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Terms & Conditions


Global Citizen Health Plan


After you pay the deductible, The Global Citizen health plan pays 100% for treatment outside the U.S., 80% for treatment received by a contracted provider in the U.S (to the coinsurance maximum)and 60% for treatment received out of network in the U.S. (to the coinsurance maximum).  Please see the deductible grid below that defines the coinsurance maximum for each plan.



Global Citizen Highlights

 

  • Approved and admitted U.S. health insurance policy
  • 180 day pre-existing condition waiting period that can be waived with proof of prior creditable coverage
  • No waiting period associated with benefits or services
  • Plan deductible is waived for physician office visits
  • No pre-certification penalty imposed
  • Cashless access to “elite” contracted doctors and hospitals in 170 countries
  • Maternity benefits for prenatal care and delivery
  • No limit on time spent in or out of the U.S. Plan can be kept upon return to home country.
  • Medical evacuation and repatriation of remains
  • “Informed Choice” medical management services for complex problems
  • Available National PPO Network in US
  • Newborns are automatically covered without underwriting
  • Freedom to access Centers of Excellence in the U.S. for serious medical problems
  • EXP option available- which reduces rates by almost 50% (worldwide coverage excluding U.S)
  • Coverage for terrorist events and professional sporting activities
  • US$ 5 Million Lifetime Benefit


Hospital Benefits

 

 

Inpatient Hospital Benefits

  • Room and Board
  • Intensive Care Unit
  • Diagnostic Radiology and Laboratory Services
  • Prescription Drugs
  • Chemotherapy & Radiation
  • Physician & Surgery Services
  • Human Organ Transplants for Approved Services   
    (US$ 5,000,000 Lifetime Maximum)
  • Blood Transfusions
  • Physical and Occupational Therapy
  • Mental Health and Substance Abuse

 

Outpatient Hospital Benefits

  • Ambulatory Surgery
  • Physician Services
  • Emergency Benefits
  • Chemotherapy & Radiation
  • Prescription Drug
  • Diagnostics
  • Physical and Occupational Therapy
  • Durable Medical Equipment

Wellness Benefits

  • No waiting period
  • Unlimited Well Baby Visits and Immunizations
  • Adult Routine Physical
  • Mammograms
  • PAP Smear
  • GYN Exams
  • PSA Screening for men

 

Professional- Non-Hospital Benefits

 

  • Doctor's Office Visits
  • Specialists Office Visits
  • Office Surgery
  • Physical and Occupational Therapy
  • Outpatient Prescription Drug (additional Rider available)
  • Diagnostic Laboratory or Radiology
  • Mental Health and Substance Abuse Visits
  • Acupuncture and Chiropractic Services
  • Home Health Care, Skilled Nursing and Hospice
  • Accidental Dental for Injury or Relief of Pain

Deductibles and Coinsurance

 

Global Citizen offers a range of deductibles as defined below. Your actual deductible varies depending on whether treatment is accessed inside or outside of the U.S.



Global Citizen
Plan 1,2,3,4,5

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

 
1. Copay waived when visiting an HTH Worldwide contracted provider.
2. Deductibles are Per Person per Policy Period.
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.

 

Direct Billing

 

HTH Members have freedom to access treatment from any provider. When you use the HTH Healthcare Community and utilize our telephone or online appointment scheduling service, HTH can pay providers directly. This avoids the hassle of filling out claim forms and waiting for reimbursement.  It also reduces the issue of Providers balance billing patients for services not covered under the plan as reasonable expenses. For non contracted providers a member would pay the provider and submit a claim to HTH Worldwide. You will receive claim instructions and claim forms along with your welcome packet and identification card. 


Who is Eligible

 

All U.S. citizens living abroad who are 74 or younger at the time of application are eligible to apply for coverage.

All legal residents of the U.S.(citizens and foreign nationals) who are age 74 or younger at the time of application are eligible if they live in a state listed below:

Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Hawaii, Illinois, Indiana, Iowa, Kentucky, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Mexico, North Carolina, North Dakota, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, West Virginia, Wisconsin, Wyoming

If you live in any other U.S state please contact your agent or HTH


Exclusions

 

The following is a partial list of excluded services.  See the Policy for a more complete list.

  • Services that are not Medically Necessary
  • Cosmetic services
  • Fertility/Infertility treatment
  • Conditions caused by or contributed by: (a) An act of war; (b) The inadvertent release of nuclear energy when government funds are available for treatment of Illness or Injury arising from such release of nuclear energy; (c) An Insured Person participating in the military service of any country; (d) An Insured Person participating in an insurrection, rebellion, or riot; (e) Services received for any condition caused by an Insured Person's commission of, or attempt to commit a felony or to which a contributing cause was the Insured Person being engaged in an illegal occupation; (f) An Insured Person, age 19 or older, being under the influence of illegal narcotics or non-prescribed controlled substances unless administered on the advice of a Physician.
  • Any amounts in excess of maximum amounts of Covered Expenses stated in this Plan.
  • Services not specifically listed in the Insurance Policy as Covered Services.
  • Services or supplies that the Insurer considers to be Experimental or Investigative.
  • Growth Hormone Treatment.
  • Routine foot care including the cutting or removal of corns or calluses; the trimming of nails, routine hygienic care and any service rendered in the absence of localized Illness, Injury or symptoms involving the feet.

 

How to apply

 

Please complete the online application or print the PDF application and return it to HTH with your initial premium payment.  HTH Worldwide offers monthly, quarterly, semi annual and annual billing. Billing options include U.S. checking account deduction or credit card deuction.

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