Annual Medical
Global Citizen FAQs
- Who is eligible to buy a Global Citizen plan?
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, Delaware, District of Columbia, Florida, Georgia, Hawaii, Illinois, Iowa, Kansas, Louisiana, Maine, Michigan, Mississippi, Missouri, Nebraska, New Mexico, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Virginia, West Virginia, Wisconsin, WyomingConnecticut, Indiana, Kentucky, Montana, Nevada, North Carolina, Tennessee, Texas, Utah, VermontIf you live in any other U.S state, please contact your agent directly or HTH at 1.888.243.2358.
- Am I guaranteed to be issued a Global Citizen policy if I apply?
No, Global Citizen is not a guaranteed issue plan. Each application is medically underwritten. Your application may be 1) accepted, 2) accepted with a rate increase due to your health status, or 3) denied.
- Is the quote I receive binding?
No, the quote you receive is not binding. The quote you receive may not apply if 1) you provided us with an inaccurate zip code, 2) you misstated a material fact on your application, or 3) we increase the rate due to your health status.
- When determining a rate while overseas, what zip code should I use?
Policies for U.S. citizens residing overseas are issued through the Global Citizens Association office in Washington D.C. The zip code that applies is 20036. Please enter "20036" or "0" in the quoting tool if applying online while living overseas.
- How long will the medical underwriting process take?
The underwriting time frame depends on the medical history listed on the application. Turnaround can be as quick as one day or as long as one month. Our commitment is to respond to a submission in writing within 3 - 5 business days. This may mean that we send a request for additional information to the applicant, such as a specific medical questionnaire, or notify the applicant that they erroneously missed a question on the application form. Occasionally we have to obtain medical records from hospitals or providers. Our turnaround time in these situations will depend on how quickly the provider responds to our request.
If we receive the application before the requested effective date, we can honor the effective date even if the approval comes through thereafter. - Once I'm approved for coverage do I have to go through medical underwriting again?
You do not need to go through medical underwriting when you renew your existing policy without changes. You may be medically underwritten again if you decide to select different benefits (see below). Plan changes can only be requested at time of renewal.
If a member would like to increase benefits (by lowering a deductible or adding pharmacy coverage) they must complete a new application. If a member would like to reduce their benefits, they do not need to complete a new application. - How do I calculate out of pocket expenses and the annual limit?
Out-of-pocket expenses are defined as the expenses a member incurs when satisfying the plan’s deductible and coinsurance requirements. The deductible and coinsurance level varies based on where treatment is delivered as shown in the table below. The total annual out-of-pocket expense limit is calculated by adding the deductible and coinsurance maximum together. In this example, it is $3,500. Deductibles must be satisfied before any benefit is paid. Coinsurance is applied as a percentage of the payable medical charges. This percentage is only applied to care delivered inside the U.S. and varies depending on whether the care is delivered in-network or out-of-network.
Table illustration
Global Citizen Plan Deductible Coinsurance Maximum Outside U.S. U.S.in Network U.S.out of Network 500 $250 $500 $1,000 $3,000 Out of Pocket Expense Example
Member is covered under the Global Citizen 500 plan and receives services from an in-network hospital in the U.S.Payable medical expenses are $20,000, the $500 deductible must be satisfied, and 20% coinsurance applies.
Member is responsible for $3,500 in out-of-pocket expenses (hits the limit) because the deductible and coinsurance amount to $4,500 ($500 + 20% of $20,000)
- How are the deductible and coinsurance calculated for families?
Deductibles reflected in the Global Citizen plan grid are per person deductibles. For a family, the maximum deductible and coinsurance are increased by a factor of 2.5., regardless of the size of the family. For example, a family covered under the 500 plan pays a maximum deductible of $1,250, calculated by multiplying $500 (per person) by 2.5. The coinsurance maximum is $7,500, calculated by multiplying the coinsurance maximum of $3,000 (per person) by 2.5. The family’s annual out-of-pocket expenses limit is $8,750 ($1,250 + $7,500).
