Student Health Advantage

Feb 16, 2017, 10:27 AM

Title : Student Health Advantage

Subtitle : Comprehensive medical insurance for international students or scholars

Short Title :

Other plans summary : Comprehensive medical insurance for international students or scholars participating in a sponsored study abroad program.

Plan type class : plan_type__student plan_type__travel_medical_insurance

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Most popular : Yes

Recommended : No

Medical Coverage - not used : 4

Ranking - Price - Not Used : 3

Sort order : 80

Designed for individuals or groups of five or more students or scholars participating in a sponsored study abroad program, and who desire an annually renewable medical plan. This plan meets student visa requirements, includes benefits for maternity, mental health, organized sports and international emergency care.

Your educational adventure should be enjoyable and gratifying. Maintaining the ability to be flexible and responsive, IMG developed Student Health Advantage, an international health care plan designed to specifically meet the needs of international students involved in long-term educational programs. The plan offers a complete package of international benefits available 24 hours a day.

For students, scholars, and cultural exchange participants when inside the U.S., the UnitedHealthcare Options network is a longstanding reputable tier 1 network that gives you more access to more doctors and services. When outside the U.S., you can also enjoy access to quality healthcare worldwide with our proprietary IPA network that includes over 18,550 physicians and facilities. For additional benefits, check out our highest level of international student insurance coverage, Student Health Advantage Platinum.

Highlights

Comprehensive medical insurance for international students or scholars participating in a sponsored study abroad program
Coinsurance in PPO network or student health center within the U.S.: Company pays 100%
Deductible of $250
Maximum limit for student: $500,000
Provides coverage for mental health, organized sports, and preexisting conditions

Summary of Benefits

All amounts shown are in U.S. dollars.

Coverage Limit / Maximum Amount for Eligible Medical Expenses

Benefits	In-Network	Out-of-Network	International
Maximum Limit	Student: $500,000 Dependent: $100,000	Student: $500,000 Dependent: $100,000	Student: $500,000 Dependent: $100,000
Per Illness or Injury limit	Student: $300,000 Dependent: $100,000	Student: $300,000 Dependent: $100,000	Student: $300,000 Dependent: $100,000
Deductible Per Illness or Injury	$250	$250	$250

Coinsurance for Eligible Medical Expenses

Benefits	In-Network	Out-of-Network	International
Coinsurance In addition to Deductible	Plan pays 90% Insured pays 10%	Plan pays 80% Insured pays 20%	Plan pays 100% Insured pays 0%
Out of Pocket Maximum	$1,000	Up to the Maximum Limit	$0

Precertification

Benefits	In-Network	Out-of-Network	International
Interfacility Ambulance Transfer, Emergency Medical Evacuation	No coverage if Pre-certification requirements are not met	No coverage if Pre-certification requirements are not met	No coverage if Pre-certification requirements are not met
All other Treatments & supplies	50% reduction of Eligible Medical Expenses if Pre-certification requirements are not met	50% reduction of Eligible Medical Expenses if Pre-certification requirements are not met	50% reduction of Eligible Medical Expenses if Pre-certification requirements are not met

Pre-existing Conditions

Charges resulting directly or indirectly from or relating to any Pre-existing Condition that existed within 36 months prior to the Effective Date are excluded until the Insured Person has maintained 12 months of continuous coverage under this insurance.

Student Health Center

Benefits	In-Network	Out-of-Network	International
Copayment per visit Not subject to the per Illness or Injury Deductible	$5	$5	$5
Coinsurance	Plan pays 100% Insured pays 0%	Plan pays 100% Insured pays 0%	Plan pays 100% Insured pays 0%

