As per the Center for Disease Control in the USA, if you are planning an international trip, you should consider getting travel insurance to cover yourself against accidents or illness while you’re abroad. Even if you already have medical insurance back home, it may not cover you when traveling outside the United States, or if it does cover you that coverage may not be enough. There are 3 types of insurance you should consider: trip cancellation insurance, travel health insurance, and medical evacuation insurance. These will cover different situations and may give you financial peace of mind, as well as allowing for safe and healthy travel.

Acute onset of pre-existing conditions is a concept that is part of any travel insurance policy. In most cases, preexisting health conditions are not covered under travel insurance. The only exception to this is acute onset of a preexisting condition, but this can get fairly tricky when it comes to travel insurance policies. To begin with, acute onset of pre-existing conditions means that you or someone that you are traveling with has a known preexisting condition and experiences a very sudden health concern while abroad.The biggest distinguishing factor here is that the health problem must, quite literally, come out of nowhere. While it is fine if the pre-existing condition raises the person’s chance of this health risk, the problem itself must arise quickly and without warning. For example, you might be diabetic and at risk of certain health problems relating to your blood sugar levels. If you have recently been experiencing problems and the issues arise again while you are traveling, this would not be considered acute onset. However, if you have been doing fine and suddenly find yourself going into diabetic shock, this would be considered acute onset and should be covered. When it comes to paying out these kinds of insurance claims, you can rest assured that your traveler’s insurance company will do everything they can to determine if you had any prior indication that there was a risk of the event occurring. They might look into medical records, ask you if you have been experiencing any recent symptoms that could have tipped you off, and more. This is because pre-existing conditions as a whole are not covered by these insurance plans, which means their job will be determining if this was a fluke or just a part of your preexisting condition that you should have been aware of. Certain plans have age restrictions as well that don’t cover any acute onset of pre-existing conditions. We highly encourage you to read through the plan details and consult with us.

Visitor medical insurance plans can be classified as either fixed (limited) benefits or comprehensive plans. Limited benefit plans are named so because they have clearly defined coverage limits that are not the same as plan medical maximum. They are more affordable when compared to comprehensive plans. This works for small ailments, but is inadequate for major expenses. For example, let’s take a limited benefit plan that says it covers up to $50K, with a $1000/day limit. For any random reason, if the insured gets admitted to the hospital and the bill comes to $30K spread over 30 days costing $1000 per month, that $30K would be covered (minus the copays and deductibles). However, if the bill comes $30K for just 3 days costing $10K per day, then only $3000 would be covered ($1000/day for 3 days), costing $27K for the insured. So it’s important one looks at the member benefits to check the daily limits to make sure they suit their needs. You can visit any hospital or doctor, since there will be no discounted rates, the plan will only pay up to the clearly defined limits for different expenses. Trip expenses are usually not covered. Our popular fixed benefit visitor insurance plans are: Visitors Care | Safe Travels visitors to USA Comprehensive plans, on the other hand, do not have benefit limits based on the type of medical expenses. Benefits for covered medical expenses go all the way up to the plan maximum (minus the deductible and coinsurance). . These plans are worth every penny of premium paid in the event of catastrophic medical emergencies. Most comprehensive plans have Preferred Provider Organization (PPO) networks, which means cashless service (direct billing as opposed to reimbursement basis), more discounted rates, as well as easier acceptance within the PPO network. They usually cover trip cancellation, baggage loss, baggage delay, etc... Our popular Comprehensive visitor insurance plans are: Atlas America | Patriot America | Patriot America Plus | Patriot Platinum | Safe Travels USA | Safe Travels USA Comprehensive

The perils protected against are listed in your plan document. These perils are similar to the trip cancellation perils except they provide coverage once you depart for your covered trip. The insured is reimbursed for unused non-refundable travel arrangements plus additional transportation costs.

Coverage begins at 12:01 a.m. on the day after the date the appropriate payment for this plan is received. This is your “Effective Date” and begins the trip cancellation benefits. Most other coverages begin when you depart on the first travel arrangement for your trip.

With an international health plan from , you have medical coverage worldwide. Our plans give you the freedom to choose your own health care provider wherever you are in the world.To view the exclusive provider list, please visit the insurance providers’ websites.

If you're planning a trip with multiple destinations, such as a vacation to Europe, you'll want to select the country that you plan on spending the most time in. Your travel medical insurance will cover you for the entirety of your trip and in countries outside of your own.

Yes, the insured does not have to be the one that fills out the application. You can purchase a travel medical plan for your parents, friends, or relatives as long as you have the necessary information.

To be eligible for trip cancellation reimbursement, you must cancel your trip due to one of the reasons covered in your plan.

