Ask Our Specialists

You sent me an email yesterday afternoon and I already replied to your questions that you are asking here. Did you have a chance to read your email with my reply? Here they are again: 1. Incidental means, as long as your primary destination is in the US, if you go to Canada for a couple of days (e.g., to see Niagara Falls), it will cover in Inbound USA. On the other hand, Visitors Care will cover you anywhere outside home country and USA doesn't have to the primary destination. e.g., your brother stays in Canada and your parents from India are planning to visit Canada for 4 months and to visit USA for 2 months, Visitors Care would cover that. 2. Yes. Please let me know if you have any other questions. Sorry I did not get your earlier e-mail. Thank you for your immediate reply. SSNS

You are really not missing anything obvious regarding coverage. You should definitely purchase WorldMed and you will not be missing anything compared to Diplomat Long Term. In fact, Diplomat Long Term costs more with no additional benefits and a restriction of $1,000 in coverage for first 30 days of effective date for sickness. If both are from the same carrier AIG, why is it like that? I will explain. But before that, let me give you one example. One small business A has 10 employees and wants to buy group insurance from Aetna. That employer has either older set of people, or several people with major sicknesses. On the other hand, another small business B has 10 employees as well and wants to buy group insurance Aetna. That employer happens to have younger people and most of them are quite healthy. The same Aetna company is going to charge more premium to employer A than employer B even if both employers are located in the same location and are getting the same coverage. Something similar has happened in case of WorldMed vs Diplomat Long Term. WorldMed (and few other products collectively) is administered by Travel Insurance Services (TIS). In other words, TIS got one master policy from AIG, called it WorldMed and started enrolling people into it. And we are helping TIS enroll people into it. Global Underwriters (GU) did the same thing and called Diplomat LongTerm. For whatever reasons, TIS enrolled many more people and had a better claims experience than GU. When the time came for renewal, AIG increased the premiums for GU and also put the $1,000/30 days restriction. That is why you see the difference in price and benefits. Therefore, please go ahead with purchasing WorldMed, available at /worldmed-insurance/ I hope that explains. If you have any other questions, please feel free to post them here or contact us at any time.

I am sorry to hear that you are having a problem with the claim. I suggest that you contact me over the phone and provide your policy details as it is not appropriate to write the personal details over the public discussion forum. I would be glad to help you to our best. This is to let everyone know that this problem got resolved and the customer posted his response in our experiences section instead at https://www.immihelp.com/visitors-insurance-reviews/ on May 9, 2008 at 10:48:34 AM >>>>> Hi This post is to let you all know about my experience with Seven Corners. I had posted a message in the discussion forum last week about my experience with Seven Corners. I thought I had probelms with getting a claim settled. My mother in law was treated for Cold and Wheezing. I had taken Inbound USA insurance for her. WE had visited the doctor twice. We got two bills from the hospital and I thought the insurance did not cover anything at all. So I posted a message in this website. The day I posted the message I got an immediate response. He was willing to help me and he got me connected to the Vice President of sales "Seven Corners" Mr. Curt Carlson. Mr. Carlson also helpe me out settling those claims in no time. He made sure that the explanation of benefits were generated and he sent a copy to me. I appreciate his help for looking into this matter so quickly. In spite of his busy schedule he kept in touch with me everyday until the problem is resolved. I appreciate Mr. Carlson for helping me in this regard. I am really happy with their service and I ask you to consider Seven Corners if you are palling to take a fixed coverage insurance. I have posted my true experience, if you have any questions do contact me. Thanks ssns, Skokie IL USA - May 09, 2008 at 10:48:34 AM I am glad that your claims issue has been resolved. And I am glad that I was able to help you out resolve the problem. Thank you for your business. This is another excellent example of how we, InsuBuy.com, as a broker, work in the best interest of our customers. Everyone please feel free to contact us at (866) INSU-BUY for execellent pre-sales and post-sales customer service. We don't stop working for you after the sale is over. We are always here to help you at any time.

1. Yes, that is how it works. Please read /international-medical-ppo-network/ /international-medical-ppo-network/ more details. When you call them, you have to ask them whether they participate and accept First Health PPO. 2. As far as the PPO, it works quite similar. However, there is no concept of co-pay in the short term plan. You have to first pay the deductible. After that insurance company pay 90% (or 80%) for first $5,000. Then it pays 100% up to the policy maximum. 3. Deductible is only once. 4. No. 5. All the coverages start according to the U.S. Eastern Time. Therefore, keeping the time zone between the U.S. Eastern and India in mind, I recommend that you put the effective date as May 12. If you have any other questions, please feel free to post them here or contact us at any time.

