FAQ's for General Insurance Terms & Definitions : <Back to Top>
This glossary provides general descriptions of commonly used terms in health, life, disability and special risk insurance. It should be noted that there are differences between plans and that they all do not function in the same way. Please refer to individual insurance policy brochures and/or policy/certificates of insurance for complete details about each insurance plan.
AD&D / Accidental Death & Dismemberment:
A type of life insurance policy that does not require medical underwriting as the plan generally covers claims related to accidental death only -- ie; this plan will not cover death related to illness or natural causes. Dismemberment is coverage related to loss of limb, sight or hearing and thus is a "living benefit" paying a certain percentage if these losses occur due to accident. War / Terrorism riders can be added to such AD&D policies, covering the insured worldwide in all countries.
AM Best Rating:
The A.M. Best Company, is considered the most authoritative source of Insurance company information. The company provides comprehensive data to insurance professionals. Founded in 1899 by Alfred M. Best, A.M. Best is the world's oldest source of insurance company ratings and information. Its Best's Ratings are the industry's standard measure of insurer financial performance.
Please note these ratings are assigned to usually the insurance underwriters of the policies you purchase and not to the policy or the policy administrator or the insurance agent.
Following are various AM Best ratings:
A+ : Superior
A : Excellent
A- : Excellent
B++: Very Good
B+ : Very Good
B : Fair
B- : Fair
C+ : Marginal
C : Weak
C- : Weak
D : Poor
E : Under Regulatory Supervision
F : In Liquidation
S : Rating Suspended
Person(s) designated by the insured(s) that would receive the proceeds of an insurance policy upon death of the insured. You would typically assign a beneficiary at the time of completing the policy application. Many of the "travel medical insurance" plans offered not only provide medical insurance but also AD&D / Life coverage and thus may ask for a beneficiary on the application.
Amount an insurance company pays to a claimant, assignee or beneficiary when the insured suffers a covered loss, injury, accident etc.
Benefit Period is the maximum time period up to which the plan will pay benefits for any one eligible condition. Some policies have a 12 month while others have a 6 month benefit period; usually this period can extend beyond the date of policy expiration.
Broker vs Agent :
Though not an absolute separation; an agent is an insurance company's representative by way of agent-principal legal custom. The agent's primary alliance is with the insurance carrier, not the insurance buyer. A broker generally has no contractual agreements with insurance carriers and relies on common or direct methods of perfecting business transactions with insurance carriers. This can have a significant beneficial impact on insurance negotiations obtained through a broker. eGlobalHealth Insurers Agency, LLC is considered an international insurance broker -- we work for you -- not the insurance companies.
Carrier (a.k.a. Insurer):
Insurance company that actually underwrites and issues the insurance policy. The term refers to the fact that the company carries (or assumes) certain risks for the policyholder. Examples are Lloyds of London, ACE, AIG, Virginia Surety Co, etc
Certificate of Coverage:
A statement of coverage, also known as a Certificate of Insurance, that an individual receives when insured under a group contract. The certificate serves as proof of insurance, and outlines benefits and provisions. It is important to review this rather large document once received from the carrier. We recommend reviewing the Exclusions section as a starting point to understanding what the insurance contract is NOT "promising".
Request by the insured(or his/her provider) to an insurance company to pay for services obtained from a health care provider. The claim is usually submitted in a pre-determined format or a claim form. Each carrier / company has differing
COBRA (Consolidated Omnibus Budget Reconciliation):
Regulations requiring an employer who employs more than 20 people to offer continued group insurance coverage to former employees for up to 18 months. If the employee dies, the employer must offer continued group health insurance coverage to widowed spouses and dependent children for up to 36 months.
After paying the deductible, Co-insurance is the percentage or amount of covered expenses that the insured pays.
For example, an insurance policy brochure may mention that the policy will pay 80% of the first $5,000 and 100% thereafter of the usual and customary charges; In some health insurance plans, it is also called "co-payment". Co-insurance, with international short and long term medical policies, is generally NOT present with overseas expenses (outside the USA or Canada).
e.g., Suppose you buy an insurance policy with $50,000 policy maximum, $250 deductible per policy period and 80/20 co-insurance for the first $5000 and 100% coverage thereafter. Suppose you incur covered expense of $10,250. You pay FIRST the $250 deductible; then out of the remaining $10,000 covered expenses, you pay 20% of the first $5000 (i.e., $1000); the insurance policy pays for the remaining expenses (i.e. $9,000). That means, you pay $250 + $1000 = $1250 total; and insurance company pays $9000.