- How do I qualify for maternity benefits?
After 12 months of continuous coverage, Global Citizen members may apply for a new plan that covers maternity costs in the same way as all other medical conditions. Members must submit a simple Health Statement to supplement their original application, indicating that they are not pregnant at the time of upgrade.
- Will my policy automatically renew? At what rate?
Global Citizen is renewable up to age 84. Policies are renewed at prevailing rates based on age and sex. Your personal health history will not prevent you from renewing and will not determine the renewal rate. Global Citizen plans do not automatically renew, and members are sent renewal notices 60 days prior to the termination date of their current policy. Only members who return these forms back to HTH Worldwide signed will be renewed.
- When does my coverage end?
We may terminate your policy if:
- You no longer meet the eligibility requirements
- You fail to pay your premium
- You exhaust the Lifetime Maximum Benefit of the plan
- We discover that you committed fraud or misrepresented a material fact to HTH
- We terminate the plan in your state or geographic service area
- Will my pre-existing condition be covered under a Global Citizen plan?
If you were previously covered by a group or annually renewable individual U.S. health plan that issues you a Certificate of Creditable Coverage, HTH Worldwide will apply this prior coverage to the pre-existing conditions waiting period, provided you meet HTH's medical underwriting criteria. HTH will also consider private health insurance issued in other countries as creditable coverage. HTH does not consider surplus lines insurance sold in the U.S. as creditable coverage.
The number of months of coverage shown on the Certificate will reduce or eliminate the six month pre-existing condition waiting period. If you have six or more months of creditable coverage, your waiting period will be eliminated. If you have less than six months creditable coverage, your waiting period will be reduced by the number of months you had creditable coverage. For example, if you have two months of creditable coverage, your waiting period will be reduced from six months to four months. - How do I access participating medical providers outside the U.S. and avoid claim forms?
HTH's Global Health and Safety services help members identify, access, and pay for quality healthcare all over the world. This includes a contracted community of elite providers in 180 countries. Members can access these carefully selected providers and arrange for the bills to be sent directly to HTH Worldwide for payment as follows: go to www.hthtravelinsurance.com and click on "Member Login" then click on "Register Here". After registering, you are able to create a Well Prepared profile and use the related web tool to request an appointment with the participating provider. HTH will automatically arrange for direct settlement of the bill for this visit. Please note, direct billing may not be available everywhere.
Direct billing can also be requested by calling the assistance telephone number listed on your member ID card, or by emailing globalhealth@hthworldwide.com. Please note that in the U.S. a member can simply show their ID card at time of service and participating providers will only bill the member for any required deductible or co-payment.
A claims instruction page is available online and can be accessed by visiting www.hthtravelinsurance.com and selecting "Contact Us" from the top right navigation bar. Claim forms are downloadable from this section of the site as well. - I am based in the U.S. Can you help me find participating doctors in my hometown?
Inside the U.S., HTH has a network of over 700,000 providers available to its members. You can find a doctor in the network by searching Aetna (search Aetna Standard Plans/Open Choice PPO) network. Always speak directly with the provider you have chosen to confirm that they are currently participating with the Aetna Open Choice PPO network.
- I am trying to find a doctor in the U.S. in your network, but there is no one listed within 25 miles of where I am searching. What should I do?
In the U.S., if a member does not have a participating physician in an appropriate specialty available to them within 25 miles, HTH will apply in-network benefits (80%) to the provider they see.
Outside the U.S., 100% coverage always applies after any applicable deductible or co-payment. - I am a Canadian citizen planning to move to the U.S. Am I eligible for your Global Citizen plan?
In order to be eligible for the Global Citizen plan, you must be a citizen or a resident of the United States. If you are in the U.S., you must reside in an approved state. As a Canadian, once you arrive in the U.S. you can apply for coverage if you reside in an approved state (see above for a list of approved states). To ensure that you meet our medical underwriting standards prior to arrival in the U.S., you may wish to complete an HTH pre-screening form.