Inpatient/Outpatient Benefits

Benefits	In-Network	Out-of-Network	International
Eligible Medical Expenses	90%	80%	100%
Physician Visits/Services Maximum Visits per day: 1 Surgery is not subject to the Maximum visit limit	90%	80%	100%
Hospital Emergency Room Injury: Not subject to Emergency Room Deductible Illness: Subject to a $250 Deductible for each Emergency Room visit for Treatment that does not result in a direct Hospital admission.	90%	80%	100%
Teleconsultation (Groups only)	Not subject to Deductible and Coinsurance Mental or Nervous Disorders are not covered Coverage for a Teleconsultation is not a determination that any specific condition discussed, raised or identified during such consultation is covered under this insurance. The Company reserves the right to decline future claims relating to or arising from any condition discussed, raised or identified during a Teleconsultation where the Illness or Injury is directly or indirectly related to any Pre-existing Condition or is otherwise excluded under this Certificate of Insurance
Hospitalization / Room & Board Average semi-private room rate Includes nursing, miscellaneous and Ancillary Services	90%	80%	100%
Intensive Care	90%	80%	100%
Outpatient Surgical / Hospital Facility	90%	80%	100%
Laboratory	90%	80%	100%
Radiology / X-ray	90%	80%	100%
Chemotherapy / Radiation Therapy	90%	80%	100%
Pre-admission Testing	90%	80%	100%
Surgery	90%	80%	100%
Reconstructive Surgery Surgery is incidental to and follows Surgery that was covered under the plan	90%	80%	100%
Assistant Surgeon 20% of the primary surgeon’s eligible fee	90%	80%	100%
Anesthesia	90%	80%	100%
Durable Medical Equipment	90%	80%	100%
Chiropractic Care Medical order or Treatment plan required	90%	80%	100%
Physical Therapy Maximum Visits per day: 1 Medical order or Treatment plan required	90%	80%	100%
Extended Care Facility Upon direct transfer from an acute care Hospital	90%	80%	100%
Home Nursing Care Provided by a Home Health Care Agency Upon direct transfer from an acute care Hospital	90%	80%	100%

Prescription Drugs and Medication - The following Prescription Drugs and Medication Period of Coverage limit accumulates toward the Maximum Limit

Benefits	In-Network	Out-of-Network	International
Period of Coverage limit Subject to the Coinsurance amounts listed below	Student: $250,000 per person Dependents: Up to the Maximum Limit ($100,000)	Student: $250,000 per person Dependents: Up to the Maximum Limit ($100,000)	Student: $250,000 per person Dependents: Up to the Maximum Limit ($100,000)
Inpatient and Outpatient Surgery Prescription Drugs and Medication	90%	80%	100%
Emergency Room and Outpatient Office Visits Prescription Drugs and Medication	90%	80%	100%
Retail Pharmacy Prescripton Drugs and Medication Dispensing maximum for Retail Pharmacy: 90 days per prescription	N/A	50%	50%

Mental or Nervous / Substance Abuse

Benefits	In-Network	Out-of-Network	International
Inpatient Mental or Nervous / Substance Abuse Maximum Limit: $10,000 Not covered if incurred at the Student Health Center	90%	80%	100%
Outpatient Mental or Nervous / Substance Abuse Maximum Limit per day: $50 Maximum Limit: $500 Not covered if incurred at the Student Health Center	90%	80%	100%

Emergency Services

Benefits	In-Network	Out-of-Network	International
Emergency Local Ambulance Period of Coverage Limit per Injury $350 Period of Coverage Limit per Illness $350 (resulting in an Inpatient Hospitalization)	100%	100%	100%
Emergency Medical Evacuation Maximum Limit: $500,000 Must be approved in advance and coordinated by the Company	100%	100%	100%
Emergency Reunion Maximum Limit: $50,000 Maximum Days: 15 Meal Maximum per day: $25 Reasonable and necessary travel costs and accommodations Must be approved in advance by the Company	100%	100%	100%
Interfacility Ambulance Transfer Up to the per Injury or Illness limit Services rendered in the United States Transfer must be a result of an Inpatient Hospital admission	100%	100%	N/A
Political Evacuation and Repatriation Maximum Limit: $10,000 Must be approved in advance by the Company	100%	100%	100%
Repatriation for Medical Treatment Maximum Benefit: $100,000. This is in addition to the plan maximum limit/per injury or illness maximum limit Approved in advance and coordinated by the Company Refer to the REPATRIATION FOR MEDICAL TREATMENT provision for further details	100%	100%	100%
Return of Mortal Remains Maximum Limit: $50,000 Local Burial / Cremation at place of death Maximum Limit: $5,000 Return of Insured Person’s Mortal Remains to Country of Residence Must be approved in advance by the Company	100%	100%	100%

Other Services

Benefits

In-Network

Out-of-Network

International

Terrorism

Not subject to Deductible and Coinsurance
Maximum Limit: $50,000

100%

Dental Treatment

Period of Coverage Limit: $350
(Treatment due to Unexpected pain to sound, natural teeth)
Period of Coverage Limit per Injury: $500