A vehicle or service licensed to carry passengers for hire on a regularly scheduled basis. Good examples are airplanes, trains etc. This term is used with AD&D life insurance policies.
Common carrier AD&D beneficiary:
If the insured person gets into an accident (while in plane for example), either loses hand, foot, eye etc. or dies, the insurance company will pay the benefit amt as outlined in the policy. You should specify the name of the relative to whom that money should go to (in case of death) as 'Common Carrier AD&D Beneficiary'. That is usually a close relative like son, daugther, son-in-law etc. You do NOT want to place the insured's name (policy holder) as the beneficiary as the idea is that the life insurance is to be paid to someone other than the deceased person.
A predetermined flat fee that the insured pays for healthcare services, in addition to what the insurance covers. Copay is usually not specified in percentage of the total healthcare cost. e.g., you pay $10 for a visit to the doctor's office, no matter how much the doctor's office visit charge is. There are not many international medical policies that offer copay's except for those offered by HTH Worldwide.
In most plans, insurance coverage can be purchased in the combination of monthly and/or 15 days increments to suit your needs. e.g., for a trip of 3.5 months, you can choose 3 monthly increments and one 15 days increment. Effective date for insurance coverage can be the date of departure from home country, or it can be any other later date specified by insured. It is wise to have the insurance effective date same as the date when you depart from home country for the destination and end date same as the date you arrive back in the home country so that you will be covered for any medical emergencies(for covered expenses) even during your journey.
Amount to be paid by the insured person before the insurance company begins to pay for the covered expenses. Deductible may be either per sickness/injury or once per policy period or once per year depending upon the insurance policy you purchase. You will not get receive any reimbursement later from insurance company for the deductible you pay.
e.g., Let us consider that you have purchased an insurance policy with a $50,000 policy maximum, $250 deductible per policy period and 80/20 co-insurance. Suppose you incur a covered expense of $10,250; then the insurance company will pay the covered expenses according to policy terms after you make a a payment of the deductible (i.e. $250).
Denial of claim:
Refusal by an insurance company to honor a request by an insured (or his/her healthcare provider) to pay for healthcare services. This would usually be due to pre-existing conditions.
See AD&D above.
Coverage for emergency medical evacuation to the nearest qualified medical facility or the country of residence, as determined by the insurance company; 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 occured, up to reasonable maximum limit. Depending on the provider, the evacuation definition can be to destination of choice (ie; MedjetAssist membership programs, etc)
Emergency reunion coverage for certain maximum amount, and for certain maximum duration such as 15 days, for the reasonable travel and lodging expenses of a relative or friend during an emergency medical evacuation: generally either the cost of accompanying the insured during the evacuation or traveling from the country of residence to be reunited with the insured.
Healthcare services not covered by an insured's health insurance policy. This would usually be due to pre-existing conditions or due to the limitation of the insurance plan. We highly recommend you review the Exclusions section of the certificate wording for full details of exclusions so you know what to expect of the policy.
Hazardous sports coverage:
Coverage for injuries incurred during amateur athletic activities which are non-contract and engaged in by an insured person solely for leisure, recreation, entertainment or fitness purposes.However, activities not covered include amateur or professional sports or other athletic activity which is organized and/or sanctioned, or which involves regular or scheduled practices, games or competition. Usually, the following hazardous activities can be included by optional sports rider at additional premium cost: scuba diving, mountain climbing(up to 4500 meters or where ropes or guides are normally used), jet, snow and water skiing and snowboarding, sky diving, amateur racing, piloting an aircraft, bungee jumping and spelunking. Note that each companies sports rider wordings can be vastly different from one plan to the next. We recommend contacting us for questions.
An insurance policy (life, health, or disability) that provides coverage for an individual person (and, in some cases, his/her immediate family members), as opposed to a group policy that provides coverage for a group of individuals such as coverage through an employer. Benefits, exclusions and pricing can vary widely between group and individual policies. Certain pre-existing health conditions are difficult to get covered under individual plans.
Person that is named as the "covered" individual on the insurance policy or enrolls into the insurance plan.
