VisitorSecuretm

From Tokio Marine HCC

Available for up to 364 days for US residents and visitors, VisitorSecuretm is a scheduled benefit travel medical plan that provides coverage for any new illness & injury that might occur while traveling outside of your home country.

**Note: Not available to individuals who are physically located in the states of New York, Maryland, or Washington or in the country of Canada or Australia at time of purchase.

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VisitorSecuretm Limitations & Exclusions

Pre-existing Conditions

This plan does not provide any coverage for Pre-existing Conditions. A Pre-existing Condition is a condition that meets any of these descriptions:

  • that would have caused a person to seek medical advice, diagnosis, care or Treatment within the 6 months (or 12 months for persons age 70 and older) prior to your Effective Date
  • for which medical advice, diagnosis, care or Treatment, including medication, was sought, recommended or received within the 6 months (or 12 months for persons age 70 and older) prior to your Effective Date
  • the symptoms which occurred within the 6 months (or 12 months for persons age 70 and older) prior to your Effective Date would have allowed a person trained in medicine to make a diagnosis of the condition producing the symptoms
  • which manifested within the 6 months (or 12 months for persons age 70 and older) prior to your Effective Date

Other exclusions include:

  1. Routine pre-natal care, Pregnancy, child birth, miscarriage, post natal care or any complication or pregnancy.
  2. Charges Incurred by or for any child under the age of 14 days.
  3. Diagnosis or treatment related to birth defects and congenital illnesses. Birth defects are deemed to include hereditary conditions.
  4. Diagnosis or treatment of Mental Health Disorders, as defined herein.
  5. Charges which are not Incurred, as herein defined, by a Member during his/her Certificate Period.
  6. Diagnosis or treatment of any condition(s) when the purpose of departing the Home Country was to obtain treatment in the destination country/countries.
  7. Charges for any benefit hereunder which are not presented to Underwriters for payment within 60 days beginning on the last day of the Certificate Period.
  8. Diagnosis, treatment, services or supplies which are not administered by or under the supervision of a Physician, and products that can be purchased without a doctor's prescription.
  9. Diagnosis, treatment, services or supplies which are not Medically Necessary as herein defined.
  10. Diagnosis, treatment, services or supplies provided at no cost to the Member.
  11. Charges which exceed Usual, Reasonable and Customary as herein defined.
  12. Telephone consultations or failure to keep a scheduled appointment.
  13. Surgeries, diagnosis, treatments, services or supplies which are Investigational, Experimental or for Research Purposes.
  14. All charges Incurred while confined primarily to receive Custodial Care, Educational or Rehabilitative Care, or any medical treatment in any establishment for the care of the aged.
  15. Diagnosis or treatment of obesity or weight modification, including wiring of the teeth and all forms of gastrointestinal bypass Surgery.
  16. Modifications of the physical body in order to improve the psychological, mental or emotional well-being of the Member, including but not limited to sex-change Surgery.
  17. Surgeries, diagnosis, treatments, services or supplies for cosmetic or aesthetic reasons, except for reconstructive Surgery when such Surgery is directly related to and follows a Surgery which was covered hereunder.
  18. Diagnosis or Treatment of Members for HIV+, AIDS or ARC. Diagnosis or treatment for HIV, AIDS or ARC, and all diseases caused by and/or related to HIV.
  19. Any drug, treatment or procedure that either promotes or prevents conception including but not limited to: artificial insemination, treatment for infertility, sterilization or reversal of sterilization.
  20. Any drug, treatment, or procedure that either promotes, enhances or corrects impotency or sexual dysfunction.
  21. Willful and/or therapeutic termination of Pregnancy.
  22. Dental Treatment, except for Emergency Dental Treatment necessary to replace sound natural teeth lost or damaged in an Accident covered hereunder.
  23. Corrective devices and medical appliances, including eyeglasses, contact lenses, hearing aids, hearing implants, eye refraction, visual therapy, and any examination or fitting related to these devices, and all vision and hearing tests and examinations.
  24. Eye surgery, such as corrective refractory surgery, when the primary purpose is to correct nearsightedness, farsightedness or astigmatism.
  25. Diagnosis or treatment of the temporomandibular joint.
  26. Medical expenses for Injury or Illness resulting from participation in organized intercollegiate or interscholastic sports, Professional Sports including practice, aviation (except when traveling solely as a passenger in a commercial aircraft); base jumping; sky surfing; Off-road motorized vehicles including all-terrain vehicles, snowmobiles and motorized dirt bikes, (jet skis excepted), snow skiing, or snowboarding, except for recreational downhill and/or cross country snow skiing or snowboarding (no coverage provided while skiing away from prepared and marked in-bound territories and/or against the advice of the local ski school or local authoritative body); racing by any animal or motorized vehicle; spelunking; sub aqua pursuits involving underwater breathing apparatus unless PADI/NAUI certified, or accompanied by a certified instructor at depths of less than 10 meters; avalanche training; Aussie rules football; big game hunting; bobsleigh, skeleton, luge, any type of boxing or martial arts, hot air ballooning as a pilot; jousting; modern pentathlon; powerlifting; quad biking outdoor endurance events, speed trials; speedway; wrestling.
  27. Injury sustained while under the influence of or due wholly or partly to the effects of intoxicating liquor or drugs other than drugs taken in accordance with treatment prescribed and directed by a Physician except drugs prescribed by a Physician for the treatment of Substance Abuse.
