How Atlas America Insurance Work: A Comprehensive Guide

How Atlas America Insurance Work: A Comprehensive Guide

You are probably here because you want to know how Atlas America Insurance work. Atlas America Insurance is designed to provide comprehensive medical coverage for travelers, particularly visitors to the USA. Here’s an overview of how the Atlas America insurance plan functions:

1. Coverage For Medical Expenses

Atlas America visitors insurance covers unexpected medical expenses that arise due to an illness or injury during the covered travel period. This includes costs related to hospitalization, surgery, doctor visits, and emergency medical evacuation if needed.

2. PPO Network For Better Coverage

Atlas America partners with the United Healthcare PPO Network in the U.S., which means that:

  • If you visit a healthcare provider within the PPO network, you receive better rates and more comprehensive coverage.
  • After your deductible is met, the insurance company covers 100% of eligible medical expenses up to the policy maximum.
  • If you visit a provider outside the PPO network, you still receive coverage, but the costs may be higher, and reimbursement may not be as generous.

3. Deductible Structure

The deductible is the amount you pay out-of-pocket before the insurance begins covering your expenses. Atlas America offers a one-time deductible for the entire policy period, which means:

  • Once the deductible is met, all eligible medical expenses will be covered 100% up to your plan’s policy maximum.
  • The deductible amount is adjustable, and you can choose a deductible that suits your needs and budget. Healthcare providers typically bill the insurance company directly, allowing you to benefit from negotiated fees and avoiding upfront payment, except for deductibles.

4. Flexibility For Travelers

  • Eligibility: Atlas America is available for a wide range of travelers, particularly those visiting the U.S. for tourism, business, or study. Eligibility extends to individuals traveling outside of their home country, ensuring coverage for various international trips.
  • Policy Duration: Coverage is available for trips ranging from 5 days to 364 days, offering flexibility depending on the traveler’s itinerary.
  • Optional Riders: Travelers can enhance their coverage by adding optional riders like Accidental Death & Dismemberment or Crisis Response to suit their specific needs.

5. Trip Interruption And Travel Delay

Atlas America Insurance also includes benefits for trip interruption and travel delay, helping to minimize the financial impact of unforeseen events. If your trip is interrupted due to a covered reason, such as a medical emergency, the plan can reimburse you for non-refundable trip expenses, ensuring that you don’t lose out financially.

Additionally, the travel delay benefit provides coverage for meals and accommodations if your trip is delayed for a covered reason. This means that if you find yourself stuck due to a flight delay or other travel disruption, Atlas America Insurance can help cover the costs of your extended stay, making an inconvenient situation a little more manageable.

6. Emergency Medical Evacuation

If you’re in a situation where the local healthcare facility cannot provide the necessary medical care, Atlas travel insurance covers emergency medical evacuation to the nearest facility that can offer treatment. This benefit is crucial for travelers going to remote or underserved areas.

7. Pre-Existing Conditions And Acute Onset

Atlas America Insurance provides coverage for the acute onset of pre-existing conditions, which refers to a sudden and unexpected outbreak or recurrence of a pre-existing condition that requires immediate medical attention.

This benefit ensures that travelers with pre-existing conditions can receive necessary care if their condition flares up unexpectedly during their trip.

However, it is important to note that the plan does not cover chronic or congenital conditions, and pre-existing conditions that are not acute onset are excluded from coverage.

Understanding these terms is crucial to ensure you know what is and isn’t covered under your plan.

How Atlas America Work To Pays Your Hospital Bill: A Real-Life Example

How Atlas America Pays Your Hospital Bill
How Atlas America Works And Pays Your Hospital Bill

One of the key aspects of Atlas America Insurance is how it covers medical expenses, including hospital bills, for unexpected illnesses or injuries.

The Atlas America plan is a comprehensive travel medical insurance product designed for international visitors to the U.S., emphasizing its coverage for acute onset of pre-existing conditions and various emergencies.

Here’s a step-by-step example to show how Atlas America works when you receive medical treatment and need to file a claim for hospitalization.

Example:

Let’s say John, an international traveler, visits the U.S. for a business trip. While traveling, he accidentally falls and fractures his leg, requiring an emergency room visit and surgery. Here’s how the process would work with Atlas America Insurance:

1st Step: Receiving Treatment

  • John goes to the hospital emergency room and gets treated for his injury. After undergoing surgery, his hospital bill totals $10,000. Since John is covered by Atlas America Insurance, he is eligible for reimbursement of his medical expenses. The Atlas America plans are known for their affordability, starting at under $1 a day, and they provide coverage for acute onset of pre-existing conditions, making them a reliable choice for travelers.

2nd Step: Meeting the Deductible

  • Atlas America has a $500 deductible that John has selected. This means that before Atlas America begins covering any of his medical expenses, John must pay the first $500 of his hospital bill.
  • Once John pays the $500 deductible, the insurance kicks in to cover the rest of the eligible medical expenses.

3rd Step: Coverage of Medical Bills

  • After the deductible is paid, Atlas America Insurance covers the remaining hospital bill. In this case, the total hospital bill is $10,000. Since John’s deductible has been met, Atlas America will cover the remaining $9,500, up to the policy maximum (depending on the plan’s limits).

4th Step: PPO Network Benefits

  • If John went to a hospital within the PPO network, the insurance provider would have negotiated lower rates, reducing the total medical expenses.
  • If the hospital is out of network, John still gets coverage, but he may have to pay higher out-of-pocket costs, and the reimbursement rate may be less generous than if he used an in-network provider.