This benefit will be paid in the event that the common carrier permanently looses an insured person's checked luggage.This coverage is secondary to any other available coverage, including the carrier's.
Out of pocket maximum:
Maximum amount of money that the insured must pay on his own before the insurance company will pay 100% for insured's healthcare expenses.
A pre-existing condition is defined as any injury, illness, sickness, disease, or other physical, medical, mental or nervous condition, disorder or ailment that existed at the time of application or during the past duration(specified by each insurance plan) prior to the effective date of the insurance, including any subsequent, chronic or recurring complications or consequences related to thereto or arising thereffrom. We recommend viewing more details on pre-existing conditions and how domestic vs. foreign policies define pre-exisiting conditions. Note that pre-existing conditions coverage for short term plans is difficult to insure unless you are a US citizen or US resident. HTH Worldwide programs are considered the best in the industry for covering pre-ex conditions.
Maximum amount of money that the insurance company will pay for covered expenses. Policy maximum can be either per policy period, per year, life time or per injury/sickness depending upon the insurance policy you purchase.
Amount you pay to purchase any insurance plan. Premium may be paid monthly, quarterly, semi-annually, annually or for entire duration of the coverage depending upon the insurance policy you purchase.
Repatriation of remains:
If a covered illness/injury results in a death, expenses are paid for repatriation of bodily remains or ashes to the country of residence.
Return of minor children:
If an insured person is hospitalized due to a covered illness/injury and is traveling alone with child(ren) of age 19 or under that otherwise would be left unattended, the cost of one way economy fare to their home country, usually up to some reasonable maximum amount. Be sure to review the paricular policy wording as they can differ slightly.
If, during a covered trip, there is a death of an immediate family member(spouse, child, parent or sibling) or the substantial destruction of the insured's principal residence, many plans would pay the insured to return to the area of principal residence. Many plans usually pay for one way air or ground transporation ticket of the same class as the unused travel ticket, less the value of the unused return ticket. TripCancellation is a benefit paying usually 100% of non-refundable trip costs PRIOR to departing on your covered trip.
Disclaimer: Please note that we have tried to answer the questions to the best of our knowledge. We make no guarantee of the accuracy of these answers, as actual answers may change from time to time as insurance companies change their policies or because of any other reason. We will not be liable in any case, for any problem arising out of reading these questions and answers. Please use this information at your own risk. If there is discrpency between the information here and in the actual insurance policy/certificate of insurance, policy /certificate of insurance will override.
FAQ's for Travel Medical Insurance (Short - Term plans up to one year in coverage) : <Back to Top>
Q: What is trip insurance (a.k.a. trip cancellation / interruption) ?
A: Trip insurance is used to help alleviate some of the financial loss that may be incurred because your trip is interrupted, delayed, or cancelled by unforeseen events.
Q: What is travel insurance (a.k.a. travel medical or health insurance) ?
A: Travel insurance usually provides broader coverage than just trip insurance alone. In addition to providing trip insurance for trip delays, trip interruptions, trip cancellations and related problems, it may also cover additional travel-related expenses such as those incurred for medical and health emergencies that may arise during your trip.
Some plans also provide services such as travel-related advice, evacuation to your home or hospital in case of a medical emergency, emergency cash or help in the event of the loss or theft of your money, valuables or travel documents.
Q: Why would I need trip or travel insurance?
A: The outlay of money for travelling can be quite substantial. You may find yourself facing the loss of more money than you want to lose should unforeseen circumstances arise that make it necessary to cancel or interrupt your trip. Trip insurance can provide protection against such losses in many cases. Other unforeseen losses such as trip delays or baggage delays can also be covered.
Depending upon the features of the plan that you purchase, travel insurance can provide the additional assurance that expenses will be covered for medical care including hospital admission, emergency dental care, and emergency medical evacuation. Emergency cash advances, and help with retrieval of luggage or other services may also be available.
Q: What kind of coverage are included in travel insurance?
1. Coverage for vacation and trip cancellation
2. Coverage for travel interruptions, delays and cancellations
3. Coverage for missed connections
4. Coverage for medical emergency; dental emergency; other health-related expenses (often including medical evacuation coverage)
5. Coverage for expenses due to lost or delayed baggage
6. Coverage for accidental death or dismemberment (ie; life insurance for accidents only).
Q: What is coverage for medical evacuation or repatriation?
