Safe Travels for Visitors to the USA - Low Cost insurance with limited benefits
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  • Community Insurance Agency, Inc., Insurance Services, Northbrook, IL
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Safe Travels for visitors to the USA   - Low-Cost insurance with limited benefits

Safe Travels for visitors to the USA is a low cost Scheduled Benefits Accident and Sickness Medical Coverage for persons traveling to North America from other countries. Coverage can be purchased online for a minimum of five (5) days up to a maximum of one (1) year. This policy has a one-time renewable feature that must be completed PRIOR to expiry of the exiting policy. We accept the credit Card. Policy documents and ID cards are issued online immediately upon payment of the premium. Coverage can be applied for online.

About The Safe Travels For Visitors To The USA Plan

There are five plan options that are available: Basic, Silver, Gold, Platinum and Diamond. If you get into an accident or just get hurt, you can get medical care and our Safe Travels for visitors to the USA . Coverage includes Inpatient care, Outpatient Care, Ambulance or doctor's visits. It covers Acute Onset of a Pre existing condition. No matter which plan you choose, travel medical insurance is a must when planning a trip out of your home country.

  • Foreign Nationals (Parents and relatives) Visiting to USA
  • Acute Onset of Pre-existing Condition(s) for Medical Expense Benefits;
  • Available for ages 14 days to 89
  • Deductible Options: $0, $50, $100 or $200
  • Policy Maximums - $50,000 to $175,000 Max per Injury/Sickness
  • Benefits options: Basic, Silver, Gold, Platinum & Diamond age 50 to 89
  • A minimum period of 5 days up to a maximum period of 364 days
  • One-time renewable feature

For visitors to the USA
5 days up to maximum period of 364 days

Brochure, Application Rates Benefits-PDF Claim forms Renewal links Get Quote & Apply Online

