Elite Plan
1,000 Plan
2,000 Plan
5,000 Plan
10,000 Plan
$1,512
$1,030
$910
$731
$636
| 2,000 Plan | |
| Deductible U.S. (In Network) | $2,000 |
| Deductible U.S. (Out of Network) | $4,000 |
| Deductible Outside the U.S. | $1,000 |
| Coinsurance Maximum (Inside the U.S. only) | $8,000 |
| Quote (per month) | $910.00 |
U.S. Benefits:
2,000 Plan
$910.00 total
per month
- Medical Limit: Unlimited
- $2,000 Deductible U.S. (In Network)
- Optional RX Upgrade: Not Included
- Optional Dental/Vision Benefits: Not Included
You may also like to visit the Product Page or Expand To View Benefits table below.
THIS IS NOT QUALIFYING HEALTH COVERAGE ("MINIMUM ESSENTIAL COVERAGE") THAT SATISFIES THE HEALTH COVERAGE REQUIREMENT OF THE AFFORDABLE CARE ACT ("ACA"). COVERAGE AND BENEFITS MAY NOT COMPLY WITH ACA OR STATE MANDATES.
Quoted prices include a $3.50 per person annual membership fee for the Global Citizens Association (GCA). If you are already a member, your membership will be extended for 12 months. Members may request a pro-rated adjustment of current membership fees. Please contact GCA at admin@gcassociation.org.
All BCBS Global Solutions plans offer a Dental/Vision rider. You can add this rider at an additional cost.
BCBS Global Solutions Worldwide Premier and Outside U.S. plans include a basic prescription drug benefit. The basic prescription drug benefit covers inpatient drugs up to the policy maximum. For outpatient drugs the insurer waives the deductible and coverage is 100% up to $3,500 per calendar year. This outpatient drug benefit applies to drugs purchased inside and outside of the U.S.
An optional prescription drug benefit is available for purchase. This offers a higher limit than the basic drug benefit. This benefit is not subject to a deductible.
For the BCBS Global Solutions Worldwide Premier plan, the benefit is $25,000 max per calendar year (subject to a copay) and includes access to outpatient drugs everywhere, including the U.S.
For BCBS Global Solutions Outside U.S., the benefit is $25,000 max (100% of actual charges) per calendar year and includes access to drugs everywhere, except the U.S.
For complete details please see the benefit schedule.
No U.S. Benefits - If you indicate that you do not want coverage for the United States, your plan will not include any coverage benefits while visiting or traveling in the U.S. and your price will adjust accordingly. This option is designed for individuals that do not require U.S. coverage. Note: Choosing this option will result in an Outside U.S. quote.
Basic U.S. Benefits - If you plan on visiting the U.S. while living abroad, this option provides health coverage for illness, accident, and/or medical emergencies during your temporary visits to the U.S. To view more information, click on the What is covered under the Basic U.S. Benefits rider? link below. Note: Choosing this option will result in an Outside U.S. quote. This option is not available with the 10,000 Plan.
Comprehensive/Full U.S. Benefits - For some medical needs, you may opt to be treated in the U.S. In these situations, you may prefer full and comprehensive coverage in the U.S. geographical area. This affords you the ability to travel to the U.S. for serious or complex issues, including treatment at centers of excellence for covered elective care. Note: Choosing this option will result in an Worldwide Premier quote. Please review the full benefits schedule for more information.
For Xplorer Select you are eligible for the maternity upgrade at the time of enrollment. Higher rates apply and you must stay continuously enrolled under a U.S. primary health plan.
If you are eligible for Medicare you must indicate that you want a plan with no U.S. Coverage.
Medicare eligible applicants are eligible for Outside U.S. but are not eligible for Worldwide Premier.