A: Medical evacuation benefits provide for transportation to a medical facility that can provide appropriate care in the event of serious injury or sickness that cannot be adequately dealt with at the location where the illness or accident took place.
Medical repatriation benefits come into play when physicians deem it medically necessary for you to be returned to your home or to a hospital or other medical facility near your home.
Q: Do I need something other than my normal health insurance plan for traveling outside the U.S.?
A: To answer this question, you need to check with your own health insurance company. Many health insurers do not cover international health coverage. A spokesperson for the Health Insurance Association of America has been quoted as saying that only about 5% of American travelers have health insurance coverage while traveling abroad. Even when traveling within the United States or to U.S. territories like Puerto Rico, Virgin Islands, etc., full coverage may not be available under many plans.
For business-related travel, you should check with your employer to find out if you are covered under a travel insurance plan for employees.
Q: Does medicare reimburse medical expenses incurred on a trip abroad?
A: Currently, Medicare does not usually reimburse for medical expenses incurred on a trip abroad.
Q: Are pre-existing conditions a problem?
A: You should be sure you understand what your policy says about pre-existing conditions beforehand if you have any medical conditions.
Unstable pre-existing conditions that may flare up during your trip are generally not covered. But, many travel medical insurance plans include a feature that will cover a sudden recurrence of a pre-existing condition. What constitutes a pre-existing condition varies from policy to policy. The Atlas plan offers "acute onset of pre-existing conditions" to those under age 70 at no additional cost. The Travel GAP Excursion plan from HTH will provide coverage for all pre-existing conditions and is the only program we are aware of that will do so, but is only available to certain US residents. Most trip cancellation insurance policies will waive exclusions (i.e. they will cover pre-existing conditions) if you buy your insurance close to the time (often within a couple of weeks) that you paid for your trip.
Again, it is recommended that you know how your particular policy handles pre-existing conditions so you know what to expect.
Q: If I go glacier skiing and hang gliding will it affect my travel coverage?
Q: If I am planning to make several trips in the next year should I buy coverage each time?
A: If you travel frequently for business or other reasons, you may be able to save money by buying a yearly multi-trip policy instead of per trip policies.
Q: What is available for our group of 6 persons traveling for two weeks to Jamaica ?
Q: How can I be sure what is covered?
A: Look carefully at the policy certificate wording of the plan in question. We would recommend your contacting us and we'd be more than happy to provide the document in question.
Q: How are the insurance companies rated?
A: The insurance companies are rated by an independent rating company A.M.Best rating. For all the plans, each insurance company's A.M. Best rating is A or better. We only offer A rated companies. Lloyds of London, for example, is rated A (Excellent).
Q: What is the definition of a Pre-Existing Medical Condition?
A: We do recommend reviewing the FAQ / Definition of Pre-existing noted in our Definitions FAQ.
Q: What is the Pre-Existing Condition Period?
A: This is the number of days that the insurance company will "look back" from the day the insurance was purchased, to see if your claim is related to a pre-existing medical condition. Each policy has a different period of "look back". Some, like HTH TravelGAP Excursion have a 0 day lookback.
Q: Can I purchase travel insurance for my friend, relative or employee online?
Q: When will my coverage become effective?
A: For Travel Medical, Multi-Trip Medical and Medical Evacuation Policies, coverage begins at 12:01AM the day of your departure. If purchased on, or after your departure date, coverage begins at 12:01AM the following day. For Flight Accident Policies, coverage becomes effective the day of your departure upon boarding your flight. Be sure to review the information on each policy in the brochure or policy wording.
Q: Can I purchase a Flight Accident or General AD&D Life Policy if I have already departed on my trip?
Q: What is the latest date I can purchase travel insurance?
A: You can purchase a policy up to the day before you travel. However we recommend that you purchase the insurance as soon as possible. Purchasing early will prevent situations where something can happen before you buy your insurance which will not be covered.
Q: I did not receive a copy of my travel insurance policy in the mail (eMail) yet. What should I do?
A: If you have received your order confirmation email you can be assured that your coverage is in full force and effect and has been since the date you purchased your policy. All of the policy and contact information is included in your email. Policies are normally sent out within 24 hours of purchase from our web site by the respective insurance company. If you have not received your policy in 14 days, please contact our office. We will verify your mailing address and request that the policy is mailed out again. NOTE: that with certain carriers, if you selected ONLINE FULFILLMENT when applying online or via paper application, the documents and ID cards will ONLY be sent to you via email.
