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International Major Medical Insurance | FAQ's
Benefits • Exclusions • FAQ's • Premiums • Apply Online
- Who is the Insurer?
- Which Coverage Area is Right for Me?
- Am I Eligible for Citizen Secure?
- Is Coverage Under Citizen Secure Renewable?
- Citizen Secure Senior Plan?
- What Should I Expect During the Underwriting Process?
- Preferred Provider Network (PPO)
- How Do I File a Claim?
- What is Pre-certification?
- What's the difference between Citizen Secure and Citizens Secure Economy?
- Is there a waiting period for maternity?
- What other optional coverage can I get with this plan?
- What does Usual Reasonable and Customary (URC) mean?
Who is the Insurer?
The Citizen Secure plan is insured by certain underwriters at Lloyd's. Lloyd's is the largest and oldest insurance market in the world and is rated 'A' (Excellent) by A.M. Best Company and 'A' (Strong) by Standard & Poor's. Lloyd's provides financial strength and security that is unparalleled in the worldwide insurance market. Lloyd's is recognized as a market leader in the accident and health insurance arena and is well known for its innovative products and services. Presently, Lloyd's provides accident and health insurance to millions of individuals in almost every country of the world.
Which Coverage Area is Right for Me?
Citizen Secure offers two coverage areas: including the US and Canada and excluding the US and Canada. If you desire worldwide coverage, select the "Including the US and Canada" option. If you do not need or desire coverage in the US and Canada, you may obtain lower premiums by selecting the "Excluding the US and Canada" option.
Am I Eligible for Citizen Secure?
Citizen Secure is available to citizens of most countries of the world who are at least age 14 days and not over age 74. If you are a US citizen, you must reside outside the US, or be departing the US within 30 days of the effective date. If you are a US citizen, you must also reside outside the US for at least 6 months within each Certificate Period. Citizens of other countries may reside abroad, including the US or their country of citizenship. Optional Term Life Insurance is not available to residents of the US, regardless of your citizenship.
Is Coverage Under Citizen Secure Renewable?
Yes. Citizen Secure products are annually renewable. There are no medical questions at renewal. Renewal is subject to your continued eligibility and timely payment of premiums. Your renewal premium will be the same as all persons of the same Certificate origination year, age and gender. If you purchase coverage before you reach the age of 65, and maintain coverage continuously for 10 years, subject to continued eligibility, you will automatically be eligible to apply for the Citizen Secure Senior Plan with no medical questions.
Citizen Secure Senior Plan
Eligibility for the standard Citizen Secure plan ends at age 75, but for those members who joined before age 65 and have maintained coverage for at least 10 years, the Citizen Secure Senior Plan is available with no medical questions. The Citizen Secure Senior Plan offers many of the same benefits and limits as the standard Citizen Secure plan. The Senior Plan deductibles available are $5,000, $7,500, and $10,000. On the Senior plan, the Overall Maximum Limit is reduced to $1 million. Additionally, the Human Organ Transplant and Emergency Medical Evacuation benefits are deleted.
What Should I Expect During the Underwriting Process?
The Citizen Secure is a medically underwritten plan, which means that your family's medical status and history will be used to determine your eligibility for coverage. Once you have submitted your application it will be reviewed within 5 business days by an underwriter. Within that period you will heard back from the underwriters and they will either:
- Issue coverage and complete your application
- Request further documentation regarding your past medical history
- Request that a rider be placed on your application that limits or excludes certain medical conditions
- Request a premium increase due to your medical and/or family history
- Deny coverage
Throughout this process you will be notified at every stage and if you are not happy with anything you can withdraw the application with no penalty.
Preferred Provider Network (PPO)
The Citizen Secure plan uses the Hygeia Network inside the USA where you can receive treatment and your coinsurance will be waived and the provider should be able to direct bill. Simply present your identification card at the provider's office so that they may contact us to verify benefits and billing information. For your convenience, there is also an international network and both networks are searchable through the Student Zone, which is accessible with your Certificate number and date of birth once coverage has been approved.
How Do I File a Claim?
Filing a claim is easy. Once your Application is accepted, you will receive a kit which contains Claimant's Statement and Authorization forms. Complete this Claimant's Statement and Authorization form, attach original, itemized bills, and forward them for processing. Be sure to complete your Claimant's Statement entirely and sign it. If you have already paid certain expenses, attach copies of your payment receipts. You will be reimbursed for eligible medical or dental expenses. In many cases, payments will be made directly to the hospital or physician that treated you. Remember, you are responsible for the deductible, coinsurance, and any ineligible charges.
What is Pre-certification
The Citizen Secure plans require Pre-certification, which simply means that you must contact the 24 hour assistance center as soon as possible before a planned hospitalization or surgical procedure, within 48 hours of an emergency hospital admission, or within the first 90 days of pregnancy. Pre-certification allows us to establish contact and make payment arrangements with your providers, negotiate discounts which will benefit both you and us, pre-arrange future care, and plan for your claim. Pre-certification helps us help you.
What's the difference between Citizen Secure and Citizens Secure Economy?
The main difference between the Citizen Secure and the Citizen Secure Economy plan are the plan benefits. The Citizen Secure Economy is called a scheduled benefit plan, which means that each benefit on the plan has a certain cap at which benefits will not be paid once this level is met. This means that the premium on the Citizen Secure Economy plan are lower as the insurance is not obligated to pay as much. The Citizen Secure generally does not have these caps on benefits and will pay coverage, typically for usual and reasonable charges for most benefits up the policy maximum. Of course, please visit the full benefit table to see the listing of benefits on both plans.
Is there a waiting period for maternity?
Maternity benefits are covered under the Citizen Secure plan with a waiting period of 12 months. Once you have past the 12 month period, maternity benefits will become available regardless of when coneption occured.
What other optional coverage can I get with this plan?
There are 3 optional coverage options that you can add to your Citizen Secure plan and they include:
- Optional Sports Rider
- Optional Dental Rider
- Optional Term Life Rider
For more information about these riders, please see the full benefits page
What does Usual Reasonable and Customary (URC) mean?
Usual Reasonable and Customary is a term that insurance companies use to describe a limitation on their responsibility to pay for eligible medical expenses. Basically, URC refers to the fee typically charged by a provider for a specific procedure in a specific geographic area. So if a particular procedure typically costs $5,000 in the New York City area, and most providers customarily charge about $5,000 for that procedure, the insurance company will not pay your provider in New York City $10,000 for the same exact procedure. Instead, they will limit their payment amount to "Usual Reasonable and Customary" - in this example, $5,000.
Learn more about the Citizen Secure - Major Medical Insurance plan:
The Citizen Secure Plan - International Major Medical Insurance
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