1. Yes, Patriot is the best. 2. If you want to take different policy maximum, different duration etc. for two people, you have to take two separate policies anyway. If you are taking the same policy max, deductible, duration etc., you can take either the same policy or different policies. Total price is the same anyway. However, we recommend that you take separate policies. Read relevant FAQ at /visitors-medical-insurance/ 3. You have to first pay the deductible before insurance company pays anything at all, even for Dr visit. You can read about the benefits at /patriot-america-lite-insurance/ If you have any other questions, please feel free to post them here or contact us at any time.

1. If you are buying for minimum 3 months initially, Patriot America is currently better choice. 2. There is no way to know in advance whether higher deductible would work out better or lower. If you never happen to go to Dr, higher deducitble is better. If you got to Dr even once or twice, lower deductible is better. Having said that, $250 is the most common deductible. But you can choose from $0 to $2,500 deductibles. 3. No. 4. Yes, if referred by physician in writing. 5. No. PCP concept is only there in HMO, not in PPO. 6. If you go out of the network, after the deductible, insurance company pays 80% for first $5,000, you pay 20%. After $5,000, insurance company pays 100% up to the policy maximum. 7. ?? 8. Covered up to $100, but subject to chosen deductible. For better options, look at CAREINGTON dental plan at /individual-family-dental-plans/ It is $12/month per family and there is one time application fee of $20. 9. El Camino Hospital and El Camino Medical Group are definitely part of First Health PPO. For the medical group, you can't search by the group but you have to search by individual drs over there. Therefore, visits to any of those (Hospital or in network Drs in the Group) would be in network. Thanks for the prompt reply. A few more clarifications. 1. You mentioned dental pain is covered upto $100 after deductible. So, is that $100 flat coverage or as per the 90/10 coverage? e.g. with $250 deductible, if multiple dentist visits for the same issue cost $350, then would I still get $100 or only 90%? 2. If deductible is applied due to dental visit, is it also counted towards the rest of the policy? 3. If the first doctor visit is less than the deductible, is it correct that we should still file the claim as usual so that it is correctly accounted for in the deductible? 4. Are prescription medication for covered illnesses reimbursable in this plan? I am not referring to usage of the Universal Rx discount card, but rather if due to cough/cold or any other covered illness, if my parents need prescription medication, I wanted to confirm that the plan would cover it regardless of whether it was purchased using the discount card? 5. I read the brochure and it mentions that renewal rates may differ from the initial rate but there were no specific figures or percentages given. Can you please clarify what the renewal rates are? 6. On the claim form, section C-5 asks for all previous ailments etc and the attending physicians name and addresses. My parents have diabetes and bp, and have visited a few doctors over the past couple of years, so is it neccessary to gave every doctor's name/address or would just the family doctor's name/address do? when is this doctor actually contacted, and do we need their India phone number as well in the claim form? 7. For the "?" answer you gave, let me clarify: I wanted to know if you are aware of any low cost medical practitioners similar to the Quick Health services, who specifically cater to non-insured or travelers who have to pay from their own pocket for small medical expenses? Thanks Raj Oh and another thing. I did a search for one of the physicians in the Camino Medical Group and they did show up as you said. However, physicians in the PAMF do not appear. Given that PAMF owns CMG, would going to a physician in PAMF be assumed to be in-network (PAMF is next door and CMG is almost 10 miles away for me). Thanks! Raj 1 & 2. There is $100 coverage, subject to deductible and coinsurance. Lets assume you have taken $50,000 policy maximum with $250 deducitble. Lets take several scenarios: Scenario 1: You have not used the insurance at all. $100 coverage goes towards your $250 deductible and you still have $150 to pay towards future medical expenses. Scenario 2: You already have spent $600 in medical expnese. Insurance company will pay 90% up to total of $100 for dental. Scenario 3: You already have spent $7,000 in medical expense. Insurance company will pay 100% up to total of $100 for dental. 3. That's right. 4. Yes, they are covered just like any other eligible medical expenses. (Having Rx discount card is just an additional bonus to reduce the price of the drug both for you and the insurance company.) 5. Renewal rates may differ for a couple of reasons: * If the person goes into a higher age bracket at the time of renewal. Lets assume the person was 64 years old when purchasing, but is 65 years old when renewing. In that case, the person would be charged renewal premium according to age 65. * If the entire insurance plan gets revised and the prices are different for everybody in the world. In that case, you may be charged different premium for renewing. However, this is really not a concern because the plan gets revised maximum once in a year and for the past 6 years, I have not seen the prices go up. 6. The exact amount of information needed is decided on a case by case basis. After looking at the current medical records (generated during the treatment in the US), if the claims department determines that they require more information to make an accurate decision, they may ask further information. 