Fixed benefits (scheduled benefits) vs comprehensive visitor insurance coverage

Travel medical insurance plans can be classified as either fixed/scheduled benefits or comprehensive plans. There are significant differences in the coverage, price, benefit limits... between the two types of plans. Listed here are details to highlight these differences.

Fixed Plans

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 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 | Inbound Guest | Inbound Immigrant | Inbound Choice | Visitors Secure | Safe Travels visitors to USA
  • Popular fixed benefit global insurance Plans
    Global Medical Silver | Reside Worldwide

Comprehensive Plans

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 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 Majestic | Liaison Continent | WorldMed | Diplomat America | Safe Travels USA | Safe Travels USA Comprehensive
  • Popular Comprehensive global insurance Plans
    Global Medical Bronze | Global Medical Gold Plus| Global Medical Gold | Global Medical Platinum| Reside Blue Worldwide| Reside Prime | Global Citizen

How these plans work?

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 Quote Comparison tool allows you to evaluate different plans based on deductible cost.