NOTE: if you haven't received your online email confirmation yet, please allow up to one hour to receive (although usually only takes minutes). VERY IMPORTANT: PLEASE ck your SPAM / JUNK boxes as the confirmations are frequently sent to them if not recognized by your ISP.
Q: Can I cancel a policy I purchased? Do I incur a penalty?
A: Most of the companies allow you to review the policy for about 10 days following purchase (varies by company and plan). If you cancel your policy within the aloted time period, you will receive a full refund except for a small non-refundable processing fee charged by the company. Also, some companies (like MultiNational Underwriters), will refund 100% of paid premium if cancelled PRIOR to effective (start) date of the policy... if after that date and you don't have any claims, they will refund premium minus a small processing fee as mentioned.
Q: I made a mistake in entering my data while purchasing the insurance, what should I do?
A: You will need to email us at info@eGlobalHealth.com and we will have the changes made to your policy and have a corrected policy sent to you. Please send us the insured's name on the policy, policy number if able, company from which it was purchased and date purchased. We can assist you via phone at 417-882-1413 BUT will require the information in writing (email) in order to request the changes. We will then have revised / updated documents / ID cards sent to you in follow up .
Q: I have questions about Visa Medical Insurance for Schengen Visa / European Visa use ?
A: Please go to our Schengen Visa Insurance FAQ section here.
Q: I live / reside in New York State. What plans are available to me for travel medical insurance online ?
FAQ specific for Visitors to USA / Immigrants : <Back to Top> =============================================================================================
Q: What is the difference between the scheduled benefits plan and a comprehensive plan?
A: Fixed Benefits Plan (Scheduled Benefits Plan) ----
These policies are characterized by various benefit limits for each type of covered medical expense. These benefit limits typically are not the same as the policy maximum.
For example, a policy with a $50,000 maximum limit may feature upto a maximum of $2000 for surgery, upto a maximum of $500 for diagnostic services (X-rays, scans) etc. The maximum amounts for different situations are detailed in the policy brochure.
Typically you are required to pay an initial deductible for each injury or sickness and then the plan pays for the rest of the covered expenses.
Scheduled Benefits Plans have the lowest premiums, but the consumer must be aware that the benefits offered are relatively limited as compared to the Comprehensive Coverage Plans.
Comprehensive Coverage Plan ---
These policies typically do not have benefit limits based on the type of medical expense. Usually benefits for covered medical expenses go all the way upto the policy maximum (less deductible and co-insurance).
Typically for all covered medical expenses during the policy period the insured pays the deductible plus 20% of the first $5,000; and then the plan pays 100% of the eligible medical expenses upto the policy maximum. Note that for those using the plans outside the USA or Canada do not incur Coinsurance costs -- only the deductible choosen.
The details for each policy such as the policy maximum, medical expense eligibility etc. are listed in the policy brochure.
Comprehensive Coverage Plans have relatively higher premiums, but in turn offer better benefits than the Scheduled Benefits Plans.
Q: Why should I purchase insurance with an American company and not buy insurance in my native country?
A: It is advisable to have insurance from an American company while in the United States, even if the premium for these plans are more expensive. The reason is that while almost all Doctors/hospitals in the United States accept American insurance company cards, they will be reluctant to acknowledge overseas insurance coverage. The medical office can easily contact an American insurance company for clarification, while the same will not be true for an overseas insurance company.
Typically medical offices in the US will bill directly to known American insurance companies. For overseas insurance companies you most probably will have to pay the bill, and then try to get the claim reimbursed from the insurance company.
Q: When should I purchase the insurance?
A: You should purchase the insurance only after being certain of your travel plans (having the passport/visa papers and the airline tickets in order). It is safest to start the insurance coverage from the date of departure from your native country.
Q: My parents are not yet here, can I purchase insurance for them in their absence?
A: Yes. You can purchase the insurance coverage on behalf of others in their absence.
Q: What is the proof of my purchasing insurance?
A: When you purchase insurance online, you should immediately receive a confirmatory email with details of the insurance. It is prudent to keep a backup of this email. You should also receive an insurance card from the insurance company by mail (if online fulfillment was not selected). This card will have your name, policy number, group number, insurance company's contact information such as the toll-free telephone number and the address where claims should be submitted.