To qualify as an “expatriate health plan,” substantially all of the primary enrollees must be “qualified expatriates.” A “qualified expatriate” is a primary insured meeting all of the following: Qualified Expatriates in the U.S.: The individual’s skills, qualification, job duties, or expertise is of a type that has caused the employer to assign him to the U.S. for a specific temporary purpose or assignment tied to employment; and In connection with such transfer or assignment, the plan sponsor reasonably determines that the individual will require access to health insurance in multiple countries, and is offered other multinational benefits on a periodic basis (e.g., tax equalization benefits, cross-border moving expenses, compensation to enable the expatriate to return to his home country); Qualified Expatriates Outside of the U.S.: The individual is working outside the U.S. for a period of at least 180 days in a consecutive 12-month period that overlaps with the plan year. For purposes of the definition, “U.S.” includes the 50 states, D.C., and Puerto Rico. There are also special provisions for members 501(c)(3) and 501(c)(4) organizations who are traveling or relocating internationally for the organization, including students and religious missionaries. Expatriate Health Plans are Minimum Essential Coverage Expatriate health plans qualify as minimum essential coverage. This means that an expatriate health plan will satisfy the employer mandate and the enrollee’s individual mandate. Employers are Still Subject to §6055/§6056 Reporting and Cadillac Tax on Certain Expatriates The exemption from ACA requirements does not apply for the new health information reporting requirements for the beginning of 2016. However, the information statements (primarily the Forms 1094-C and 1095-C for employers) may be provided electronically to individuals covered under an expatriate health plan even if the individual has not consented to electronic distribution (as long as the individual has not explicitly refused electronic distribution). Expatriate health plans will be exempt from the §4980I excise tax on high cost employer-sponsored health coverage (generally referred to as the “Cadillac tax”) that is scheduled to take effect in 2018, except for expatriates assigned to work in the U.S. Effective Date These provisions related to expatriate health plans apply to expatriate health plans issued or renewed on or after July 1, 2015. What is the Definition of an "Expatriate Health Plan?" "Expatriate health plans" are defined as a group health plan or health insurance coverage offered in connection with a group health plan meeting all of the following: Substantially all of the primary enrollees are "qualified expatriates" (see below). Primary enrollees do not include individuals who are not U.S. nationals residing in the country of their citizenship; Substantially all of the benefits provided by the plan are not excepted benefits (e.g., not limited-scope dental/vision, health FSA, fixed indemnity); The plan provides coverage for inpatient hospital services, outpatient facility services, physician services, and emergency services; The plan sponsor reasonably believes that the plan’s benefits provide minimum value (i.e., the percentage of the total allowed costs of benefits provided under the plan is no less than 60 percent); If the plan provides dependent children coverage, such coverage is available until the adult child turns age 26; The plan is administered by an administrator that has licenses to sell insurance in more than two countries, maintains a number of related international standards specified in the law, and offers reimbursement for items or services in the local currency in eight or more countries; and The plan satisfies a number of coverage requirements set forth in the Public Health Service Act (PHSA), Internal Revenue Code, and ERISA, other than those added by the ACA (e.g., NMHPA, MHPAEA, WHCRA, Michelle’s law). This definition includes both fully insured and self-insured plans. Prior transitional relief had applied only to insured expatriate plans. I am a non-U.S. citizen and an international student. Will PPACA's individual mandate affect my insurance plan? As non-resident aliens, international students on F, J, M and Q visas (and certain family members of students) are not subject to the individual mandate for their first 5 years in the U.S. All other J categories (teacher, trainee, work and travel, au pair, high school, etc.) are not subject to the individual mandate for 2 years (out of the past six). Since international students are not subject to the mandate, they are not required to purchase a plan that meets PPACA requirements and can purchase an appropriate insurance plan. International Students – Exempt as Non-Resident Aliens Under the IRS international student exemption, anyone “temporarily in the United States on an “F”, “J”, “M”, or “Q” visa for the primary purpose of studying at an accredited academic institution or vocational school (and certain family members of students), and who substantially complies with the requirements of that visa,” is exempt from being treated as a resident alien, and is therefore exempt from the individual mandate as a non-resident alien. That exemption applies for 5 years. After 5 years, a student is no longer exempt, and the substantial presence test must be applied. See examples here. Even after 5 years in the U.S., an international student may continue to be a non-resident alien for tax purposes under the “Closer Connection” exception if they can prove that they still have a closer connection to their home country than to the U.S. The Individual Mandate and Alien / Non-Alien Status The IRS provides a questions and answers page on the individual mandate. Question 11 asks whether all individuals living in the U.S. are subject to the mandate. The answer is that U.S. citizens and permanent legal residents are subject to the mandate, as are “foreign nationals who are in the U.S. long enough during a calendar year to qualify as resident aliens for tax purposes.” Thus, non-resident aliens are not subject to the individual mandate, even if they have to file a tax return.

