International Full-time students attending a language programs/school or university who is a minimum of 17 years and a maximum of 64 years. Student must have a current passport and be travelling outside their Home County; and student must have a valid F1, M1, or J1 visa type. International full-time students (as defined by the educational institution) enrolled in an associate, bachelor, master, or Ph.D. program at a university or other accredited higher education institution outside of their Home Country. The full-time requirement is waived for summer if the student was enrolled in this Plan as a full-time student in the immediately preceding spring term. Students must actively attend classes. Home study, correspondence, and online courses do not fulfill the Eligibility requirements that the student actively attend class. The Insurer has the right to investigate Eligibility status and attendance records to verify Eligibility requirements are met. The Insured Person on this Plan who is an Eligible Person as identified in the Schedule of Benefits, a Non-United States Citizen travelling outside their Home Country and travelling to the United States and has their true, fixed and permanent home and principal establishment outside of the United States and holds a current and valid passport, and for whom proper Premium payment has been made when due.
Maximum per sickness/injury | $500,000 |
Co-insurance in network | 90% |
Co-insurance out-of-network | 70% |
Deductible in network | $100 |
Deductible in non-network | $100 |
Out of pocket in network | Unlimited |
Co-pay in ER (waived if admitted) | $250 |
Co-pay in SHC | $5 |
Co-pay primary care | $50 |
Co-pay specialist visit | $50 |
Co-pay hospitalization | $0 |
Pre-existing condition waiting period | 90% UCR-Up to $25,000 for emergency care and stabilization only |
Preventative care | N/A |
Medical evacuation | 90% up to $50,000 |
Repatriation | 90% URC-Up to $25,000 |