Q: How do I purchase the insurance? When does the insurance take effect?
A: Purchasing insurance online is very simple. All you have to do is to complete the appropriate online application form. You will receive an email acknowledgement immediately and coverage will start from the start date as indicated on the form. Within a week you will receive a package from the insurance company, which will include the insurance card and a hard copy with details regarding the insurance plan. If you had choosen online fulfillment, the ID cards and documents are sent via email only. You may request hardcopies at anytime.
Q: Can I purchase insurance for only part of the stay of my parents in the US?
A: Yes you can purchase for only partial duration of the entire stay. However the purpose of purchasing insurance is in the event of unanticipated medical emergencies. One can never be sure when such an emergency can happen. Having purchased insurance for part of their stay will not help in the event of an emergency during the uninsured period.
Q: Is the insurance plan purchased on a calendar monthly basis, or can a plan span 2 calendar months ?
A: A month is calculated as 30 continuous days from the start date requested and it can include two partial calendar months.
Q: Do I need a Social Security number to complete the form?
A: No you can complete the form using the visitors passport number.
Q: Can I go to any doctor/hospital, or am I limited to specific medical practitioners?
A: This will vary for different insurance plans. Some plans allow you to visit any medical practitioners, while others have their provider network.
In the latter case, if you visit a doctor/hospital within the provider network, the fee will be a standard rate that has been agreed between the insurance company and the provider. However, if you visit a provider outside of the insurance companies provider network, there may be a difference between the amount charged to you and the amount the insurance company considers reasonable. In this event, you will have to pay the difference between the two.
Q: How do I find out which doctors are part of a given insurance network?
A: You can also get this information by calling the toll free number of the insurance company or by visiting the insurance company web site. The toll free number should be on the insurance card that you receive on purchasing the insurance plan.
Q: Can you give an example of my medical expenses with different insurance plans?
A: This really depends on the policy. For example if your medical bill is $24,000.
After the deductible, the policy covers up to a maximum of $50,000.
Here your expense is only the first $100 deductible.
Thus your final expense is only $100 while the insurance company will cover the remaining $23,900.
Deductible is $100 with Maximum coverage of $50,000.
Policy covers 80% of first $5000 then 100% to the policy limit.
So 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.
Q: Should I pay the medical practitioner/organization initially and then get reimbursed or will the insurance company be billed directly?
A: On purchasing insurance from an American insurance firm, you will receive an insurance card with details about your insurance. When you visit the doctor/hospital, the billing office at the hospital will usually make a photo-copy of your insurance card, call the insurance company to verify your policy, and will then bill the insurance company directly. You will have to pay the deductible amount.
In some instances if the medical office has not dealt with this particular insurance company, they might insist that you pay the bill on receiving medical treatment. In this scenario, you would get a detailed bill, which should be sent to the insurance company for reimbursement. eGlobalHealth advises policy holders to visit hospitals with in the provider network wherever possible.
FAQ specific for Students / Exchange Visitors / J-1 Visas : <Back to Top> ============================================================================================
Q: What is a J-1 visa?
A: A J-1 Visa is issued for an Exchange Visitor who is participating in an established J Exchange program pre-approved by the State Department . Exchange Visitors under J-1 visas include secondary school and college students, business trainees, trainees in flight aviation programs, primary and secondary school teachers, college professors, research scholars, medical residents or interns receiving medical training in the U.S., certain specialists, international visitors, and Government visitors.
Q: What are the insurance requirements specified by the US department of state to maintain the J1 or J2 visa status?
A: The Department of State has established the following requirements for the type and amounts of coverage required to maintain J-1 or J-2 status:
1) J1 Scholar (Exchange Visitor Visa) Health Insurance policy must provide "medical benefits of at least $50,000 for Each accident or illness."
2) If a J visa holder dies in the U.S. the policy must provide at least $7,500 in repatriation benefits to send the remains to the home country.
3) The deductible should not exceed $500 per accident or illness.
4) The co-payment of medical expenses (the portion not covered by insurance that the insured pays him or herself) should be of no more than 25%.
5) If, because of a serious illness or injury, you must be evacuated on the advice of a doctor, the policy must pay up to $10,000 for the expenses of your travel.
