Surgery
(Inpatient & Outpatient)
Anesthetist
(Inpatient & Outpatient)
Assistant Surgeon
(Inpatient & Outpatient)
Physician Office Visits, including Urgent Care and Telehealth Consultations or Care
(Inpatient & Outpatient)
$75 per visit, 1 per day,
30 visits maximum
$100 per visit, 1 per day,
30 visits maximum
Telehealth Consultations or Care includes long-distance or remote (i) health-related services and information, (ii)treatment of injury or illness, or (iii) other live consultations, each of which involves an insured person and a physician or
nurse practitioner at different locations using telecommunications technologies including internet, phone, video, audio, and computers.
Considered a covered medical expenses when requested and approved by the attending Physician.
Private Duty Nursing Services includes:
- Private duty nursing care only; and
- While Hospital confined; and
- Ordered by a licensed Physician; and
- Medically Necessary.
General nursing care provided by the Hospital is not covered under this benefit.
Limited to routine tests such as complete blood count, urinalysis, and chest x-ray when administered within seven days of Hospital admission.
Diagnostic Basic
(X-rays & Laboratory Tests)
Diagnostic Comprehensive
(PET, CAT, MRI)
Only in connection with a Medical Emergency as defined in the plan document. Benefits will be paid for the use of the emergency room and supplies.
$200 per Period of Coverage
$350 per Period of Coverage
Outpatient Surgical Facility and
Day Surgery Miscellaneous
(related to outpatient day surgery and surgery performed in a hospital emergency room, trauma center, physician's office, or clinic.) Includes operating room, lab tests,
x-rays, anesthesia, drugs and medicine, therapeutic services, and supplies.
Other Treatments and Services
Initial Orthopedic Prosthesis or Brace
This benefit includes medically necessary rental of a non-motorized wheelchair, crutches, or a basic hospital bed for up to 60 days or the duration of the injury or illness, whichever ends first.
Mental Illness including Substance Abuse
Benefits are limited to one Physician’s visit per day.
Physiotherapy
(Inpatient & Outpatient)
$40 per visit, 1 per day,
12 visits maximum
$60 per visit, 1 per day,
12 visits maximum
This means physical therapy, recommended by a Physician as Medically Necessary for the treatment of a specific Injury or Illness. It must be administered by a licensed physical therapist and be intended to improve, adapt or restore functions
which have been impaired or permanently lost as a result of a covered Illness or Injury and involve goals an individual can reach in a Reasonable Period of Time.
Pre-certification Penalty
$500 Required inside the United States for specific types of treatment. Penalty does not apply to a medical emergency.
$500 Required inside the United States for specific types of treatment. Penalty does not apply to a medical emergency.
The following expenses must always be pre-certified in the United States:
- Outpatient surgeries or procedures;
- Inpatient surgeries, procedures, or stays including those for rehabilitation;
- Diagnostic procedures including MRI, MRA, CT, and PET Scans;
- Physiotherapy;
- Extended Care Facility.
To comply with the pre-certification requirements, you must:
- Contact Seven Corners Assist before the expense is incurred;
- Comply with Seven Corners Assist’s instructions;
- Notify all medical providers of the pre-certification requirements and ask them to cooperate with Seven Corners Assist.
Once we pre-certify your expenses, we will review them to determine if they are covered by the plan. If you do not comply with the pre-certification requirements or if the expenses are not pre-certified, we will review the expenses to determine if they are covered by the plan. If covered:
- Covered Expenses will be reduced by $500; and
- The Deductible will be subtracted from the remaining benefit amount.
Pre-certification does not guarantee coverage, payment, or reimbursement.
Contact information for Seven Corners Assist is provided on your ID card.
Incidental trips to Home Country
This covers an illness or injury that begins on an incidental trip in your home country. You earn covered days at home at approximately 5 days per month up to 60 days for every 364 days of purchased coverage. Unused days do not carry over
to a subsequent 364-day period. It does not cover pre-existing conditions or an illness or injury that began while you were outside your home country. Coverage is available if your period of coverage is greater than 30 days.