The IRS states that you are a non-resident alien unless you meet either the green card test or the substantial presence test. Under IRS Publication 519, Tax Guide for Aliens (the green card test), green card holders are resident aliens for tax purposes. The substantial presence test uses a formula to count the number of days present in the U.S. over the past 3 years. Generally, you a resident alien after six months of presence in the U.S. – unless you are exempt. I am a U.S. citizen that will be temporarily traveling outside of the U.S. Do I need PPACA coverage for this? Some of our international travel medical products are not a substitute for minimum essential coverage that you may need to have under PPACA. However, since most PPACA plans do not provide the types of international benefits and assistance that travelers need, you should strongly consider purchasing an international travel medical plan for coverage while you travel outside of the U.S. If you are a U.S. citizen, national or an “alien lawfully present” in the U.S., you will need to maintain minimum essential coverage unless you are exempt. Exemptions include: Individuals not residing in the U.S. Non-U.S. citizens who are “non-resident aliens” (for U.S. income tax purposes). See Am Individuals with a coverage gap of less than 3 months. Individuals who cannot afford coverage (i.e. required contribution exceeds 8% of household income). Individuals with a religious conscience exemption (applies only to certain faiths). Members of a health care sharing ministry. Incarcerated individuals. Individuals with income below the tax filing threshold; and Members of Indian tribes In general, PPACA does not govern short-term limited duration insurance, like short-term travel medical insurance programs. However, please understand that under PPACA, as of January 1, 2014, extensions of short-term coverage will be limited to less than 12 months to meet the definition of a short-term limited duration plan.

coverage? Some of our international travel medical products are not a substitute for minimum essential coverage that you may need to have under PPACA. If you are a U.S. citizen, national or legal resident alien in the U.S., you will need to maintain minimum essential coverage unless you are exempt. Exemptions include: Individuals not residing in the U.S. Non-U.S. citizens who are “non-resident aliens” (for U.S. income tax purposes). See Am I a Resident or Non-Resident Alien? Individuals with a coverage gap of less than 3 months Individuals who cannot afford coverage (i.e. required contribution exceeds 8% of household income) Individuals with a religious conscience exemption (applies only to certain faiths) Members of a health care sharing ministry Incarcerated individuals Individuals with income below the tax filing threshold; and Members of Indian tribes You will not need PPACA coverage for short-term travel to the U.S., unless you are considered an “alien lawfully present” in the U.S. See I am a Non-U.S. citizen covered under a Global Medical Insurance Plan. In general, PPACA does not govern short-term limited duration insurance, like our short-term travel medical insurance programs. However please understand that under PPACA, as of January 1, 2014, extensions of short-term coverage will be limited to less than 12 months to meet the definition of a short-term limited duration plan. I am a non-U.S. citizen covered under a Global Medical Insurance Plan. Does the individual mandate apply to me? Under PPACA, all U.S. citizens, nationals and resident aliens will be required to purchase minimum essential coverage (PPACA compliant coverage), unless they are exempt. Our Global Medical Insurance Plan does not meet the definition of “minimum essential coverage” under PPACA. While your GMI plan for worldwide coverage will not be affected by PPACA, you should review the information below to see if you are exempt from the requirements of PPACA or not, and whether you will have to pay a tax penalty or not. The IRS provides a questions and answers page on the individual mandate. Question 11 asks whether all individuals living in the U.S. are subject to the mandate. The answer is that U.S. citizens and permanent legal residents are subject to the mandate, as are “foreign nationals who are in the U.S. long enough during a calendar year to qualify as resident aliens for tax purposes.” Thus, non-resident aliens are not subject to the individual mandate, even if they have to file a tax return.

The IRS states that you are a non-resident alien unless you meet either the green card test or the substantial presence test. According to IRS Publication 519, Tax Guide for Aliens, under the green card test, green card holders are resident aliens for tax purposes. The substantial presence test uses a formula to count the number of days present in the U.S. over the past 3 years. Generally, you are a resident alien after six months of presence in the U.S. – unless you are exempt. Exempt non-U.S. citizens include: A non-U.S. citizen who is not a permanent legal resident (the green card test) or has not been in the U.S. for 183 days over the last three year period. A non-U.S. citizen temporarily present in the United States as a foreign government-related individual under an “A” or “G” visa. A non-U.S. citizen teacher or trainee temporarily present in the United States under a “J” or “Q” visa. A non-U.S. citizen student temporarily present in the United States under an “F,” “J,” “M,” or “Q” visa. A non-U.S. citizen professional athlete temporarily in the United States to compete in a charitable sports event; and Expatriate employees living outside of their home countries for six months or more of a year. A person who is required to, but does not have minimum essential coverage for up to three months during the year (only one three-month period allowed each year). What is the Patient Protection and Affordable Care Act? (PPACA) The "Patient Protection and Affordable Care Act," commonly known as PPACA, was first introduced as a measure to deal with rising healthcare costs and numbers of uninsured. The heart of PPACA consists of three provisions: guaranteed issue (insurers must offer coverage regardless of the applicant's health status or pre-existing conditions), community rating (insurers must offer policies within a given territory at the same price regardless of health status, age, gender, or other factors), and an individual mandate. The individual mandate assures that everyone has a minimum amount of coverage: those above a certain annual income are required to purchase coverage or incur a tax penalty; those who cannot afford it will have their coverage paid for by the government. As PPACA continues to be implemented and challenged throughout the country, understanding the issues and implications for the international insurance industry and your business becomes all the more important.