  • Benefits
    MEDICAL SCHEDULE OF BENEFITS
    AGE 14 DAYS TO
    AGE 69
    BASIC SILVER GOLD PLATINUM DIAMOND AGE 50 to 89
    Policy Maximums $50,000 Max per Injury/Sickness $75,000 Max per Injury/Sickness $100,000 Max per Injury/Sickness $175,000 Max per Injury/Sickness $50,000 Annual Policy Max
    Deductible options(per Incidence)
    $0, $50 $100
    $100 or $200
    INPATIENT
    Hospital Room and Board Charges: Up to $1400/day,30 day max Up to $1750/day,30 day max Up to $2000/day,30 day max Up to $2700/day,30 day max Up to $1500 /day,15 day max
    Hospital Intensive Care Unit Additional $700/day, 8 day Max Additional $800/day, 8 day Max Additional $900/day, 8 day Max Additional $1150/day, 10 day Max Additional $500/day, 8 day Max
    Surgical Treatment Up to $3500 Up to $4750 Up to $6000 Up to $7500 Up to $3500
    Anesthetist Up to $850 Up to $1200 Up to $1400 Up to $1800 Up to $850
    Assistant Surgeon Up to $850 Up to $1200 Up to $1400 Up to $1800 Up to $850
    Physician's Non-Surgical Visits Up to $55/visit, 1/day, 30 visits Max Up to $70/visit, 1/day, 30 visits Max Up to $85/visit, 1/day, 30 visits Max Up to $115/visit, 1/day, 30 visits Max Up to $55/visit, 1/day, 30 visits Max
    A Consulting Physician, when requested by attending Physician Up to $450 Up to $550 Up to $550 Up to $700 Up to $450
    Private Duty Nurse Up to $450 Up to $550 Up to $550 Up to $700 Up to $450
    Pre-Admission Tests w/in 7 days before admission Up to $1100 Up to $1100 Up to $1200 Up to $1500 Up to $1100
    OUTPATIENT
    Surgical Treatment Up to $3500 Up to $4750 Up to $6000 Up to $7500 Up to $3000
    Anesthetist Up to $850 Up to $1200 Up to $1400 Up to $1800 Up to $700
    Assistant Surgeon Up to $850 Up to $1200 Up to $1400 Up to $1800 Up to $700
    Physician's Visits/ Urgent Care Up to $55/visit, 1/day, 30 visits Max Up to $70/visit, 1/day, 30 visits Max Up to $85/visit, 1/day, 30 visits Max Up to $115/visit, 1/day, 30 visits Max Up to $55/visit, 1/day, 30 visits Max
    Diagnostic X-rays & Lab Services
    Scans, PET scan or MRI
    $450 Up to $650 Scan PET scan or MRI $475 $875 scan, PET scan or MRI $500 Up to $1050 scan, PET scan or MRI $675 Up to $1300 Scan, PET scan or MRI $450 Up to $650 Scan PET scan or MRI
    Hospital Emergency Room (all expenses incurred therein) Up to $350 Up to $450 Up to $550 Up to $800 Up to $350
    Prescription Drugs (outpatient) Per Sickness/Injury Up to $100 Up to $125 Up to $150 Up to $200 Up to $90
    Outpatient Surgical Facility Up to $1000 Up to $1150 Up to $1275 Up to $1400 Up to $1000
    Physical Therapy Up to $40/visit, 1/day, 12 visits Max Up to $40/visit, 1/day, 12 visits Max Up to $40/visit, 1/day, 12 visits Max Up to $60/visit, 1/day, 12 visits Max Up to $40/visit, 1/day, 12 visits Max
    OTHER TREATMENT AND SERVICES
    Ambulance Services Up to $500 Up to $500 Up to $500 Up to $750 Up to $500
    Initial Orthopedic Prosthesis/brace Up to $1100 Up to $1225 Up to $1350 Up to $1750 Up to $1100
    Chemotherapy &/ or radiation therapy Up to $1100 Up to $1225 Up to $1350 Up to $1750 Up to $1100
    Dental Treatment for Injury to Sound, Natural Teeth Up to $600 Up to $600 Up to $600 Up to $600 Up to $600
    Mental & Nervous Disorder & Substance Abuse Up to $5000 Up to $5000 Up to $5000 Up to $20,000 30 days Max Up to $5000
    Emergency Medical Evacuation* $100,000 $100,000 Unlimited Unlimited $50,000
    Repatriation of Remains* $7,500 $10,000 $20,000 $25,000 $7,500
    Natural Disaster, Political Evacuation & Repatriation* Up to $500 Up to $1,000 Up to $1,500 Up to $2,000 Up to $500
    Return of Minor Children or Grand-Children* Up to $5,000 Up to $7,500 Up to $7,500 Up to $10,000 Up to $5,000
    Felonious Assault AD&D* Up to $5,000 Up to $7,500 Up to $7,500 Up to $10,000 Up to $5,000
    Return to Home Coverage Up to 30 days per 12 months Max $2000 Up to 60 days per 12 months Max $2500 Up to 60 days per 12 months Max $5000 Up to 90 days per 12 months Max $7,500 N/A
    AD&D Principal Sum* $25,000 Common Carrier $35,000 Common Carrier $35,000 Common Carrier $35,000 Common Carrier N/A
    Acute Onset of Pre-existing Condition(s) per policy period for Medical Expense Benefits; subject to the sub limits for each benefit shown above. Note: $10,000 per policy period for Emergency Medical Repatriation to home country. $25,000 per policy period (subject to the sub limits above $50,000 per policy period (subject to the sub-limits above $50,000 per policy period (subject to the sub-limits above $50,000 per policy period (subject to the sub-limits above $25,000 per policy period (subject to the sub limits above.
    Travel Assistance by GBG Assist Included Included Included Included Included
  • Plan Description
    1. Medical Insurance
    2. AD&D and Travel Related Benefits for persons traveling to the USA
    3. Coverage 5 days up to maximum period of 364 days
    4. Renewable up to 2 years
    ELIGIBILITY

