Plan benefits of Safe Travels Visitors to USA insurance
BenefitsCoverage
Policy MaximumEconomy: $25,000 maximum per Injury/Sickness Basic: $50,000 maximum per Injury/Sickness Silver: $75,000 maximum per Injury/Sickness Gold: $100,000 maximum per Injury/Sickness Platinum: $175,000 maximum per Injury/Sickness Cardiac Conditions/Treatment $25,000 per Policy Period Limit
Deductible$0
Well Doctor VisitPays up to $75 - One Visit per person per Policy Period. The Well Doctor Visit must occur within the first 21 days from the
effective date of coverage. To be eligible you must purchase at least 30 days of coverage initially
Hospital Room & Board including Laboratory Tests, X-Rays, Prescription Medical and other miscellaneousEconomy: Up to $1,400/day, 30 day maximum Basic: Up to $1,400/day, 30 day maximum Silver: Up to $1,750/day, 30 day maximum Gold: Up to $2,000/day, 30 day maximum Platinum: Up to $2,700/day, 30 day max
Hospital Intensive Care UnitEconomy: Additional $700/ day, 8 day maximum Basic: Additional $700/ day, 8 day maximum Silver: Additional $800/ day, 8 day maximum Gold: Additional $900/ day, 8 day maximum Platinum: Additional $1,150/ day, 10 day maximum
Surgical TreatmentEconomy: Up to $3,500 Basic: Up to $3,500 Silver: Up to $4,750 Gold: Up to $6,000 Platinum: Up to $7,500
Dental Treatment for Injury to Sound, Natural TeethUp to $600
Pre-existing conditionsAcute Onset of a Pre-existing Condition - up to policy maximum for age up to 69 years, $35,000 for age 70-79 years, $15,000 for age 80-89 per policy period subject to the sub limits as mentioned ( any coverage related to cardiac disease or conditions is limited to $25,000 for age up to 69 years, $15,000 for age 70 years and above)
AnesthetistEconomy: Up to $850 Basic: Up to $850 Silver: Up to $1,200 Gold: Up to $1,400 Platinum: Up to $1,800
Assistant SurgeonEconomy: Up to $850 Basic: Up to $850 Silver: Up to $1,200 Gold: Up to $1,400 Platinum: Up to $1,800
Physician’s Visit/Urgent careEconomy: Up to $55/visit, 1/day, 30 visits maximum Basic: Up to $55/visit, 1/day, 30 visits maximum Silver: Up to $70/visit, 1/day, 30 visits maximum Gold: Up to $85/visit, 1/day, 30 visits maximum Platinum: Up to $115/visit, 1/day, 30 visits maximum
Diagnostic X-rays & Lab ServicesEconomy: Up to $450 Basic: Up to $450 Silver: Up to $475 Gold: Up to $500 Platinum: Up to $675
Mental & Nervous Disorder & Substance AbuseEconomy: Up to $5,000 Basic: Up to $5,000 Silver: Up to $5,000 Gold: Up to $5,000 Platinum: Up to $20,000 30 days Max
Local Burial/CremationUp to $5,000 maximum limit
Initial Orthopedic Prosthesis/braceEconomy: Up to $1,100 Basic: Up to $1,100 Silver: Up to $1,225 Gold: Up to $1,350 Platinum: Up to $1,750
Chemotherapy or radiation therapyEconomy: Up to $1,100 Basic: Up to $1,100 Silver: Up to $1,225 Gold: Up to $1,350 Platinum: Up to $1,750
AD&D Principal Sum*Economy: Up to $25,000 common carrier Basic: Up to $25,000 common carrier Silver: Up to $35,000 common carrier Gold: Up to $35,000 common carrier Platinum: Up to $35,000 common carrier
Natural Disaster, Political Evacuation & RepatriationEconomy: Up to $500 Basic: Up to $500 Silver: Up to $1,000 Gold: Up to $1,500 Platinum: Up to $2,000
Return of Minor Children or Grand Children*Economy: Up to $5,000 Basic: Up to $5,000 Silver: Up to $7,500 Gold: Up to $7,500 Platinum: Up to $10,000
Felonious Assault AD&D* Economy: Up to $5,000 Basic: Up to $5,000 Silver: Up to $7,500 Gold: Up to $7,500 Platinum: Up to $10,000
Return to Home Coverage*Economy: Up to 30 days per 12 months maximum $2,000 Basic: Up to 30 days per 12 months maximum $2,000 Silver: Up to 60 days per 12 months maximum $2,500 Gold: Up to 60 days per 12 months maximum $5,000 Platinum: Up to 90 days per 12 months maximum $7,500
Private Duty Nurse Economy: Up to $450 Basic: Up to $450 Silver: Up to $550 Gold: Up to $550 Platinum: Up to $700
Physician’s Visits/ Urgent CareEconomy: Up to $55/visit,1/day, 30 visits Max
Basic: Up to $55/visit,1/day, 30 visits Max Silver: Up to $70/visit,1/day, 30 visits Max Gold: Up to $85/visit,1/day, 30 visitsMax
Platinum: Up to $115/visit,1/day, 30 visits Max
Prescription Drugs(outpatient) Per Sickness/InjuryEconomy: Up to $100 Basic:Up to $100 Silver: Up to $125 Gold: Up to $150 Platinum: Up to $200
Outpatient Surgical FacilityEconomy:Up to $1000 Basic: Up to $1000 Silver:Up to $1150 Gold: Up to $1275 Platinum: Up to $1400