Share These Quote Results
Copy Quote Link
Benefits
Benefit Maximums |
Outside U.S. |
U.S. (In Network) |
U.S. (Outside Network) |
| Lifetime Maximum per Insured Person | Unlimited | Unlimited | Unlimited |
| Annual Maximum per Insured Person | Unlimited | Unlimited | Unlimited |
| Preventive and Primary Care | Insurer Waives Deductible | ||
| Preventive Care For Babies/Children: (Birth through Age 18) a. Office Visits/examination b. Immunizations, Lab work & X-rays done in conjunction with an office visit |
100% | 80% to Coinsurance Maximum then 100% | 60% to Coinsurance Maximum then 100% |
| Preventive Care for Adults: (Age 19 and Older) a. Office Visits/examination b. Immunizations as recommended on the published Center for Disease Control (CDC) immunization schedule for adults c. Routine Pap Smears, annual mammogram d. PSA For Men e. Diagnostic lab work & X-rays done in conjunction with an office visit |
100% | 80% to Coinsurance Maximum then 100% | 60% to Coinsurance Maximum then 100% |
| Annual Physical Examination/Health Screening, Subject to a $1,000 Maximum per Calendar Year and limited to one per Calendar Year | 100% | 80% to Coinsurance Maximum then 100% | 60% to Coinsurance Maximum then 100% |
| Primary Care Physician or Specialist Office Visits | All except a $10 copay per visit1 | All except a $30 copay per visit | 60% to Coinsurance Maximum then 100% |
| Urgent Care Facility | 100% | All except a $75 copay per visit | 60% to Coinsurance Maximum then 100% |
| Professional Services | Insurer 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 Services | Insurer Pays After Deductible is Met | ||
| Surgery, X-rays, in-hospital doctor visits, Organ/Tissue Transplant | 100% | 80% to Coinsurance Maximum then 100% | 60% to Coinsurance Maximum then 100% |
| Inpatient medical emergency6 | 100% | 80% to Coinsurance Maximum then 100% | 60% to Coinsurance Maximum then 100% |
| Inpatient drugs | 100% | 80% to Coinsurance Maximum then 100% | 60% to Coinsurance Maximum then 100% |
| Ambulatory and Therapeutic Services | Insurer Pays After Deductible is Met, Unless Noted | ||
| Ambulatory Surgical Center | 100% | 80% to Coinsurance Maximum then 100% | 60% to Coinsurance Maximum then 100% |
| Ambulance Service | 100% | 80% to Coinsurance Maximum then 100% | 60% to Coinsurance Maximum then 100% |
| Accidental Dental | $1,000 per calendar year, $200 per tooth | $1,000 per calendar year, $200 per tooth | $1,000 per calendar year, $200 per tooth |
| Acupuncture and Chiropractic Services, Subject to a $2,000 Maximum per Calendar Year if under the care of a licensed Physician | 100% | 80% to Coinsurance Maximum then 100% | 60% to Coinsurance Maximum then 100% |
| Durable Medical Equipment | 100% | 80% to Coinsurance Maximum then 100% | 60% to Coinsurance Maximum then 100% |
| Infusion Therapy | 100% | 80% to Coinsurance Maximum then 100% | 60% to Coinsurance Maximum then 100% |
| Physical/Occupational Therapy, Limited to 20 visits per Calendar Year | 100%, no deductible | 100%, no deductible | 100%, no deductible |
| Rehabilitation and Therapy | Insurer Pays After Deductible is Met, Unless Noted | ||
| Inpatient Mental Health | 100% | 80% to Coinsurance Maximum then 100% | 60% to Coinsurance Maximum then 100% |
| Outpatient Mental Health | 100%, no deductible $10 Copayment1 |
100%, no deductible $30 Copayment |
60% to Coinsurance Maximum then 100%, no deductible |
| Inpatient Substance Abuse | 100% | 80% to Coinsurance Maximum then 100% | 60% to Coinsurance Maximum then 100% |
| Outpatient Substance Abuse | 100%, no deductible $10 Copayment1 |
100%, no deductible $30 Copayment |
60% to Coinsurance Maximum then 100%, no deductible |
| Other Services | Insurer Pays After Deductible is Met | ||
| Home Health Care, Subject to a maximum of 30 visits per Calendar Year | 100% | 80% to Coinsurance Maximum then 100% | 60% to Coinsurance Maximum then 100% |
| Skilled Nursing Facilities, Subject to a maximum of $250 per day for a maximum of 50 days per Calendar Year | 100% | 80% to Coinsurance Maximum then 100% | 60% to Coinsurance Maximum then 100% |
| Hospice, Subject to a maximum of $5,000 per lifetime | 100% | 80% to Coinsurance Maximum then 100% | 60% to Coinsurance Maximum then 100% |
| Prescription Drug Benefit Options | Insurer Waives Deductible | ||
| Basic Prescription Drug Benefit, Subject to $3,500 Maximum per Insured Person per Calendar Year Max 90-day supply |
100% of actual charges (pay and claim only) | 100% of actual charges | 100% of actual charges |
| Optional Rider, Subject to $25,000 maximum per Insured Person per Calendar Year Max 90-day supply |
100% of actual charges (pay and claim only) | Generics: 100% after $10 copay per 30-day supply Brand name: 100% after $10 copay per 30-day supply Injectables: 70% |
Generics: 100% after $10 copay per 30-day supply Brand name: 100% after $10 copay per 30-day supply Injectables: 70% |
| Global Travel Benefits | Insurer Waives Deductible | ||
| Emergency Medical Transportation | Up to $250,000 | n/a | n/a |
| Repatriation of Mortal Remains | Up to $25,000 | n/a | n/a |
| Accidental Death and Dismemberment | $50,000 | $50,000 | $50,000 |
Plan Deductible Choices
Deductible |
Coinsurance Maximum |
|||
BCBS Global Solutions Long-Term Worldwide Premier1,2,3,4,5,6 |
Outside U.S. |
U.S. In Network |
U.S. Out of Network |
|
| Elite | $0 | $0 | $1,000 | $2,000 |
| 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 |
- Copay waived when visiting a BCBS Global Solutions contracted provider outside the U.S.
