Global Citizen Plan Benefits

 

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Global Citizen has three tiers of coinsurance: 100% outside the U.S. , 80% in network in the U.S. , 60% out of network inside the U.S.

All Global Citizen plans have an Unlimited Lifetime Maximum and a $250,000 maximum benefit for emergency medical evacuation.

HTH Global Citizen Benefit Summary

FeaturesOutside U.S.U.S.(In Network)U.S.(Outside Network)
Lifetime Maximum per Insured PersonUnlimitedUnlimitedUnlimited
Annual Maximum per Insured PersonUnlimitedUnlimitedUnlimited
Preventative and Primary CareInsurer waives deductible
Preventative Care For Babies/Children: (Birth to Age 18)100%80% to Coinsurance Maximum then 100%60% to Coinsurance Maximum then 100%
a. Office Visits/examination
b. Immunizations, Lab work & X-rays
Preventative Care For Adults: (Age 19 and Older)100%80% to Coinsurance Maximum then 100%60% to Coinsurance Maximum then 100%
a. Routine Pap Smears, annual mammogram
b. PSA For Men
c. Annual Physical Examination/Health Screening
d. Diagnostic lab work & X-rays
Primary Care Office VisitsAll except a $10 copay per visit 1All except a $30 copay per visit60% to Coinsurance Maximum then 100%
Professional ServicesInsurer Pays After Deductible is Met
Surgery, anesthesia, radiation therapy, in-hospital doctor visits, diagnostic X-ray and lab work.100%80% to Coinsurance Maximum then 100%60% to Coinsurance Maximum then 100%
Inpatient Hospital ServicesInsurer Pays After Deductible is Met
Surgery, X-rays, in-hospital doctor visits, Organ/Tissue Transplant100%80% to Coinsurance Maximum then 100%60% to Coinsurance Maximum then 100%
In-patient medical emergency 6100%80% to Coinsurance Maximum then 100%60% to Coinsurance Maximum then 100%
In-patient drugs100%80% to Coinsurance Maximum then 100%60% to Coinsurance Maximum then 100%
Ambulatory and Therapeutic ServicesInsurer Pays After Deductible is Met; Unless Noted
Ambulatory Surgical Center100%80% to Coinsurance Maximum then 100%60% to Coinsurance Maximum then 100%
Ambulance Service100%80% to Coinsurance Maximum then 100%60% to Coinsurance Maximum then 100%
Accidental Dental$1,000 per year, $200 per tooth$1,000 per year, $200 per tooth$1,000 per year, $200 per tooth
Acupuncture and Chiropractic Services100% up to $200080% up to $200060% up to $2000
Durable Medical Equipment100%80% to Coinsurance Maximum then 100%60% to Coinsurance Maximum then 100%
Infusion Therapy100%80% to Coinsurance Maximum then 100%60% to Coinsurance Maximum then 100%
Physical/Occupational Therapy$30/visit, 12 visits per year$30/visit, 12 visits per year$30/visit, 12 visits per year
deductible is waived
Rehabilitation and TherapyInsurer Pays After Deductible is Met
a.Inpatient Mental Health100% up to 60 days80% up to 60 days60% up to 60 days
b.Outpatient Mental Health75% up to 40 visits/60% thereafter75% up to 40 visits/60% thereafter75% up to 40 visits/60% thereafter
c.Inpatient Substance Abuse100% up to 60 days detox80% up to 60 days detox60% up to 60 days detox
d.Outpatient Substance Abuse75% up to 40 visits/60% thereafter75% up to 40 visits/60% thereafter75% up to 40 visits/60% thereafter
Prescription Drug Benefit OptionsInsurer Waives Deductible
Basic Prescription Drug Benefits100% of actual charges up to $500$0$0
Optional Rider, subject to $25,000 maximum benefit per Insured Person per Policy Period.100% of actual chargesGenerics: 100% after $10 copayGenerics: 100% after $10 copay
Brandname:100% after $25 copayBrandname: 100% after $25 copay
Injectables: 70%Injectables: 70%
Global Travel BenefitsInsurer Waives Deductible
Medical EvacuationUp to $250,000n/an/a
Repatriation of RemainsUp to $25,000n/an/a
Accidental Death and Dismemberment$50,000 $50,000 $50,000
Plan Options
1,2,3,4,5,6
Deductible Coinsurance Maximum
Outside U.S. U.S.in Network U.S.out of Network
Elite $0 $0 $1,000 $2,000
500 $250 $500 $1,000 $3,000
1,000 $500 $1,000 $2,000 $4,000
2,000 $1,000 $2,000 $4,000 $8,000
5,000 $2,500 $5,000 $10,000 $10,000
10,000 $10,000 $10,000 $10,000 $10,000
25,000 $25,000 $25,000 $25,000 $10,000


1. Copay waived when visiting an HTH Worldwide contracted provider outside the U.S..
2. Deductibles are Per Person per Calendar Year.
3. The Out of Pocket Maximum is calculated by adding the deductible and coinsurance maximum together. A family is charged a maximum of 2.5 deductibles.
4. Amounts paid to satisfy a deductible are credited to all other deductibles, both inside and outside the U.S. For example, if you satisfy your Outside U.S. deductible, this amount is credited to the U.S. (In Network) and U.S. (Outside Network) deductible requirement.
5. An Insured Person only has to satisfy his/her Out of Pocket Maximum once a Year for all services received outside of the U.S. and in the U.S.
6. Emergency room visits that do not result in inpatient admissions will be subject to a $50 penalty


Services provided in addition to the benefits above

Other Benefits

Limits

Home Health Care 100% Covered Expenses, as many as 30 visits per year
Skilled Nursing Facilities 100% with a maximum Covered Expense of $250 per day, as many as 50 days per year
Hospice 100% with a maximum Covered Expense of $5,000 per lifetime

Ready access to quality care

  • Access to HTH Worldwide’s global community of carefully selected, contracted hospitals, physicians, dentists and behavioral health professionals in over 180 countries.
  • Detailed provider profiles including medical training.
  • Personalized appointment scheduling and recruitment.
  • Fully profiled international treatment options.
  • Competitive U.S. PPO network and centers of excellence.
  • Emergency evacuation.
  • View More Details

mPassport and Global Health and Safety Resources

  • Online and mobile assistance tools with full telephone support.
  • Daily email of health and security alerts
  • Detailed descriptions of health facilities and security issues by destination
  • Translation databases for brand name drugs and medical terms/phrases.
  • Web pages capturing key personalized HTH Resources by destination.
  • View More Details

For Exclusions and Limitations see Plan Description.

Ten Day Money Back Guarantee
YOUR SATISFACTION IS GUARANTEED. We are so confident in our products that we offer the best guarantee in the business! If you are not completely satisfied with our Global Citizen Product, simply return your Certificate of Insurance and your ID Card to HTH within 10 days of your policy effective date. If you have not already used your insurance benefits, you will receive a full refund.