    Safe Travels For Visitors To The USA plan provides Accident and Sickness Medical, Accidental Death and Dismemberment, Emergency Medical Evacuation, Emergency Reunion, Political Evacuation, Repatriation, and Travel Assistance to individuals while visiting the United States. It can provide coverage for you, your spouse/domestic partner/traveling companion and dependent children/grandchildren up to age 21 years. Coverage for Travel with Trip Cancellation is available through the Safe Travel USA or Safe Travel Care 360. Customized coverage for groups of 5 or more people is available under the Safe Travels for Groups

    EFFECTIVE DATE

    Effective Date under the program shall become effective at 12:01 AM North American Central Time on the latest of the following dates:

    1. your departure from your Home Country; or
    2. The date the application and premium are received by the Administrator; or
    3. The date the application and premium are accepted by the Administrator; or
    4. The date requested on the application.
    EXPIRATION DATE

    The coverage provided with respect to the Named Insured shall terminate at 12:01 AM North American Central Time on the earliest of the following dates:

    1. The date shown on the insurance confirmation card, for which the premium is paid; or
    2. The date the Insured Person returns to his Home Country; or
    3. Three hundred and sixty four (364) days after the Insured Person's original effective date; or
    4. The date the Insured Person becomes a United States citizen;
  • Rates

    $100 deductible per person per Injury/Sickness


    BASIC - $50,000 per Injury/Sickness
    AGE Monthly Rates Daily
    14 Days -18 Years $29.50 $1.00
    19-29 $24.00 $0.80
    30-39 $27.00 $0.90
    40-49 $29.50 $1.00
    50-59 $40.00 $1.30
    60-69 $44.00 $1.50
    SILVER - $75,000 per Injury/Sickness
    AGE Monthly Rates Daily
    14 Days -18 Years $34.00 $1.15
    19-29 $28.50 $0.95
    30-39 $31.50 $1.05
    40-49 $34.00 $1.15
    50-59 $47.50 $1.55
    60-69 $53.50 $1.80

    $100 deductible per person per Injury/Sickness


    GOLD - $100,000 per Injury/Sickness
    AGE Monthly Rates Daily
    14 Days -18 Years $39.00 $1.30
    19-29 $32.50 $1.05
    30-39 $36.50 $1.20
    40-49 $39.00 $1.30
    50-59 $56.00 $1.85
    60-69 $61.50 $2.05
    PLATINUM - $175,000 per Injury/Sickness
    AGE Monthly Rates Daily
    14 Days -18 Years $52.00 $1.70
    19-29 $42.50 $1.40
    30-39 $47.50 $1.55
    40-49 $52.00 $1.70
    50-59 $72.00 $2.40
    60-69 $80.50 $2.70

    $50 deductible per person per Injury/Sickness.


    BASIC - $50,000 per Injury/Sickness
    AGE Monthly Rates Daily
    14 Days -18 Years $31.50 $1.05
    19-29 $26.00 $0.85
    30-39 $29.50 $1.00
    40-49 $31.50 $1.05
    50-59 $43.50 $1.45
    60-69 $47.50 $1.60
    SILVER - $75,000 per Injury/Sickness
    AGE Monthly Rates Daily
    14 Days -18 Years $36.50 $1.25
    19-29 $30.50 $1.00
    30-39 $34.00 $1.15
    40-49 $36.50 $1.25
    50-59 $50.00 $1.65
    60-69 $56.00 $1.85

    $50 deductible per person per Injury/Sickness


    GOLD - $100,000 per Injury/Sickness
    AGE Monthly Rates Daily
    14 Days -18 Years $42.50 $1.40
    19-29 $35.00 $1.15
    30-39 $39.00 $1.30
    40-49 $42.50 $1.40
    50-59 $56.50 $1.90
    60-69 $63.50 $2.15
    PLATINUM - $175,000 per Injury/Sickness
    AGE Monthly Rates Daily
    14 Days -18 Years $55.50 $1.85
    19-29 $45.00 $1.55
    30-39 $51.00 $1.70
    40-49 $55.50 $1.85
    50-59 $74.50 $2.45
    60-69 $83.00 $2.75

    $0 deductible per person per Injury/Sickness.