- Deductibles are per person per Calendar Year.
- 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.
- 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.
- An Insured Person only has to satisfy his/her Coinsurance Maximum once per calendar year for all services received outside of the U.S. and in the U.S.
- Emergency room visits that do not result in inpatient admissions will be subject to a $50 penalty.
Benefits
Benefit Maximums |
Benefits - Outside of the U.S. only |
||
| Lifetime Maximum per Insured Person | Unlimited | ||
| Annual Maximum per Insured Person | Unlimited | ||
| Preventive and Primary Care | Insurer Waives Deductible | ||
| Preventive Care For Babies/Children: (Birth through Age 18) a. Office Visits/examination b. Immunizations, Lab work & X-rays done in conjunction with an office visit |
100% | ||
| Preventive Care for Adults: (Age 19 and Older) a. Office Visits/examination b. Immunizations as recommended on the published Center for Disease Control (CDC) immunization schedule for adults c. Routine Pap Smears, annual mammogram d. PSA For Men e. Diagnostic lab work & X-rays done in conjunction with an office visit |
100% | ||
| Annual Physical Examination/Health Screening, Subject to a $1,000 Maximum per Calendar Year and limited to one per Calendar Year | 100% | ||
| Primary Care Physician or Specialist Office Visits | All except a $10 copay per visit1 | ||
| Urgent Care Facility | 100% | ||
| Professional Services | Insurer Pays After Deductible is Met | ||
| Surgery, anesthesia, radiation therapy, in-hospital doctor visits, diagnostic X-ray and lab work. | 100% | ||
| Inpatient Hospital Services | Insurer Pays After Deductible is Met | ||
| Surgery, X-rays, in-hospital doctor visits, Organ/Tissue Transplant | 100% | ||
| Inpatient medical emergency | 100% | ||
| Inpatient drugs | 100% | ||
| Ambulatory and Therapeutic Services | Insurer Pays After Deductible is Met, Unless Noted | ||
| Ambulatory Surgical Center | 100% | ||
| Ambulance Service | 100% | ||
| Accidental Dental | $1,000 per calendar year, $200 per tooth | ||
| Acupuncture and Chiropractic Services, Subject to a $2,000 Maximum per Calendar Year if under the care of a licensed Physician | 100% | ||
| Durable Medical Equipment | 100% | ||
| Infusion Therapy | 100% | ||
| Physical/Occupational Therapy, Limited to 20 visits per Calendar Year |
100%, no deductible | ||
| Rehabilitation and Therapy | Insurer Pays After Deductible is Met, Unless Noted | ||
| Inpatient Mental Health | 100% | ||
| Outpatient Mental Health | 100%, no deductible $10 Copayment1 |
||
| Inpatient Substance Abuse | 100% | ||
| Outpatient Substance Abuse | 100%, no deductible $10 Copayment1 |
||
| Other Services | Insurer Pays After Deductible is Met | ||
| Home Health Care, Subject to a maximum of 30 visits per Calendar Year | 100% | ||
| Skilled Nursing Facilities, Subject to a maximum of $250 per day for a maximum of 50 days per Calendar Year | 100% | ||
| Hospice, Subject to a maximum of $5,000 per lifetime | 100% | ||
| Outpatient Prescription Benefits (pay and claim only) | Insurer Waives Deductible | ||
| Basic Prescription Drug Benefit, Subject to $3,500 Maximum per Insured Person per Calendar Year Max 90-day supply |
100% of actual charges | ||
| Optional Enhanced Prescription Drug Rider, Subject to $25,000 maximum per Insured Person per Calendar Year Max 90-day supply |
100% of actual charges | ||
| Global Travel Benefits | Insurer Waives Deductible | ||
| Emergency Medical Transportation | Up to $250,000 | ||
| Repatriation of Mortal Remains | Up to $25,000 | ||
| Accidental Death and Dismemberment | $50,000 | ||
Optional Benefits Basic U.S. Benefits Rider (Xplorer Long-Term Outside U.S. plan only)
Benefit Maximums |
Benefits - Inside of the U.S. only |
|
| Calendar Year Maximum Medical Benefit per Insured Person | $1,000,000 | |
| Emergency Medical Care, Illness and Accidental Injury Services while temporarily visiting the United States | Insurer Pays After Deductible is Met, Unless Noted | |
| U.S. Participating Provider | U.S. Non-Participating Provider | |
| Physician's Office Visit Services | 100%, No Deductible, $50 Copayment | 60% to Coinsurance Maximum, then 100% |