7. No. You mention in your post that you have not seen the visitor insurance price go up in the past 6 years. As you are an experienced insurance specialist, what is your thought on this? Is it because the coverage is limited/fixed with exclusions for pre-existing conditions that the cost has remained stable? For example, for insurance provided by my employer (100% coverage, no deductible), my monthly cost has gone up from $45/month to close to $200 per month (100% coverage, 250 deductible) in the past 6 years also changing from PPO initially to EPO/HMO recently for the same coverage. I understand that the employer might have changed their contribution but still, the prices have been going up for medical insurance and visitor insurance remains the same. Any thoughts appreciated. Oh and another thing. I did a search for one of the physicians in the Camino Medical Group and they did show up as you said. However, physicians in the PAMF do not appear. Given that PAMF owns CMG, would going to a physician in PAMF be assumed to be in-network (PAMF is next door and CMG is almost 10 miles away for me). Thanks! Raj I am not sure how exactly you are searching. Are you searching by entering PAMF? Are you searching by a doctor name? By an address? If PAMF owns CMG, I would think PAMF is a superset of CMG. And therefore, going to PAMF may be considered the same as going to CMG. I would suggest you call them ask them whether they participate in First Health PPO or not to be sure. You mention in your post that you have not seen the visitor insurance price go up in the past 6 years. As you are an experienced insurance specialist, what is your thought on this? Is it because the coverage is limited/fixed with exclusions for pre-existing conditions that the cost has remained stable? For example, for insurance provided by my employer (100% coverage, no deductible), my monthly cost has gone up from $45/month to close to $200 per month (100% coverage, 250 deductible) in the past 6 years also changing from PPO initially to EPO/HMO recently for the same coverage. I understand that the employer might have changed their contribution but still, the prices have been going up for medical insurance and visitor insurance remains the same. Any thoughts appreciated. This is my best estimation: It is primarily due to the fact that it is short term insurance plan that does not cover pre-existing conditions, preventive checks up, immunizations, maternity etc. Those are the factors that drive the cost up. Of course, I am a broker and don't own any of the insurance companies and therefore I don't have the complete premium data and claims data to make more precise comments than given above. Actually I was searching on the specific doctor's name as you recommended. I found a doctor in CMG and he was found as in-network on the provider directory. However, a few doctors I know in PAMF do not show up. Even though PAMF owns CMG my understanding also was that they should be using the same network, however, PAMF site explicitly says that they take First Health but that they are not preferred vendors. I will call up and confirm. Thanks for all your inputs. Regards raj Even though I can't comment on a specific facility or doctor, many times, if there are multiple doctors in the same clinic, only one or few of them are contracted with a given PPO network and when patients visits any of the doctors in that clinic, the clinic would send the claims through the doctor who is contracted with a particular PPO network. Of course, that may not happen everywhere all the time and that is why you need to confirm. Also, for your information, you can always go to the doctors outside the network. There is no restriction that you have to go in the network only. If you go to the provider outside the network, instead of 90/10 coinsurance for first $5,000, it will be 80/20 coinsurance for first $5,000. Many times, even if a particular doctor is not in the network, he may still bill the insurance company directly and not demand payment upfront. (That was the case with one of the Drs I used to go to when I used to stay in Virginia.) Even if, the provider is not in the nework, and does not agree to bill the insurance company directly, still that is not a problem. You just take the bill from the provider, download a claim form from /myaccount/ and send it to the insurance company. After the papers reach the insruance company, rest of the processing is the same whether the doctor billed the insurance company directly or you mailed them the papers. Additional suggestion: Please confirm with the clinic or doctor before the visit that they are still part of the network. In RARE cases, the PPO contract expired between the time the appointment was made and the actual appointment date. Couple of more questions as I am about to book Patriot America for my parents. 1. They are starting Bombay at 4am 17-May-2008 (3:30pm PST 16-May-2008) and arriving same day here in SFO. I had a question on when to start their coverage: I read in earlier posts that you recommended starting one day early, however the brochure says coverage effective date is LATER of requested effective date or departure date from home country. In this case since home country is India that means coverage would only be effective 17th May, so is that the date I should put? 2. I also wanted to confirm how "departure from home country" is identified? e.g. one of the posts you mentioned how older parents can hurt their backs lifting luggage etc., so in case there is some injury to the back starting from Bombay itself; or say during a stop over in Seoul, would that be covered? Is boarding flight/check-in counter at Bombay airport be considered as effectively "departed from home country"? 3. Does Patriot America give international collect phone numbers for use in the unlikely event they need urgent hospitalzation? Thanks! 1. The coverage starts according to the US Eastern time at 12.01 AM on the day you specify. You need to put the departure date, effective date, arrival date etc. on May 16, 2008. These systems and policies were made when so many people from India didn't come to USA. Therefore, they didn't realize that it takes more than a day to get here. 2. Any new medical conditions occuring outside the home country are covered. Therefore, if something new happens in Seoul, they are covered. Any problem arising in home country is not covered. 3. Yes.