    BASIC - $50,000 per Injury/Sickness
    AGE Monthly Rates Daily
    14 Days -18 Years $37.50 $1.30
    19-29 $32.00 $1.10
    30-39 $35.00 $1.20
    40-49 $38.00 $1.30
    50-59 $52.00 $1.75
    60-69 $57.50 $1.90
    SILVER - $75,000 per Injury/Sickness
    AGE Monthly Rates Daily
    14 Days -18 Years $44.00 $1.50
    19-29 $36.50 $1.25
    30-39 $41.50 $1.40
    40-49 $44.00 $1.50
    50-59 $60.50 $2.00
    60-69 $67.00 $2.20

    $0 deductible per person per Injury/Sickness


    GOLD - $100,000 per Injury/Sickness
    AGE Monthly Rates Daily
    14 Days -18 Years $51.00 $1.70
    19-29 $42.50 $1.40
    30-39 $47.50 $1.55
    40-49 $51.00 $1.70
    50-59 $69.00 $2.30
    60-69 $76.50 $2.55
    PLATINUM - $175,000 per Injury/Sickness
    AGE Monthly Rates Daily
    14 Days -18 Years $67.00 $2.20
    19-29 $55.50 $1.85
    30-39 $62.00 $2.05
    40-49 $67.00 $2.20
    50-59 $88.50 $3.00
    60-69 $98.50 $3.30

    $100 or $200 deductible per person per Injury/Sickness


    DIAMOND - $100 Per Injury / Sickness Deductible Per Person I $50,000 Annual Maximum
    AGE Monthly Rates Daily
    50-59 $40.00 $1.30
    60-69 $44.00 $1.50
    70-74 $74.50 $2.50
    75-79 $82.00 $2.75
    80-84 $166.00 $5.55
    85-89 $239.50 $8.00
    DIAMOND - $200 Per Injury / Sickness Deductible Per Person I $50,000 Annual Maximum
    AGE Monthly Rates Daily
    50-59 $33.00 $1.10
    60-69 $36.50 $1.25
    70-74 $61.50 $2.10
    75-79 $68.50 $2.30
    80-84 $139.00 $4.60
    85-89 $204.00 $6.80
  • Pre-Existing Condition Benefit
    Pre-Existing Condition- means any medical condition, Sickness, Injury, illness, disease, Mental Illness or Mental Nervous Disorder, regardless of the cause including any congenital, chronic, subsequent, or recurring complications or consequences related thereto or resulting there from that with reasonable medical certainty existed at the time of application or within the one hundred and eighty (180) days (three hundred and sixty five (365) days for Insured Persons 70 and older) immediately prior to the Insured Person's Effective Date under the policy, whether or not previously manifested, symptomatic, known, diagnosed, treated or disclosed. This specifically includes but is not limited to any medical condition, Sickness, Injury, illness, disease, Mental Illness or Mental Nervous Disorder, for which medical advice, diagnosis, care or treatment was recommended or received or for which a reasonably prudent person would have sought treatment during the one hundred and eighty (180) days (three hundred and sixty five (365) days for Insured Persons 70 and older) immediately preceding the effective date of coverage under this policy. See exclusion #1.
  • Exclusions

    Unless specified in the Schedule of Benefits, in any written endorsement, or agreed by the Company in writing, no claim can be made for compensation or payment for damage or expenses caused by or as a result of the following

