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$161.8 per month
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Highlights
  • Deductible and copay is waived in Student Health Center
  • Preventive care 100% cover like HPV, Flu and other vaccines
  • In network Pharmacy/SHC expense is directly billed(except appliable copay)
  • Medical bill is charged to company directly in Network except your costs
  • GlobalReach Rx network available in Pharmacy
  • Expenses in excess of $5,000, fully paid by company
  • No waiting period on pre-existing condition
  • Use the Aetna PPO network covering the entire United States
  • In network Coinsurance 100% (Surgery90%)

Eligibility Guidelines 1. Who is Eligible: Class 1 (Primary Insured Student): International students aged 17–45 holding F1, J1, or M1 visas. Officially registered at an accredited higher education institution and enrolled in a full-time* associate's, bachelor's, master's, or doctoral degree program (Approaching graduation and in their final semester on a part-time program also qualify for Class 1 status*). Class 2 (Spouse): The legal spouse of a Class 1 primary insured student. Class 3 (Children): Eligible dependent children of a Class 1 primary insured student. 2. Who is Not Eligible: Students enrolled in distance learning or home study, graduates in OPT (Optional Practical Training) programs, or U.S. citizens or permanent residents (green card holders). 3. Essential Conditions for Maintaining Insurance Validity (Attendance & Withdrawal) * Attendance Requirements: Insured students must attend at least the first 90 days of classes during the coverage period and/or strictly meet their visa attendance requirements. * Withdrawal within the First 31 Days: If a student withdraws from school within the first 31 days of registration (except in cases of policy replacement waiver refusal or withdrawal due to illness/injury), the insurance will lapse and coverage will be terminated; the insurance company will fully refund the premium, but any claims already paid will be deducted. * Withdrawal/Graduation after 31 Days: If a student graduates or withdraws normally after 31 days of registration, the insurance remains valid for the purchased period, and the premium will not be refunded. For the complete eligibility information, please refer to the original Policy terms and conditions or contact customer service for confirmation.

Lifetime maximum Unlimited
Annual maximum Unlimited
Co-insurance in network 100%
Co-insurance out-of-network 80%
Deductible in student health center $0
Deductible in network $0
Deductible in non-network $200
Out of pocket in network $5,000
Co-pay in ER (waived if admitted) $150
Co-pay in SHC $0
Co-pay specialist visit $25
Co-pay hospitalization $0
Pre-existing condition waiting period No Waiting
Preventative care 100%
Medical evacuation 100%
Repatriation 100%
DIANins · International Student Health Plans
Compar with Blue 80 & 90 !
The Blue plan comes in three tiers by coinsurance level — Blue 80 (80%), Blue 90 (90%), Blue 100 (100%). All three share identical covered benefits, caps, and exclusions; only the coinsurance rate, deductible, and out-of-pocket maximum (OOPM) differ. U.S. network is Aetna throughout.

Blue 80: The lowest-premium tier. The insurer pays 80% of claims (you pay 20%), with the highest deductible and OOPM. Best for students prioritizing a lower premium.

Blue 90: The middle tier. The insurer pays 90% (you pay 10%), with a mid-level deductible and OOPM. A balance of premium and coverage.

Blue 100: The top tier. After the deductible, the insurer pays 100% of In-Network claims, so your out-of-pocket cost is lowest. With the lowest deductible ($0) and OOPM, it suits students wanting predictable costs.
Covered    Not covered    orange text = has a cap    best in this row
  Blue 8080% Coinsurance Blue 9090% Coinsurance Blue 100100% Coinsurance
Core Benefits
DeductibleIn-Network $500 $100 $0
DeductibleOut-of-Network $750 $500 $200
Maximum per policy year UnlimitedUnlimited UnlimitedUnlimited UnlimitedUnlimited
Out-of-pocket maximumIn-Network $7,000OON $14,000 $6,000OON $12,000 $5,000 OON $10,000
CoinsuranceIn-Network 80%OON 70% 90%OON 70% 100% OON 70%
Pre-existing condition No waitStudent / Dependents 24mo No waitStudent / Dependents 24mo No waitStudent / Dependents 24mo
Vaccine & Physical Exam In-Net 100% In-Net 100% In-Net 100%
Copay — Office visitPhysician / Specialist $25 $25 $25
Copay — ERwaived if admitted $150 $150 $150
Copay — SHC / Urgent CareSHC / Urgent Care $0 / $50 $0 / $50 $0 / $50
Prescription Drugs $10 / $30 / $50Tier 1 / 2 / 3 $10 / $30 / $50Tier 1 / 2 / 3 $10 / $30 / $50Tier 1 / 2 / 3
Other Key Benefits
Hospitalization 80% 90% 100%
ICU / Cardiac
Surgical Benefits 80% 90% 90%
Reconstructive Surgery
Inpatient Rehabilitation 45 days 45 days 45 days
Maternity 80% 90% 100%
Elective Abortion $1,500 $1,500 $1,500
Mental Health 80% 90% 100%
Physical / Therapeutic 12 visits 12 visits 12 visits
Cancer & Oncology 80% 90% 100%
AIDS · HIV · STD 80% 90% 100%
Alcohol / Substance 80% UCR 90% UCR 100% UCR
Chiro / Acupuncture $500 $500 $500
Home Health / Hospice Hospice 45 days / $5,000 Hospice 45 days / $5,000 Hospice 45 days / $5,000
Organ / Transplant
Congenital / Habilitative
Allergy / HIV Screening
Pediatric Dental / Vision
Emergency Dental $250/tooth · $1,000 $250/tooth · $1,000 $250/tooth · $1,000
Palliative Dental $600 $600 $600
Recreational Sports 80% 90% 100%
Evacuation / Repatriation 100% 100% 100%
Excluded in all three tiers
Gender identity/dysphoria · cosmetic/elective surgery · infertility (IVF)/sterilization · vision correction·glasses·LASIK (except pediatric vision) · dental (except accidental/pediatric) · hearing aids · obesity/weight-loss treatment · smoking cessation · sleep studies (sleep apnea) · sexual dysfunction · genetic screening · breast reduction · travel immunizations · competitive/hazardous sports (varsity·club competition, skydiving, scuba beyond 30m, etc.)·motorcycles · war·terrorism · home-country care (beyond schedule) · care by a family member · costs reimbursable by other insurance/government
How to choose a tier — important: All three tiers share identical covered benefits, caps, and exclusions; only the coinsurance rate, deductible, and OOPM differ. A higher payout (80→100) means a higher premium but lower out-of-pocket cost per claim. Out-of-network is 70% for all three tiers.
Out-of-network OOPM is 2× the In-Network figure ($14,000 / $12,000 / $10,000).
Common: all four plans use the U.S. Aetna network, are issued by Spectrum Life, and use Global Reach Rx network pharmacies for prescriptions.
This table summarizes the Schedule of Benefits; final contract terms follow the official policy document.