 and 100% after that.
  • Preferred provider organization (PPO) network:
    Most comprehensive plans have PPO networks, which means cashless service (direct billing as opposed to reimbursement basis), more discounted rates, as well as easier acceptance within the PPO network.
  • Trip expenses
    Covers trip cancellation, baggage loss, baggage delay...
  • Any limitation on hospitals and doctors?
    It is recommended that you visit Doctors/Hospitals within the PPO network, even though you can go outside the network also. Within PPO network entitles you to discounted rates and direct billing.
  • Popular Comprehensive visitor insurance plans
    Atlas America | Patriot America | Patriot America Plus | Patriot Platinum | Liaison Travel Elite | Liaison Travel Economy | WorldMed | Diplomat America | Safe Travels USA | Safe Travels USA Comprehensive | INF Elite Network Insurance | INF traveler USA Insurance | INF Advantage Plan Insurance
  • Popular Comprehensive global insurance plans
    Global Medical Bronze | Global Medical Gold Plus| Global Medical Gold | Global Medical Platinum| Global Citizen

What is the difference between comprehensive and limited benefit visitor medical insurance?

There are significant differences between comprehensive and limited benefit visitors insurance. The limited coverage or fixed coverage visitors insurance have a specific fixed coverage amount for each medical situation as indicated in the policy brochure. Even though the overall maximum medical coverage might be a higher limit, it is a specific fixed limited for each situation which is the capping for that situation.
As opposed to this the comprehensive visitor insurance plans do not have any ‘sub-limits’ within the medical maximum coverage. Given this flexibility and comprehensive nature of the coverage, the comprehensive coverage visitor insurance plans are more expensive when compared to fixed coverage visitor insurance.

What are the cheapest types of visitor insurance?

The cheapest visitor travel insurance is with fixed benefits or limited coverage visitor insurance. However, the cheapest visitor insurance has significant limitation in the coverage and travelers can find this too constraining for serious medical ailments involving hospitalization. Given that travelers are buying visitor insurance not for small ailments but rather for more serious situations involving hospitalization, comprehensive visitors insurance is recommended especially while traveling to the US.
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Explain the difference between Fixed benefit (Scheduled benefit) and Comprehensive insurance coverage

Let us take an example: The medical bill is $24,000; Deductible is $100 and choosen Policy Maximum is $50,000

Fixed benefit policy

After deductible, the plan covers set amount up to a maximum of $50,000. You must pay the first $100 (deductible). After that, the insurance company only pays the fixed amount for the policy, In this hypothetical case mentioned below in the table, the insured has to pay $15,900 because of the difference between the fixed amount the insurance pays and the actual billed amounts. Note that if you purchase a policy with a higher maximum, all the fixed amounts go up, so you can get better coverage of a medical bill. However, you may not get 100% coverage of ANY medical bill with a fixed plan.

Comprehensive plan

Deductible is $100 with maximum coverage of $50,000. Policy covers 80% of first $5000 then 100% to the policy limit. In this case your expense is the first $100 deductible followed by 20% of first $5000, which is $1000. Thus your final expense is $1100 while the insurance company will cover the remaining $22,900.
The above scenario is explained in this table:
Benefit Expense Fixed plan pays Customer owes Comprehensive plan pays Customer owes
Room rent $6,000 for 3 days $4,200 for 3 days $1,800 $5,000 $1,000 (20% of first $5000)
Surgery $16,000 $3,300 $12,700 $16,000 $0
Prescription drugs $600 $150 $450 $600 $0
X Ray $1,400 $450 $950 $1,400 $0
Total $24000 $8,100 $15,900 $23,000 $1,000
Our Compare visitor medical insurance tool allows you to evaluate differences between Limited benefit and Comprehensive travel insurance plans based on deductible cost.

Select the visitor insurance plans that you want to compare

F Fixed Benefits Plans      C Comprehensive Plans

Popular traveler’s queries about fixed benefit vs comprehensive visitors insurance

Factors that determine the insurance cost

questionHello,
I’m visiting the US for 6 months, I want to buy visitor medical insurance, please can you help me in getting quotes for insurance plans and how much it would cost?
Thanks,
Kim

questionDear Kim

Before you get quotes for the insurance plans, there are some important aspects of insurance that determine the coverage and cost of an insurance plan which are as follows:
  • Visitor insurance is broadly classified as Fixed and Comprehensive plans. Fixed benefit or Scheduled benefits offer limited coverage and have specific benefit limits on medical expenses. These plans are cheaper when compared to comprehensive plans which do not have limits and cover expenses up to the plan maximum. Review the differences between fixed and comprehensive plans to know more.
  • The next factor is the plan maximum, this is medical maximum coverage that a plan will offer to pay your medical expenses. The higher the plan maximum, the higher will be the premium.
  • A Deductible is the amount that the insured needs to pay before the plan starts paying. The higher the deductible, the lower will be the premium.
  • Coinsurance is the percentage of amount the plan will pay after the deductible and the remaining you will have to pay. Only a few plans give you the option of choosing the coinsurance.
  • Travelers age and the travel dates will also affect the premium of the plan. Older travellers have to pay more and the coverage available may be limited.
  • Some other important factors like special coverage for pre-existing ailments, maternity, adventure sports… also impact the price of the insurance.
  • If you need extra coverage you may have to pay more. For some plans these extra benefits are optional and may be expensive than the ones that do not offer these benefits.
You can review more factors that determine the cost of an insurance plan here:
Factors to consider

To find the best insurance plans please use our quick “find the best coverage” tool:
Find the best coverage

Please let us know if we can help you in any further.

Regards,
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