  28. Costs resulting from self-inflicted Injury or Illness and/or suicide or attempted suicide whether sane or insane.
  29. Diagnosis or treatment of venereal disease, including all Sexually Transmitted Diseases and conditions.
  30. Routine medical examinations, including but not limited to vaccinations, immunizations, annual check-ups, the issue of medical certificates and attestations, and examinations as to the suitability of employment or travel.
  31. Diagnosis or treatment by a chiropractor.
  32. Charges resulting from or occurring during the commission of a violation of law by the Member, including without limitation, the engaging in an illegal occupation or act, but excluding minor traffic violations.
  33. Diagnosis or treatment of Substance Abuse or addiction or conditions that may be attributed to Substance Abuse or addictions and direct consequences thereof.
  34. Speech, vocational, occupational, biofeedback, acupuncture, recreational, sleep or music therapy, holistic care of any nature, massage and kinesitherapy.
  35. Psychometric, intelligence, competency, behavioral and educational testing.
  36. Any services, diagnosis, supplies, or treatment performed or provided by a Relative of the Member or any family member of the Member or any person who ordinarily resides with the Member.
  37. Orthoptics and visual eye training.
  38. Diagnosis, treatment, or supplies for the feet: orthopedic shoes, orthopedic prescription devices to be attached to or placed in shoes, treatment of weak, strained, flat, unstable or unbalanced feet, metatarsalgia or bunions, and treatment of corns, calluses or toenails.
  39. Diagnostic testing or procedures, services, supplies, and treatment for hair loss including wigs, hair transplants or any drug that promises hair growth, whether or not prescribed by a Physician.
  40. Pre-existing Conditions. Charges resulting directly or indirectly from any Pre-existing Condition, as herein defined, are excluded from this insurance, except charges resulting directly from an Acute Onset of Pre-existing Condition, as herein defined, are covered for all Members subject to the limits set forth in the Schedule of Benefits and Limits.
  41. Exercise programs, whether or not prescribed or recommended by a Physician.
  42. Diagnosis or treatment required as a result of complications or consequences of a treatment or condition not covered hereunder.
  43. Charges for travel or accommodations, except as provided for in the Local Ambulance, Emergency Medical Evacuation, and Repatriation of Remains sections of this insurance.
  44. Diagnosis or treatment incurred as a result of exposure to non-medical nuclear radiation and/or radioactive material(s).
  45. Organ or Tissue Transplants or related services.
  46. Diagnosis or treatment for acne, other acne, moles, skin tags, diseases of sebaceous glands, seborrhea, sebaceous cyst, unspecified disease of sebaceous glands, hypertrophic and atrophic conditions of skin, nevus.
  47. Diagnosis or treatment of all forms of cancer / neoplasm.
  48. Diagnosis or treatment of sleep apnea or other sleep disorders.
  49. All expenses of any cryo preservation and implantation or re-implantation of living cells.
  50. All Emergency Medical Evacuation or Repatriation of Remains costs not approved or arranged in advance by Underwriters.
  51. Medical conditions while on duty as a member of a police or military force unit.
  52. Claims, payable under any government system, including the Australian Medicare system, are excluded from coverage.
  53. The Accidental Death & Dismemberment benefit shall be excluded with respect to Accidents occurring while the Member is participating in any of the following:
    1. Amateur Athletics, Contact Sports, intercollegiate, interscholastic, intramural, and club sports or athletic activities and Professional Sports. Non-contact and non-organized/nonsanctioned amateur sports or athletic activities engaged in by the Member solely for leisure, recreational, entertainment or fitness purposes are not excluded unless they are excluded by (b) through (u) of this provision; and
    2. aviation (except when traveling solely as a passenger in a commercial aircraft);
    3. base jumping or bungee jumping;
    4. sky surfing;
    5. Off road motorized vehicles including all-terrain vehicles, snowmobiles and motorized dirt bikes, (jet skis excepted),
    6. snow skiing, or snowboarding, except for recreational downhill and/or cross country snow skiing or snowboarding (no cover provided while skiing away from prepared and marked in-bound territories and/or against the advice of the local ski school or local authoritative body);
    7. racing by any animal or motorized vehicle;
    8. spelunking;
    9. sub aqua pursuits involving underwater breathing apparatus unless PADI/NAUI certified, or accompanied by a certified instructor at depths of less than 10 meters;
    10. avalanche training;
    11. Aussie rules football;
    12. big game hunting;
    13. bobsleigh, skeleton or luge ,
    14. Any type of boxing or martial arts,
    15. hot air ballooning as a pilot;
    16. jousting;
    17. modern pentathlon;
    18. powerlifting;
    19. quad biking outdoor endurance events,
    20. speed trials; speedway;
    21. wrestling
  54. Diagnosis, treatment, services, or supplies provided by Home Nursing Care.
  55. Expenses incurred within the Member’s Home Country
  56. Services, supplies, or treatment that are not included as Eligible Expenses as described herein.

Patient Protection and Affordable Care Act

(“PPACA”): This insurance is not subject to, and does not provide certain of the insurance benefits required by, the United States PPACA. PPACA requires certain U.S. residents and citizens to obtain PPACA compliant insurance coverage. In certain circumstances penalties may be imposed on U.S. residents and citizens who do not maintain PPACA compliant insurance coverage. You should consult your attorney or tax professional to determine if PPACA’s requirements are applicable to you. The policy contains the plan benefits, including a lifetime maximum that you have selected. Please review your choices to ensure that you have sufficient coverage to meet your medical needs.

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