| Hospital Emergency Room | 80% to Coinsurance Maximum, then 100% Additional $250 Copayment per visit - waived if admitted |
60% to Coinsurance Maximum, then 100% Additional $250 Copayment per visit - waived if admitted |
| Outpatient Professional Services (radiology, pathology and ER Physician) | 80% to Coinsurance Maximum, then 100% | 60% to Coinsurance Maximum, then 100% |
| Urgent Care Facility | 100%, No Deductible, $75 Copayment | 60% to Coinsurance Maximum, then 100% |
| X-ray and/or Lab performed at the Emergency Room or Urgent Care Facility (billed as part of the visit) | 80% to Coinsurance Maximum, then 100% | 60% to Coinsurance Maximum, then 100% |
| X-ray and/or Lab performed at the Independent facility in conjunction with the Emergency Room visit | 80% to Coinsurance Maximum, then 100% | 60% to Coinsurance Maximum, then 100% |
| Ambulance | 80% to Coinsurance Maximum, then 100% | 60% to Coinsurance Maximum, then 100% |
| Inpatient Hospital - Facility/Professional Charges | Admissions limited to Emergency Medical Care, Illness and Accidental Injury Services while temporarily visiting the United States | |
| U.S. Participating Provider | U.S. Non-Participating Provider | |
| Bed and Board Charges | 80% to Coinsurance Maximum, then 100% | 60% to Coinsurance Maximum, then 100% |
| Physician's Visits/Consultations | 80% to Coinsurance Maximum, then 100% | 60% to Coinsurance Maximum, then 100% |
| Professional Services (Surgeon, Radiologist, Pathologist, Anesthesiologist) |
80% to Coinsurance Maximum, then 100% | 60% to Coinsurance Maximum, then 100% |
| Prescription Drugs Purchased inside the United States | ||
| Limited to Emergency Medical Care, Illness and Accidental Injury Conditions covered under this package. Pre-existing Condition Limitation Applies | 100% of the Actual Cost, Deductible does not apply Maximum benefit of $1,000 per Calendar Year and the maximum supply of 30 days per covered prescription |
|
Plan Deductible Choices
| Elite | $0 |
| 1,000 | $1,000 |
| 2,500 | $2,500 |
| 5,000 | $5,000 |
| 10,000 | $10,000 |
- Copay waived when visiting a BCBS Global Solutions contracted provider outside the U.S.
- Deductibles are Per Person per Calendar Year.
- For a family, the maximum deductible is increased by a factor of 2.5, regardless of the size of the family.
- 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 requirements.
- 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.
- Emergency room visits that do not result in inpatient admissions will be subject to a $100 penalty.
- The 10,000 Plan deductible choice is not available for Long-Term Ouside U.S. Basic U.S. Benefits.
For Exclusions and Limitations see the following:
|
Worldwide
Excluding U.S. Coverage
*Pricing is Per Month |
Worldwide
With Basic U.S. Coverage
*Pricing is Per Month |
|||||||||
| Plan Choice | Base Coverage |
With Rx Upgrade |
With Dental/Vision |
With Dental/Vision and Rx Upgrade |
Plan Choice | Base Coverage |
With Rx Upgrade |
With Dental/Vision |
With Dental/Vision and Rx Upgrade |
|
| Elite | $897.00 | $1,097.00 | $980.00 | $1,180.00 | Elite | $932.00 | $1,152.00 | $1,015.00 | $1,235.00 | |
| 1,000 | $647.00 | $847.00 | $730.00 | $930.00 | 1,000 | $673.00 | $893.00 | $756.00 | $976.00 | |
| 2,500 | $532.00 | $732.00 | $615.00 | $815.00 | 2,500 | $553.00 | $773.00 | $636.00 | $856.00 | |
| 5,000 | $465.00 | $665.00 | $548.00 | $748.00 | 5,000 | $484.00 | $704.00 | $567.00 | $787.00 | |
| 10,000 | $405.00 | $605.00 | $488.00 | $688.00 | 10,000 | $0.00 | $0.00 | $0.00 | $0.00 | |
|
|
|
|||||||||
|
Worldwide
With Comprehensive/Full U.S. Coverage
*Pricing is Per Month |
|||||
| Plan Choice | Base Coverage |
With Rx Upgrade |
With Dental/Vision |
With Dental/Vision and Rx Upgrade |
|
| Elite | $1,512.00 | $1,875.00 | $1,595.00 | $1,958.00 | |
| 1,000 | $1,030.00 | $1,393.00 | $1,113.00 | $1,476.00 | |
| 2,000 | $910.00 | $1,273.00 | $993.00 | $1,356.00 | |
| 5,000 | $731.00 | $1,094.00 | $814.00 | $1,177.00 | |
| 10,000 | $636.00 | $999.00 | $719.00 | $1,082.00 | |
|
|
|||||
Copy this pricing grid and paste it into an email or Word document for your records.