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Types of visitor insurance, Difference between Fixed and Comprehensive 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.

Feature Fixed benefit plans Comprehensive plans
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.
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)
Cost Cheapest options with basic coverage Expensive but exhaustive coverage.
Coverage Clearly defined coverage limits. More affordable when compared to comprehensive plans, but with correspondingly less coverage. 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.
Deductibles For fixed benefit plans deductibles can be per period of coverage, or per injury/sickness basis Comprehensive insurance plans typically include deductibles, requiring the insured individual to pay a specified amount out of pocket before the insurance coverage begins.
Policy maximum The policy maximum, like $50K or $100K, is the total limit for all scheduled benefits. It doesn't guarantee full coverage for all medical expenses up to that limit. Get the coverage up to the chosen policy maximum.
Out-of-Pocket Expenses Policyholders may face higher out-of-pocket expenses for services not covered or not fully covered by the plan. The fixed benefits may not cover the entire cost of medical care. Comprehensive plans often involve cost-sharing mechanisms such as deductibles, co-pays, and co-insurance. Policyholders share the costs with the insurance company, and there may be an annual out-of-pocket maximum for added protection.
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. 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.
How does the plan 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. The insured has to pay the deductible and an additional 20% co insurance for the first $5K of the medical expense incurred. After $5K, 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 $5K and 100% after that.
Trip expenses Trip Expenses are not covered. Include extensive travel coverage’s, such as trip cancellation, trip interruption, and baggage protection. These plans offer more comprehensive protection for various travel-related risks.
Pre-existing condition Fixed benefit plans may have limitations or exclusions for pre-existing conditions, potentially excluding coverage or imposing waiting periods. Comprehensive benefit plans typically cover pre-existing conditions, but there may be waiting periods before such coverage takes effect.
Benefits Fixed benefits plan pays benefits like set of maximum amount.
For example: Surgery up to $3k, Local Ambulance up to $300 and Hospital emergency room up to $350 etc...
Comprehensive plans pays up to the maximum limit
For example: Hospital emergency room: subject to a $250 deductible for each emergency room visit for treatment that does not result in direct inpatient hospital admission. Up to the maximum limit.
Popular insurance plans Visitors Care | Visitors Secure | Safe Travels Elite | Safe Travels Advantage Insurance | INF Premier Plan Insurance | Atlas America | Patriot America Lite | Patriot America Plus | Patriot Platinum | Travel Medical Basic | WorldMed | Diplomat America | Safe Travels USA | Safe Travels USA Comprehensive | INF Elite Plan Insurance | INF Safe traveler USA Insurance | Travel Medical Choice | Atlas Premium | Visitors Protect

What is the difference between comprehensive and fixed travel insurance?

There are significant differences between comprehensive vs limited travel 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

Difference between comprehensive and fixed travel insurance
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.

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
Total: $24,000 $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.

USA travel insurance coverage highlights

What does Travel Medical Insurance cover? What is travel Insurance USA?

Some of the other important travel health insurance for USA benefits are listed below. Travelers can compare visitor travel insurance to review specific coverage details offered by the different companies and insurance plans.

Medical coverage for accidents and emergency medical ailments:
The high cost of healthcare in the US makes it imperative for travelers to have good travel health insurance while traveling outside ones home country. The best travel insurance medical maximum coverage varies based on the travel insurance plan chosen, however travelers have the option of getting coverage up to $1,000,000. The available medical maximum coverage however decreases for travelers over 70 years.

Doctor visit
This allows travelers to visit Doctors for sudden unanticipated medical ailments (continuing treatment for pre-existing ailments and preventive care are not covered). The Co-pay and deductible will vary depending on the travel insurance plan chosen, travelers do have the option of No Co-pay and $0 deductible.

Pharmacy drugs
Doctor prescribed eligible pharmacy drugs are covered up to $50,000, but this varies from plan to plan.

Surgery Charges
Emergency surgery treatment will be covered. The maximum available amount for surgery is typically $50,000, but this varies from plan to plan.

Medical Evacuation
The best travel insurance provides coverage for medical evacuation up to $1,000,000 if the traveler has to be evacuated to get access to proper medical treatment in the event of a medical emergency.

Repatriation of Remains
The repatriation of remains benefit pays for the repatriation expenses back to the home country in the event of death of the traveler for any reason. While this depends on the travel insurance plan chosen, one can get repatriation coverage up to $50,000.