    1. Pre-Existing Conditions as defined.
    2. Costs related to medical examination, treatment and surgical intervention which are not administered in a licensed healthcare institution.
    3. Costs related to medical examination where no Sickness has been diagnosed or Accident has been ascertained; for non specified pain; or preventative or routine exams.
    4. Any visit to a medical provider that does not result in a covered Diagnosis code after medical review or testing.
    5. Any treatment by a family member/family associate or any type of direct relationship.
    6. In respect of accidental damage to Natural Teeth, no benefit is payable for Injury caused by eating or drinking (even if it contains a foreign body), normal wear and tear, tooth brushing or any other oral hygiene procedure or any means other than extra-oral impact, any form of restorative or remedial work, the use of precious metals, orthodontic treatment of any kind or dental treatment performed in a hospital unless dental surgery is the only treatment available.
    7. Suicide or attempted suicide, intentional self-injury, the effect of intoxicating liquors or drugs.
    8. Treatment of hernia, Osgood-Schlatter's Disease, osteochondritis, osteomyelitis, cardiac disease or conditions (including lipidemia – high cholesterol), pathological fractures, congenital weakness whether or not caused by a Covered Accident.
    9. Evacuation costs where the Insured Person is not being admitted to a Hospital for Treatment or where costs have not been approved by Company prior to travel commencing.
    10. Any costs arising after expiry of the current Policy Period unless this plan has been renewed for a subsequent 12 months or the Insured Person was being treated during the Policy Period as a result of an accident.
    11. Any form of treatment or surgery which in the opinion of the Doctors(s) in attendance and GBGAssist that can be delayed until your return to your home country.
    12. Medical Expenses incurred after you have returned to your home country which exceed the number of days or in excess of a limit stated in the Schedule of Benefits.
    13. Medical Expenses in excess of a limit stated in the Schedule of Benefits.
    14. The amount of the Policy Excess, Deductible or Co-Payment, as stated in the Schedule of Benefits.
    15. Any cost resulting in a Sickness, Injury or death from the misuse of drugs or being under the influence or effect of alcohol (other than a legally prescribed medication by a licensed medical professional).
    16. Needless self-exposure to peril except in an attempt to save human life.
    17. Intentional or fraudulent acts on the Insured Person's part or their consequences.
    18. Trips specifically made for the purpose of obtaining medical treatment.
    19. Cosmetic surgery or remedial surgery, removal of fat or other surplus body tissue and any consequences of such treatment, weight loss or weight problems/eating disorders, whether or not for psychological purposes, unless required as a direct result of an Accident which occurs during the Policy Period.
    20. Treatment for alcoholism, narcotics, drug and substance abuse/dependency or any addictive condition of any kind and any Injury or Sickness arising from the Insured Person being under the influence of alcohol, drugs or any other intoxicating substance.
    21. Pregnancy, childbirth whether normal or complicated, including the transfer of a pregnant woman to hospital to give routine childbirth or air travel when the Insured Person is more than 20 weeks pregnant and was NOT a result of an accident or onset of complications relating from an accident.
    22. HIV-AIDS or any disease of the immune suppression system.
    23. Treatment for transitional life Events, homesickness, fatigue, jet-lag or work related stress;
    24. Any loss as the result of the use of any type of firearm(s) (Defined as any device that discharges a projectile of any type).
    25. Any expenses relating to search and rescue operations to find an Insured Person in mountains, at sea, in the desert, in the jungle and similar remote locations, including air/ sea rescue charges for evacuation to shore from a vessel or from the sea.
    26. Charges or fees incurred for the completion of Medical Claim Forms.
    27. Any expenses as the result of or related to participating in any sports or sport related activity. Inclusive of conditions that arise out of sport activity including but not limited to Cardiac, Respiratory, Orthopedic conditions etc.
    28. Any loss as the result of the use of a Motorcycle or two or three wheeled device of any kind.
    29. The radioactive, toxic, explosive or other hazardous or contaminating properties of any nuclear installation, reactor or other nuclear assembly or nuclear component thereof.
    30. War Insurrection and Terrorism related to the following:
      1. Nuclear, and Weapons of mass destruction: means the use of any explosive nuclear weapon or device or the emission, discharge, dispersal, release or escape of fissile material emitting a level of radioactivity capable of causing incapacitating disablement or death amongst people or animals.
      2. Chemical Weapons: mass destruction means the emission, discharge, dispersal, release or escape of any solid, liquid or gaseous chemical compound which, when suitably distributed, is capable of causing incapacitating disablement or death amongst people or animals.
      3. Utilization of Biological weapons of mass destruction means the emission, discharge, dispersal, release or escape of any pathogenic (disease producing) micro-organism(s) and/or biologically produced toxin(s) (including genetically modified organisms and chemically synthesized toxins) which are capable of causing incapacitating disablement or death amongst people or animals.
      4. Terrorism: Terrorist activity means an act, or acts, of any person, or group(s) of persons, committed for political, religious, ideological or similar purposes with the intention to influence any government and/or to put the public, or any section of the public, in fear. Terrorist activity can include, but not be limited to, the actual use of force or violence and/or the threat of such use. Furthermore, the perpetrators of terrorist activity can either be acting alone, or on behalf of, or in connection with any organization(s) or governments(s).

