Coinsurance & Deductible - How a Plan Works?

Thank you for contacting us at American Visitor Insurance for your visitor medical insurance needs!.

The insurance plans that we have can be used in any city and state in the United States.

Each plan have different provider network as the company is associated with these networks.

The insurance plans that we have recommended to you are classified as fixed and comprehensive. Here are the details:

Travel Medical USA Visitor Choice

Patriot America Lite

Visit USA HealthCare

To understand the difference between fixed and comprehensive plans, please see the below link

Fixed Vs Comprehensive

For comprehensive visitors insurance plans, there is a co-insurance factor that you need to consider. For instance, Patriot America Lite has a 10% co-insurance applicable on the total medical expense in case an expense is incurred within the network, where as for out of network the co-insurance is 20%.

This is applicable only for the first $5000 of the expense after which there is no co-insurance applicable. Co-insurance is the amount you need to pay after the deductible for the expense incurred.

Please let us know in case of any further questions.

Thank you for contacting us at American Visitor Insurance for your visitor medical insurance needs!.

This is what we mean to say to the customers when it comes to the co-insurance.

There are 2 kinds of plans "Fixed" and "Comprehensive". The wording that you are seeing are for the Fixed plans which show up in yellow in the summary page. There is no co insurance for the fixed plans.

A fixed plan pays a set amount (variable by company and maximum amount) for each medical expense. If the customer is charged more than this amount, then they must pay the difference. All of that, is of course, after the deductible is met. Please understand the difference between Fixed and Comprehensive plans.

Please let us know if you need anything further.

Thank you for contacting us at American Visitor Insurance for your visitor medical insurance needs!.

It depends on the type of plan you buy. If it a "Per policy period" plan then you pay the deductible only once in the plan maximum lifetime.

If the plan is : Per injury/sickness" plan, then you will have to pay the deductible every time you visit the provider for each and every injury/sickness incident.

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

Thank you for contacting us at American Visitor Insurance for your visitor medical insurance needs!.

Yes. The 20% co-insurance depends on the insurance plan you purchase.

In some plans, there is a 10% Co-insurance and in some others there is a 20% co-insurance. In some plans the entire 20% co-insurance is waived if you use a facility within the PPO network, and is charged only when you use a facility that is outside the PPO network. Details of the co-insurance can be reviewed by using our quote comparison tool.

This is applicable for the first $5,000 of the expense incurred by you.

For Example:
If you incur an expense of $3,000, this is how the co-insurance and deductible apply:

Expense = $3,000

Deductible(This is the amount that you pay) = $250

Final Expense amount that the Insurance Company will pay = $3,000 - $250 = $2,750.
Now, the 20% co- insurance will be applied on $2,750 when you receive treatment outside of PPO. So, 20% of $2,750 is 550.

Final expense that Insurance company pays = $2,200

The amount that you pay = $800

The PPO network links for both the plans are as below:

Atlas America Provider Network

Patriot America Provider Network

You can also buy Atlas America Insurance and Patriot America Insurance online.

Please let us know in case you have any questions

Thank you for contacting us at American Visitor Insurance for your visitor medical insurance needs!.

Deductible is the amount that will be deducted from the medical expense incurred when you come across an injury or sickness. From the total amount of the expense you pay the deductible and the rest of the expense will be taken care of by the insurance company.

For ex: If your policy has a deductible of $100 . Then, if you come across an injury or sickness and the bill or the expense is $2000 for example.

Then you will have to pay the deductible $100, then the remaining expense is $1900 will be paid by the insurance company.

If there is a co-insurance amount associated with your plan, then this is how it works:

From the $1900 of expense that the insurance company has to pay, if the coinsurance percentage is 80%, then 80% of $1900 will be paid by the insurance company and remaining 20% has to be paid by the insured (which is you).

Let us know if you need any further clarification.