insurance? Visitors should plan to get insurance after they plan their trip and receive their visa, but before they arrive in the U.S. The effective dates for coverage should match their visa. I already have health insurance. Why would I need Visitor Insurance in the U.S.? If you were to suffer an injury or get sick while visiting the United States, you might be surprised by the cost of medical care. You may also be surprised by the limited assistance your domestic insurance provider can provide while you're visiting. Visitor insurance coverage in the U.S. helps to ensure that you don't incur any unforeseen expenses, receive excellent care, and get home quickly and safely if anything were to happen during your visit. Do these plans cover sports-related illness or injuries? Our plans include customization options and add-ons, including add-on coverage for high school sports, interscholastic, intramural, or club sports, personal liability and legal assistance. Am I required to complete a Claim Form every time I go to the doctor? The Claims department of our insurance providers encourages all insureds to complete a Claim Form for each new onset of an illness or injury. This process gives them knowledge that you are receiving medical treatment and allows us to watch for appropriate billing to be filed on your behalf. If you fail to submit a Claim Form and additional information is requested, the insurance providers will contact you with an Explanation of Benefits and attach a Claim Form if one is required.

Precertification is a requirement under your certificate for certain medical services. Please see your certificate for a list of services which require precertification. During the precertification process, medical professionals review the planned medical services against standard medical criteria to ensure that the services are within accepted medical standards and are medically necessary. Precertification may be initiated by you, your representative or your medical provider. This can be done through the insurance providers. Most U.S. hospitals and physicians are familiar with the precertification process and will make the phone call for you, though they are not required to do this. Generally speaking, you are responsible for ensuring the precertification process is done five days before you are hospitalized or within 48 hours of an accident or emergency illness.

A written formal claims appeal may be sent to the insurance provider requesting a review of previously processed claims. It is important that you submit your appeal and any supporting documentation within (usually) sixty days of the original claims determination. Please refer to the insurance providers’ policies on claims. Your appeal will be reviewed and promptly responded to in accordance with your particular insurance plan or certificate. Claim appeals should be forwarded to insurance providers’ address as per the insurance providers’ process.

You are eligible for our Global Medical insurance plan if you reside outside of the U.S. or have a good faith intent to reside outside of the U.S. for six months or more in a calendar year. Please note that our Global Medical Insurance Plan does not meet the definition of “minimum essential coverage” under PPACA. GMI is not intended to provide U.S. citizens residing in the U.S. with health insurance. While your GMI plan for worldwide coverage will not be affected by PPACA, you should review the information below to see if you are exempt from the requirements of PPACA or not, and whether you will have to pay a tax penalty or not. Under PPACA, all U.S. citizens, nationals and resident aliens will be required to purchase minimum essential coverage (PPACA compliant coverage), unless they are exempt. Exempt U.S. citizens include U.S. citizens who reside outside of the U.S. The exemption applies to a U.S. citizen who has a tax home (main place of work or employment, or if you don’t have a main place of work or employment, your main residence) in a foreign country, and is a bona fide resident of a foreign country. See details under the IRS foreign earned income exclusion test. If a person was required to purchase minimum essential coverage and did not, she/he would be required to pay a tax penalty for not purchasing PPACA coverage (if she/he files a U.S. tax return). In many cases, this tax is far less than the premiums that a person would pay for obtaining PPACA coverage.

Your ID card contains important information including contact information for your insurance provider, should a medical emergency arise. We recommend that you carry it with you at all times.

Complete Proof of Claim must be received by the insurance providers prior to making any benefit determinations. Proof of Claim is defined within your plan or Certificate of Insurance. Once all information is received, then claims are promptly processed in accordance with industry standards. However, when additional information is required to complete the Proof of Claim, processing will be delayed. The insured will receive an Explanation of Benefits indicating what is needed for further consideration. Failure to comply may result in the insured's claim being closed for lack of response. The information provided above is for general informational purposes only. While we have attempted to provide current, accurate and clearly expressed information, this information is provided "as is" and 360HealthBenefits.com makes no representations or warranties regarding its accuracy or completeness. The information provided should not be construed as legal or tax advice or as a recommendation of any kind. External users should seek professional advice from their own attorneys and tax advisers with respect to their individual circumstances and needs.