    We will not pay benefits for any Accidental Death and Dismemberment loss or Injury that is caused by, or results from:

    1. Intentionally self-inflicted Injury.
    2. Suicide or attempted suicide.
    3. War or any act of war, whether declared or not (except as provided by the Policy).
    4. Service in the military, naval or air service of any country.
    5. Disease or bacterial infection except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food.
    6. Sickness resulting from pregnancy, childbirth, miscarriage (except as provided by the Policy). With "Hernia of any kind"
    7. Piloting or serving as a crewmember or riding in any aircraft except as a passenger on a regularly scheduled or charter airline.
    8. Commission of, or attempt to commit, a felony.
    9. Injury or Sickness that occurs while the Covered Person has been determined to be legally intoxicated as determined according to the laws of the jurisdiction in which the Injury or Sickness occurred, or under the influence of any narcotic, barbiturate, or hallucinatory drug, unless administered by a Doctor and taken in accordance with the prescribed dosage.
    10. Flying in any aircraft being used for or in connection with acrobatic or stunt flying, racing or endurance tests; flying in any rocket propelled aircraft; flying in any aircraft being used for or in connection with crop dusting, or seeding or spraying, firefighting, exploration, pipe or power line inspection, any form of hunting bird or fowl herding, aerial photography, banner towing or any test or experimental purpose; flying any aircraft which is engaged in flight which requires a special permit or waiver from the authority having jurisdiction over civil aviation, even if granted.
    11. Specific named hazards: Abseiling, Aviation (except when traveling as a passenger in a commercial aircraft), BASE Jumping, Bobsleigh, BMX, Bungee Jumping, Canopying, Canyoning, Caving, Extreme Sports, High Diving, Hang Gliding, Heli-skiing, Hot Air Ballooning, Inline Skating, Jet Skiing, Kayaking, Luge, Motocross, Motorcycling, MotoX, Mountaineering, Mountain Biking,   Mountain Climbing, Paragliding, Parasailing, Parascending, Piloting any Aircraft,   Racing of any kind, Rock Climbing, Rodeo Activities, Rappelling, Scuba Diving, , Ski Jumping, Skydiving Snow Skiing, Snowboarding, Snowmobiling, Spelunking, Surfing, Trekking, Water Skiing, Wind Surfing, White Water Rafting, Zip Lining, Zorbing.
    12. All professional and semi-professional sports.
  • U.S.A Nationwide PPO Network

    The CMN network is for major medical, foreign travel and other expatriate benefit plans offering service at Centers of Excellence with over 400,000 physicians. The CMN network offers nationwide coverage across the U.S. with concentrations in metropolitan and urban cities, traditional travel states, and many rural areas. To search for providers participating in our network. For these plans you are not restricted to go to this specific list of doctors but it is recommended for easier claim process and negotiated rates.