- I live in New York and therefore am not eligible to buy a Global Citizen plan. When will New York be an approved state?
It is very difficult to predict state approvals. We are working with state insurance regulators to accelerate the process if possible.
If you are going abroad, you may wish to complete a pre-screening form prior to leaving. You can then apply for coverage using an abbreviated application when you are no longer a resident of New York. - I purchased an annual plan, but would like to cancel my insurance prior to its expiration. Will I have to pay any cancellation fees?
Any cancellation requests must be received by HTH in writing via email, fax or regular mail. There are no cancellation fees or penalties. However, HTH does not refund premium for a partial month. Retroactive cancellations are also not permitted.
- Are acts of terrorism covered under this plan?
Yes. The Global Citizen plan does not exclude illnesses or injuries related to terrorism or a terrorist act. In order to be covered in countries where there are open hostilities, such as Iraq and Afghanistan, a member must not be engaged in hostile or combative activities.
- How does the optional pharmacy benefit work?
The optional pharmacy benefit provides coverage inside the U.S. and a higher benefit limit outside the U.S.
HTH offers members the convenience of a direct billing service inside the U.S. so that the member is only responsible for co-payment at participating pharmacies. Most major pharmacies participate in this program. Outside the U.S., members pay the pharmacy directly and then submit a claim to HTH for reimbursement. The optional pharmacy benefit is not subject to the deductible or to the co-insurance on the plan. - How are medical evacuation decisions made?
The evacuation benefit pays for a medical evacuation to the nearest Hospital, appropriate medical facility or back to the U.S. Transportation must be by the most direct and economical route. All evacuations require written certification by the attending physician that the evacuation is medically necessary.
- Is birth control covered?
Use of birth control is not automatically excluded on the policy. HTH reviews the medical condition for which birth control is being used. If it is being used solely as a contraceptive, it is excluded. If it is being used to treat an approved condition, it will be covered. In this instance, the member will have to pay for the prescription up front and submit a claim to HTH, along with a letter from the prescribing doctor indicating the medical necessity of the contraceptive.
- Are we able to add the optional prescription benefits to a Global Citizen HSA plan?
No, we cannot add the optional prescription benefits to our HSA plans.
- Can I add my partner to my Global Citizen policy? Will my partner have to be medically underwritten?
Yes, you can add a spouse or dependent to your policy. A dependent must prove evidence of insurability by submitting an underwriting application. They may be accepted, accepted with a rate up, or declined for coverage based on their medical history. Adding a partner or dependent should follow a life event, such a marriage or birth.
- How can I add an adopted child to my Global Citizen policy?
An adopted child must be medically underwritten in order to be added to a policy.
- Can you tell me what an HSA is? How would I benefit from choosing an HSA account with HTH?
HSA stands for Health Savings Account and is used to pay health-related expenses with tax-sheltered contributions if you are covered by a qualifying high-deductible health plan (HDHP). Global Citizen 1050 for individuals or 2100 for families are qualified HDHPs. HSAs also allow you to build up savings to pay for future medical expenses. Please consult your tax advisor for further details. You can open an HSA by going to the www.hthworldwidebank.com and clicking on "Personal Banking", then "Health Savings Account". Note: HTH Members can choose to set up an HSA with any bank of their choice.
The optional RX plan is not available on the HSA plans due to IRS regulations. Please contact your agent or HTH for more information regarding HSA plan. - What is the Global Citizens Association?
GCA is a not-for-profit association serving those who travel the world for business, study and leisure. GCA promotes health and safety around the world through online knowledge tools and email news alerts. GCA members also benefit from the Association's group purchasing programs for travel, insurance, entertainment and telecommunication services. GCA benefits are available through its Rewards Worldwide program at www.rewardsworldwide.com.
- Where can I read the fine print?
To see plan definitions, limitations or to review a sample certificate visit: hthtravelinsurance.com/gl_citizen/gl_ctzn_cert_sample.pdf.