6) J1 Scholar (Exchange Visitor Visa) Health Insurance policy may establish a waiting period before it covers pre-existing conditions (that is, health problems you had before you bought the insurance), as long as the waiting period is reasonable by current standards in the insurance business.
7) If you elect to satisfy the insurance requirement through a policy issued in your home country, the policy must be backed by the full faith and credit of your government. Otherwise, the company providing the insurance must meet minimum rating requirements established by Department of State (an A.M. Best rating of "A-" or better, an Insurance Solvency International, Ltd. (ISI) rating of "A-1" or better, a Standard & Poor's Claims-Paying Ability rating of "A-" or better, or a Weiss Research, Inc. rating of "B+" or better).
8) These requirements apply to both J-1 students and scholars and to their J-2 dependent spouses and children.
Q: What will happen if I do not comply with the insurance requirement?
A: The new regulations require your J program sponsor to terminate your status in the U.S. if you willfully fail to comply with the insurance requirement.
Q: Who is a "visiting foreign scholar?"
A: A visiting foreign scholar is a person who comes to the university temporarily, mainly to teach, do research, or both. The broad term "visiting foreign scholar" encompasses, for example, Fulbright scholars who come to teach, post doctoral research fellows, and visiting professors. Some foreign scholars are at the university for only a few days; others remain for three years. Visiting foreign scholars come to the University for academic enterprises, not for non-academic employment.
Visiting foreign scholars normally hold a visa known as a J-1 or exchange-visitor visa. Some people who acquire J-1 status are subject to what is known as the two-year, home-country physical presence requirement. Dependents (spouses and children below the age of 21 of J1 visa holder) are in a status called J-2.
A: Foreign students studying in the U.S. under age 55 who have a valid visa status in the U.S. and are registered and engaged in academic activities at a US school, college or university, OR
U.S. registered students studying outside the U.S. under age 55 who are registered with a U.S. school, college or university and engaged in academic activities abroad (excluding home country).
Q: Are dependents of student's eligible for coverage?
A: Yes. Dependents (spouse and/or child under age 18) of enrolled students may apply for insurance with the student, or within 31 days of birth, legal adoption, marriage or arrival in country of study. If your dependents are not eligible for Student insurance, they may enroll in one of our other plans for people outside their home country.
Q: May I purchase Student insurance if I am already studying outside my home country?
A: Yes. You may purchase Student insurance regardless of how long you have been studying outside your home country, as long as you fulfill the eligibility requirements described earlier.
Q: Will proof of insurance be mailed or emailed to me?
A: Yes. After your enrollment is processed, your Certificate of Insurance, ID card, etc will be mailed to the mailing address you specified while enrolling and / or emailed to you -- depending on how you request in the application.
Q: May I renew my policy if I extend my stay in my country of study?
A: Yes, as long as you fulfill one of the eligibility requirements described above. Send the appropriate premium with another completed enrollment form within 30 days following the end of the first coverage period to avoid a lapse in coverage. Alternately, you may complete and return a renewal form that will be mailed to you one month prior to your current certificate expiration date.
Q: May I go to any doctor or hospital, or must I use my school's Student Health Center or a preferred provider from HTH's network?
A: For Foreign Students Studying in the U.S.: You may choose any of these. If you choose choose to be seen at your Student Health Center when it is equipped to treat your condition, you will receive the in-network benefit and also your deductible for such incidents will be waived. For other incidents, if you use a doctor or hospital in HTH's large preferred provider network, you will pay a lower deductible and reach your plan limits more slowly than if you go outside the network.
For US Registered Students Studying Abroad: Outside the U.S., refer to the international provider networks listing. You may choose to be seen at the Student Health Center or at another doctor or hospital and receive the in-network benefit. If you go to the Student Health center when it is equipped to treat your condition, your deductible for such incidents will be waived. You may also use any doctor or hospital of your choice. The Emergency Assistance Company can help you locate a doctor or hospital in the country where you are studying.
Q: Is a network provider located in my area?
Q: How will I receive care at In-Network level if there are no Network providers in my area?
A: If there is no HTH provider qualified to provide the care needed within a 50 mile radius of your residence, you may choose to be treated outside the Network by a non-HTH provider. In this situation, benefits will be paid at in-network level.
A: Yes. Global Student USA covers the Insured worldwide, except in your country of permanent residence, as long as you fulfill one of the eligibility requirements described above.