5th Step: Submitting a Claim

  • To get reimbursement, John needs to submit a claim to Atlas America. This involves providing medical receipts, treatment records, and the hospital bill to the insurance provider.
  • Once the claim is processed, Atlas America will pay John directly or pay the hospital directly (depending on the agreement). If there are any remaining out-of-pocket costs after reimbursement, John will need to pay those.

6th Step: Final Outcome

  • John’s final cost will be:- $500 deductible (paid by John),
  • The remaining balance of $9,500 will be covered by Atlas America, assuming it falls within the policy’s limits and the medical expenses are eligible.

Key Points To Remember:

  • The deductible is the amount you pay upfront before insurance coverage begins. It can be selected when purchasing the plan.
  • Atlas America covers 100% of eligible medical expenses after the deductible is met, up to the policy maximum.
  • In-network hospitals usually offer more affordable rates, reducing out-of-pocket expenses compared to out-of-network providers.
  • Claims must be submitted with proper documentation (e.g., hospital bills, medical receipts) for reimbursement to be processed efficiently.

Cost And Pricing

The cost of Atlas America Insurance varies based on several factors, including your age, health, destination, and the duration of your stay.

The plan offers flexible pricing options to suit different needs and budgets. You can choose from a range of deductibles, from $0 to $5,000, and policy maximums ranging from $50,000 to $2,000,000.

This flexibility allows you to tailor the plan to your specific requirements, ensuring you get the coverage you need at a price you can afford.

Quotes for Atlas America Insurance are available instantly online or through a licensed insurance agent, making it easy to find the right plan for your trip.

Restrictions And Exclusions

Atlas America Insurance has certain restrictions and exclusions that potential buyers should be aware of.

The plan is not available to:

  • Individuals who are physically located in the states of New York, Maryland, or Washington, or
  • In the countries of Canada or Australia at the time of purchase.

Additionally, the plan excludes coverage for certain high-risk activities, such as extreme sports, and for pre-existing conditions that are not considered acute onset.

It is essential to carefully review the plan’s terms and conditions before purchasing to ensure that it meets your specific needs and circumstances.

International And Domestic Coverage

Atlas America also covers medical emergencies for travelers both within the U.S. and abroad through its Atlas Travel Medical Insurance. Whether you’re touring the U.S. or exploring other countries, Atlas America ensures that you’re covered in case of unforeseen medical incidents.

Optional Add-On Benefits For Atlas America Insurance

Enhance your Atlas America Insurance coverage for additional protection and peace of mind during your trip. You can select these optional add-on benefits during the checkout process to tailor the plan to your specific needs.

Personal Liability Benefit Rider

  • Add more protection for unforeseen incidents: Purchase an additional $75,000 in Personal Liability coverage, on top of the $25,000 included in the base plan, bringing the total liability coverage to $100,000.
  • Affordable Coverage: This rider costs only $0.40 per person per day, ensuring you’re covered for unexpected accidents or damage to third-party property.
  • Coverage Breakdown:
    • Base PL Coverage: $25,000.
    • Additional PL Coverage Available: $75,000.
    • Total PL Coverage Amount: $100,000.

Crisis Response Benefit Rider

  • Increase your crisis response coverage: Atlas America provides $10,000 for crisis response as part of the base plan. You can enhance this coverage by an additional $90,000, bringing the total coverage to $100,000 for only $1.50 per person per day.
  • What does this cover?: This rider provides financial protection in case of political instability, natural disasters, or other crises that require emergency evacuation.
  • Coverage Breakdown:
    • Base CR Coverage: $10,000.
    • Additional CR Coverage Available: $90,000.
    • Total CR Coverage Amount: $100,000.

Accidental Death And Dismemberment (AD&D) Coverage

  • Extra protection in case of an accident: If you’re between the ages of 18 and 69, this rider allows you to double the base Accidental Death & Dismemberment (AD&D) benefit, increasing the coverage from $25,000 to $50,000.
  • Key Benefits: This rider ensures that in the event of your death or loss of a limb due to an accident, you or your beneficiaries receive compensation. AD&D coverage is not subject to the overall policy maximum.
  • Affordable Addition: This optional rider is available for only $0.40 per person per day.
  • Coverage Breakdown:
    • Base AD&D Coverage: $25,000.
    • Additional AD&D Coverage Available: $25,000.
    • Total AD&D Coverage Amount: $50,000.

Important Notes:

  • Pricing for add-ons may vary based on the specific details entered during the checkout process.
  • All optional add-ons can be selected based on your travel requirements to ensure maximum coverage for emergencies.
  • Coverage details for these add-ons, including exclusions, are provided in the policy documentation.
  • Optional add-on benefits and their pricing may change refer to your policy document for the exact pricing details.

How The Claims Process Works

  • Filing Claims: To make a claim, you need to notify Atlas America of any medical treatment received during your trip. This process is similar for Atlas Travel Health Insurance, ensuring that your medical expenses are covered efficiently.
  • Submitting Documentation: You’ll be required to submit medical bills, receipts, and a claim form for reimbursement.
  • Claims Processing: Once all documentation is provided, claims are processed within 30-60 days, with most claims being approved quickly.

Conclusion: Atlas America Insurance Work

In this example, Atlas America Insurance helps John cover his hospital bill after an unexpected injury while traveling. By paying the deductible and submitting a claim, John is able to receive coverage for his medical expenses, including surgery and hospitalization, without facing exorbitant costs out of pocket. The reimbursement process is designed to be straightforward and efficient, ensuring travelers like John are protected when emergencies arise.