Acute Onset of Pre-Existing Conditions
Ages 14 days to 69 years
up to $50,000
Ages 70 to 79 years
up to $25,000
Age 80 and older
N/A
Ages 14 days to 69 years
up to $75,000
Ages 70 to 79 years
up to $25,000
Ages 80 and older
N/A
Many travel insurance plans do not cover pre-existing conditions. Seven Corners Travel Medical Visitor USA covers them through the Acute Onset of Pre-Existing Conditions benefit.
An Acute Onset of Pre-Existing Condition is the occurrence of a pre-existing condition that meets these criteria:
- It is sudden, unexpected, and occurs without advanced warning;
- It is a medical emergency;
- It occurs during the period of coverage;
- You obtained treatment within 24 hours of the occurrence;
- You did not have a change in prescription or treatment related to the underlying pre-existing condition within the last 30 days; and
- Your pre-existing condition is not congenital, a previously diagnosed chronic condition with expected episodes or flare-ups, or a deteriorating condition which cannot be controlled and gradually intensifies over time.
Review the plan document for more details.
Coverage ends on the earlier of:
- The condition no longer being considered acute or
- Your discharge from the hospital.
If you are injured as a result of terrorist activity, we will provide medical benefits if the following conditions are met:
- You have no direct or indirect involvement in the terrorist activity.
- The Terrorist Activity is not in a country/location where the U.S. government has issued a Level 3 Terrorism, Level 3 Civil Unrest, or any Level 4 Travel Advisory or the appropriate authorities of your host country or your home country
have issued similar warnings, any of which have been in effect within 6 months before your date of arrival and
- You departed the country/location following the date a warning to leave was issued by the U.S. government or the appropriate authorities of your host country or your home country.
Dental — Sudden Relief of Pain
The plan can pay for emergency treatment for the relief of pain for sound natural teeth. Coverage is available if your period of coverage is greater than 30 days.
The plan can pay for emergency treatment to repair or replace sound natural teeth damaged because of an accidental injury caused by external contact with a foreign object. You are not covered if you break a tooth while eating or biting
into a foreign object.
Emergency Medical Evacuation
$100,000 separate from medical maximum
$100,000 separate from medical maximum
If medically necessary, we will pay and arrange to transport you to the nearest adequate medical facilities. The plan pays regardless of whether your evacuation is related to a pre-existing condition. This benefit must be arranged by Seven Corners Assist. Failure to use Seven Corners Assist may result in a denial of
benefits.
We can pay reasonable expenses for embalming, a minimally-necessary container for transportation, shipping costs, and government authorizations to return your remains to your home country if you die while outside your home country. The
plan pays regardless of whether your death is related to a pre-existing condition. You cannot use this benefit if you use the Local Cremation or Burial benefit. This benefit must be arranged by Seven Corners Assist. Failure to use Seven Corners Assist may result in a denial of benefits.
Local Burial or Cremation
This benefit can pay reasonable expenses for the preparation and either your local burial or cremation if you die while outside your home country. The plan pays regardless of whether your death is related to a pre-existing condition. You
cannot use this benefit if you use the Return of Mortal Remains benefit. This benefit must be arranged by Seven Corners Assist. Failure to use Seven Corners Assist may result in a denial of benefits.
24/7 Travel Assistance Services
Common Carrier Accidental Death and Dismemberment
$25,000 per Insured Person
(aggregate limit of $125,000 per any one accident)
$25,000 per Insured Person
(aggregate limit of $125,000 per any one accident)
This benefit pays funds if you die because of an injury caused by an accident that occurred while you were a passenger on a common carrier. A common carrier is a public air conveyance that transports passengers for hire.
International Travel Coverage
The benefit can cover you up to 14 days when you travel to countries other than the United States. It does not cover travel to your home country, and it does not extend after your expiration date. This benefit must be used during your
current period of coverage, and the trip must originate in the United States. Coverage is available if your period of coverage is greater than 30 days.
