DIANins ACA Elite 450 OPT
- We will issue 1095 tax form. You don't need to pay the penalty any more.
- Preventive care 100% cover like HPV, Flue and other vaccines
- In network Pharmacy/SHC expense is directly billed(except appliable copay)
- Telehealth service via Teladoc
- Medical bill is charged to company directly in Network except your costs
- Worldwide coverage including vacation travel in other country(not home country)
- Expenses in excess of $5,000, fully paid by company
- No waiting period on pre-existing condition
- Serviced by one of the biggest provider, UHC
• You must be a non-US citizen who has been a full-time student for one academic year enrolled in an SEVP-certified college, university, conservatory or seminary. • Your proposed employment must relate to your major area of study. • You must be residing outside your Home Country and depart not more than thirty (30) days from purchasing this plan. You must remain engaged in full-time educational or research activities outside your Home Country during the Benefit Period. You are not eligible for this Policy if your intent is to live in a fixed location outside your Home Country (living abroad versus traveling). • You must not have obtained residency status in the United States. • You must hold a valid passport and a valid F-1 or M-1 visa on OPT. Policyholder must, at all times during the Benefit Period, meet all requirements of the applicable US visa that has been obtained to enter the United States. An Insured Person with an F-1 Student Status, Form I-20 will be provided to you by your school which you and your school official must sign.
| Lifetime maximum | Unlimited |
| Annual maximum | Unlimited |
| Co-insurance in network | 80% |
| Co-insurance out-of-network | 50% |
| Deductible in student health center | $0 |
| Deductible in network | $450 |
| Deductible in non-network | $500 |
| Out of pocket in network | $5,000 |
| Co-pay in ER (waived if admitted) | $200 |
| Co-pay in SHC | $0 |
| Co-pay primary care | $20 |
| Co-pay specialist visit | $20 |
| Pre-existing condition waiting period | No Waiting |
| Preventative care | 100% |
| Medical evacuation | $120,000 |
| Repatriation | $50,000 |