Dental Coverage
Emergency dental coverage up to $300 is available for acute onset of pain to natural teeth.

Given all these benefits, it is important that international travelers buy the best travel insurance given the relative low cost of travel insurance when compared to the cost of healthcare. This is particularly important for Seniors citizens, as older travelers are most vulnerable and likely to need the benefits offered by the best USA travel insurance plans.

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Why You Need Visitors Insurance in the USA

  • The U.S. healthcare system is known for its high costs, making it essential for visitors to have insurance to avoid out-of-pocket expenses.
  • Coverage ensures peace of mind, especially in case of unexpected accidents or medical emergencies.

Visitors Insurance Coverage for the USA – FAQ's

01. what is a fixed benefit plan?

Fixed benefits plans have specific benefit limits forid="forum different covered medical expenses. These benefit limits are not the same as the plan medical maximum.

02. what is comprehensive health insurance?

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).

03. Can I buy visitors insurance after arriving in the USA?

Yes, you can buy visitors insurance after arriving in the USA. However, it is generally recommended to purchase insurance before your trip to ensure you are covered from the moment you enter the country. Some policies may have waiting periods for certain benefits or exclusions for pre-existing conditions, so buying coverage ahead of time ensures you are protected from any immediate medical or travel-related incidents upon arrival.

04. Is visitor insurance mandatory?

No, visitor insurance is not mandatory for most travelers entering the USA. However, it is highly recommended due to the high cost of healthcare in the country. Some situations, such as specific visa types (like J-1 visas for exchange visitors), may require insurance. Even if it’s not legally required, having visitors insurance provides financial protection in case of medical emergencies, accidents, or unexpected travel issues during your stay in the U.S.

05. How do I file a claim with my visitors insurance provider?

To file a claim with your visitors insurance provider, follow these general steps

  • Contact the Insurance Provider: Reach out to your insurance company’s customer service or claims department as soon as the incident occurs to notify them of the claim.
  • Fill Out a Claim Form: Obtain and complete the claim form, which is usually available on the insurance provider’s website or sent to you by email.
  • Provide Necessary Documentation:
  • Medical Claims: Submit medical records, bills, and receipts from healthcare providers.
  • Trip-Related Claims: Include receipts, proof of travel (flight tickets, etc.), and any relevant documents like a police report for lost baggage or a doctor’s note for trip cancellations due to medical reasons.
  • Submit the Claim: Send the completed claim form along with all supporting documents to the insurance provider, either online, via email, or by mail.
  • Follow Up: Keep track of your claim status by checking in with your insurance provider to ensure it’s being processed. Some claims may take time depending on the complexity and the documentation provided.

Always review your policy’s terms for specific claim requirements and deadlines, as they may vary by provider.

06. How much is visitor insurance in USA?

The cost of the travel insurance for US visitors is based on the age of the insured, the maximum of the policy, the deductible on the policy, and the number of days of the trip. With visitor insurance, you can choose a fixed or a comprehensive plan. A fixed or limited benefit plan is generally much cheaper than a comprehensive plan because the plan has limits on what it pays out for each medical expense. The comprehensive plan is more expensive because it offers more complete coverage of medical expenses to the medical maximum.

07. Do tourists need travel insurance?

Often health insurance from a home country will not cover you while you are traveling in a different country. If you are in a country with high medical costs such as the US, Canada, or Japan, you should consider purchasing international travel insurance in case you should need any medical care. The travel insurance for tourists will help defray costs and also often has many travel benefits (trip delay, trip interruption, baggage loss) that will also assist a traveler in getting back on track with their trip.

08. What is Visitor Insurance USA?

Visitor insurance USA is travel insurance that can be purchased for travel in the US and for travel outside one’s home country. Visitors Insurance provides coverage for unexpected health care expenses due to accident or sickness while traveling. Travelers can compare and buy the best US travel insurance plans at American Visitor Insurance.

Travel insurance for acute onset of pre-existing conditions

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

Hi,

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?

Thank you,
Kim
Dear 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.

Sincerely,
www.americanvisitorinsurance.com
(877) 340 7910

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You can find reliable US insurance providers like International Medical Group(IMG), Seven Corners, WorldTrips, Global Underwriters, Travel Insure, GeoBlue, HTH Worldwide and INF insurance.

Which are the best visitors insurance companies in USA?

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