Visitor insurance types - Comprehensive vs Fixed benefit 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.

Types of visitor insurance, Difference between US travel health 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.
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What is the difference between comprehensive and limited benefit visitor medical insurance?

There are significant differences between comprehensive and limited benefit visitors 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 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.

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Explain the difference between Fixed benefit (Scheduled benefit) and Comprehensive insurance coverage

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: $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.

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F Fixed Benefits Plans      C Comprehensive Plans

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Visitors Insurance USA - FAQ

01. How to buy visitors insurance? How to find the best visitor health insurance?

There are many visitor health insurance plans for coverage in the USA offered by US insurance providers. Given the several US visitor insurance options, it can be confusing to find the best health insurance for travel to USA for your needs.

What is very useful in making this decision is to compare travel insurance USA of different companies. The US travel insurance comparison allows travelers compare prices as well as coverage benefits in an objective manner.

The traveler can change relevant factors like the medical maximum coverage required, the US traveler insurance deductible, any US travel health insurance plans with coverage for pre-existing ailments, travel insurance USA coverage for Covid19... The global travel insurance comparison also allows travelers to buy the best travel insurance based on ones needs by completing an online application and paying using a credt card. One completing the purchase the travel insurance plan is emailed to the customer.

02. Can a visitor get health insurance in USA?

Yes. Visitors, tourists, students, and others can all buy travel health insurance in the US. We recommend travel insurance for visitors be bought from the day they leave their home country until they return, however, most companies allow you to purchase it even after the traveler has already started their journey.

03. How does visitor insurance work?

Visitor or travel medical insurance is for unexpected medical expenses while on your trip. Many travel insurance for visitors plans also cover baggage loss/ delay, trip delays, and have other benefits to help travelers with unexpected problems (loss of documents, etc). Since they are meant to be used in an emergency, you can use any doctor/hospital. In a non-emergency situation, you should consult your documentation and try to stay in-network (if applicable) while in the US since this will likely help defray your out-of-pocket cost.

04. 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.

05. 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.

06. What are the disadvantages of travel insurance?

Travel insurance is only for unexpected medical problems like illness or injuries while on a trip. Most medical insurance for travelers do not cover preventive care or vaccinations or even emergencies for a pre-existing medical condition. Also, if you are engaging in specific sports or recreational activities (motorcycle riding, motocross, skiing, bungie jumping, etc) be sure you get a plan that will cover any injuries you may have while participating in that activity as many will exclude them from coverage.

07. 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.

08. What happens if a tourist gets sick in USA?

Tourists can use Urgent Care clinics, make appointments at a doctor's office or go the the hospital, if needed. However, they will have to pay out-of-pocket for any and all medical care they receive. This is why we recommend getting a travel or US tourist health insurance plan for the duration of their stay.

09. What is an example of acute onset of pre-existing conditions?

An acute onset of a pre-existing condition is a sudden and unexpected recurrence or flare-up of a pre-existing medical condition that requires immediate medical attention while you're traveling.

Here's an example of an acute onset of a pre-existing condition:
Let's say the traveller has a history of asthma and are planning a trip overseas. While on the trip, he/she suddenly experience a severe asthma attack, which requires the traveller to seek medical attention at a local hospital. Since this was an unexpected occurrence, it would be considered an acute onset of a pre-existing condition, and the traveller may be eligible for coverage under a travel insurance policy with acute onset coverage for pre-existing conditions.

It's important to note that the specific terms and conditions of the travel insurance policy, as well as the severity and timing of the medical emergency, will determine whether or not your claim will be covered. It's always a good idea to carefully review your policy before purchasing to ensure that you understand the coverage and limitations, including any exclusions or restrictions that may apply. Travelers should compare the best US travel insurance plans, costs, benefits and coverage for pre-existing conditions options on American Visitor Insurance to find the best fit for their specific needs.

Popular traveler’s queries about fixed benefit vs comprehensive visitors

Factors that determine the insurance cost


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?

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.

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US visitors insurance providers

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.

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