Here are some common questions about J1 and J2 insurance plans.
What is the difference between the scheduled benefits plan and a comprehensive plan?
Fixed Benefits Plan (Scheduled Benefits Plan)
These policies are characterized by various benefit limits for each type of covered medical expense. These benefit limits typically are not the same as the policy maximum.
For example, a policy with a $50,000 maximum limit may feature up to a maximum of $2000 for surgery, up to a maximum of $500 for diagnostic services (X-rays, scans) etc. The maximum amounts for different situations are detailed in the policy brochure.
Typically you are required to pay an initial deductible for each injury or sickness and then the plan pays for the rest of the covered expenses.
Scheduled Benefits Plans have the lowest premiums, but the consumer must be aware that the benefits offered are relatively limited as compared to the Comprehensive Coverage Plans.
Examples of Scheduled Coverage Plans include ‘Inbound USA’ underwritten by Lloyds and ‘Visitors Care’ underwritten by Sirius International.
Comprehensive Coverage Plan
These policies typically do not have benefit limits based on the type of medical expense. Usually benefits for covered medical expenses go all the way up to the policy maximum (less deductible and co-insurance).
Typically for all covered medical expenses during the policy period the insured pays the deductible plus 20% of the first $5,000; and then the plan pays 100% of the eligible medical expenses up to the policy maximum.
The details for each policy such as the policy maximum, medical expense eligibility etc. are listed in the policy brochure.
Comprehensive Coverage Plans have relatively higher premiums, but in turn offer better benefits than the Scheduled Benefits Plans.
Examples of Comprehensive coverage plans include ‘Diplomat America’, ‘Atlas America’, ‘Liaison International’ and ‘Patriot America’.
Why should I purchase insurance with an American company and not buy insurance in my native country?
It is advisable to have insurance from an American company while in the United States, even if the premium for these plans are more expensive. The reason is that while almost all Doctors/hospitals in the United States accept American insurance company cards, they will be reluctant to acknowledge overseas insurance coverage. The medical office can easily contact an American insurance company for clarification, while the same will not be true for an overseas insurance company.
Typically medical offices in the US will bill directly to known American insurance companies. For overseas insurance companies you most probably will have to pay the bill, and then try to get the claim reimbursed from the insurance company.
There is such a wide array of choices between insurance plans offered by different companies. How do I know what to purchase?
It is precisely to help you make this decision that we built our insurance comparison facility. Using NRIOL’s comparison engine, you can evaluate different plans based on their cost, the deductible and their rating. This will help you identify the plan that best suits for your needs.
When should I purchase the insurance?
You should purchase the insurance only after being certain of your travel plans (having the passport/visa papers and the airline tickets in order). It is safest to start the insurance coverage from the date of departure from your native country.
My parents are not yet here, can I purchase insurance for them in their absence?
Yes. You can purchase the insurance coverage on behalf of others in their absence.
Is the insurance plan refundable should I leave the country during its validity?
A Some insurance plans do refund money if given enough advance notice, however since travelers insurance is typically for a short duration, they are often not refundable. If this situation is a concern for you, you should look out for insurance plans which are renewable. Such plans are available among the plans listed in our comparison engine.
What is the proof of my purchasing insurance?
When you purchase insurance online, you will immediately receive a confirmatory email with details of the insurance. This is the virtual insurance card, and it is prudent to print this and to keep a backup of this email. You will also receive an insurance card from the insurance company by mail. This card will have your name, policy number, group number, insurance company’s contact information such as the toll-free telephone number and the address where claims should be submitted.
How do I purchase the insurance? When does the insurance take effect?
Purchasing insurance online is very simple. From our compare engine, you can click on the ‘Buy’ button in the first column. This leads you to the appropriate online application form. You have to complete the appropriate online application form and you will immediately receive an email acknowledgement which is the virtual ID card. The coverage will start from the start date as indicated on the form. Within a week you will receive a package from the insurance company, which will include the insurance card and a hard copy with details regarding the insurance plan.
Can I purchase insurance for only part of the stay of my parents in the US?
Yes you can purchase for only partial duration of the entire stay. However the purpose of purchasing insurance is in the event of unanticipated medical emergencies. One can never be sure when such an emergency can happen. Having purchased insurance for part of their stay will not help in the event of an emergency during the uninsured period.
Do I need a Social Security number to complete the form?
No you can complete the form using the visitors passport number.
Can I go to any doctor/hospital, or am I limited to specific medical practitioners?
This will vary for different insurance plans. Some plans allow you to visit any medical practitioners, while others have their provider network.
In the latter case, if you visit a doctor/hospital within the provider network, the fee will be a standard rate that has been agreed between the insurance company and the provider.
However, if you visit a provider outside of the insurance companies provider network, there may be a difference between the amount charged to you and the amount the insurance company considers reasonable. In this event, you will have to pay the difference between the two.
How do I find out which doctors are part of a given insurance network?
You can also get this information by calling the toll free number of the insurance company or by visiting the insurance company web site. The toll free number should be on the insurance card that you receive on purchasing the insurance plan.
Can you give an example of my medical expenses with different insurance plans?
This really depends on the policy. For example if your medical bill is $24,000.
After deductible, policy covers up to a maximum of $50,000.
Here your expense is the only the first $100 deductible.
Thus your final expense is only $100 while the insurance company will cover the remaining $23,900.
Deductible is $100 with Maximum coverage of $50,000.
Policy covers 80% of first $5000 then 100% to the policy limit.
So 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.
Our insurance comparison engine allows you to evaluate different plans based on deductible cost.
Should I pay the medical practitioner/organization initially and then get reimbursed or will the insurance company be billed directly?
On purchasing insurance from an American insurance firm, you will receive an insurance card with details about your insurance. When you visit the doctor/hospital, the billing office at the hospital will usually make a photo-copy of your insurance card, call the insurance company to verify your policy, and will then bill the insurance company directly. You will have to pay the deductible amount.
In some instances if the medical office has not dealt with this particular insurance company, they might insist that you pay the bill on receiving medical treatment. In this scenario, you would get an detailed bill, which should be sent to the insurance company for reimbursement. NRIOL advises policy holders to visit hospitals with in the provider network wherever possible.
What is a deductible?
A If your plan has a $100 deductible, you pay the first $100 of expenses and then the insurance company picks up the rest. The higher the deductible, the lower the premium cost and vice versa.
What are the types of deductible?
A Per incident deductible: You pay the deductible every time you get a new medical ailment (be it sickness of accident related) before the insurance company pays anything. Inbound USA and Inbound Immigrant from SRI have deductible per incident.
Per visit deductible: You pay the deductible every time you you visit a health care provider (doctor, hospital, laboratory etc..) before the insurance company pays anything.
Per policy period deductible: You pay the deductible only once during the entire policy period, irrespective of how many times you get sick or injured during the policy period.
Annual deductible: You pay the deductible only once in a year irrespective of how many times you get sick or injured during the entire year.
I made a mistake in entering my data while purchasing the insurance, what should I do?
You can email us and we will have the changes made to your policy and have a corrected policy sent to you.
What is co-insurance?
After your deductible is met, co-insurance is the percentage of the covered medical expenses that you, the insured person, must pay.
For instance, if your health plan has an 80/20 co-insurance rate, your insurance plan pays for 80% of your eligible medical expenses and you are responsible for the remaining 20%.