(Non-emergency Treatment at a Dental Provider due to an Accident)

N/A

90%

100%

Traumatic Dental Injury

Treatment at a Hospital Facility due to an Accident
Additional Treatment for the same Injury rendered by a Dental Provider will be paid at 100%

90%

80%

100%

Intercollegiate, Interscholastic, Intramural, or Club Sports

Period of Coverage Limit per illness or injury: $5,000

90%

80%

100%

Accidental Death & Dismemberment

Not subject to Deductible and Coinsurance
Death must occur within 90 days of the Accident

Accidental Death: 100% of Principal Sum Student: $25,000 Spouse: $10,000 Child: $5,000
Accidental Dismemberment:
Loss	Percent of Principal Sum
Sight of 1 eye	50%
1 hand or 1 foot	50%
1 hand and loss of sight of 1 eye	100%
1 foot and loss of sight of 1 eye	100%
1 hand and 1 foot	100%
Both hands or both feet	100%
Sight of both eyes	100%

Incidental Trip

Maximum days: 14
Country of Residence is outside the United States
Refer to the INCIDENTAL TRIP provision for further details

90%

80%

100%

Personal Liability

Secondary to any other insurance
No coverage for Injury to a related Third Party or damage to related Third Person’s property
Refer to the PERSONAL LIABILITY provision for further details and requirements

Combined Maximum Limit: $10,000

Injury to Third Person:
Per Injury Deductible: $100

Damage to Third Person’s property: Per damage Deductible: $100

Made for...

Students / Scholars

personas :

Student

Tags :

Student Health Advantage

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Student / Scholar
Travel Medical Insurance

Student Health Advantage Brochure

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Student Health Advantage

Feb 16, 2017, 10:27 AM

Title : Student Health Advantage

Subtitle : Comprehensive medical insurance for international students or scholars

Short Title :

Other plans summary : Comprehensive medical insurance for international students or scholars participating in a sponsored study abroad program.

Plan type class : plan_type__student plan_type__travel_medical_insurance

Hero quote 1 text :

Hero quote 2 text :

Quote button 1 text : Get Quote

Quote button 2 text :

Quote button 3 text :

Quote button 4 text :

Most popular : Yes

Recommended : No

Medical Coverage - not used : 4

Ranking - Price - Not Used : 3

Sort order : 80

Highlights

Comprehensive medical insurance for international students or scholars participating in a sponsored study abroad program
Coinsurance in PPO network or student health center within the U.S.: Company pays 100%
Deductible of $250
Maximum limit for student: $500,000
Provides coverage for mental health, organized sports, and preexisting conditions

Summary of Benefits

All amounts shown are in U.S. dollars.

Coverage Limit / Maximum Amount for Eligible Medical Expenses

Benefits	In-Network	Out-of-Network	International
Maximum Limit	Student: $500,000 Dependent: $100,000	Student: $500,000 Dependent: $100,000	Student: $500,000 Dependent: $100,000
Per Illness or Injury limit	Student: $300,000 Dependent: $100,000	Student: $300,000 Dependent: $100,000	Student: $300,000 Dependent: $100,000
Deductible Per Illness or Injury	$250	$250	$250

Coinsurance for Eligible Medical Expenses

Benefits	In-Network	Out-of-Network	International
Coinsurance In addition to Deductible	Plan pays 90% Insured pays 10%	Plan pays 80% Insured pays 20%	Plan pays 100% Insured pays 0%
Out of Pocket Maximum	$1,000	Up to the Maximum Limit	$0

Precertification

Benefits	In-Network	Out-of-Network	International
Interfacility Ambulance Transfer, Emergency Medical Evacuation	No coverage if Pre-certification requirements are not met	No coverage if Pre-certification requirements are not met	No coverage if Pre-certification requirements are not met
All other Treatments & supplies	50% reduction of Eligible Medical Expenses if Pre-certification requirements are not met	50% reduction of Eligible Medical Expenses if Pre-certification requirements are not met	50% reduction of Eligible Medical Expenses if Pre-certification requirements are not met

Pre-existing Conditions

Student Health Center

Benefits	In-Network	Out-of-Network	International
Copayment per visit Not subject to the per Illness or Injury Deductible	$5	$5	$5
Coinsurance	Plan pays 100% Insured pays 0%	Plan pays 100% Insured pays 0%	Plan pays 100% Insured pays 0%

Inpatient/Outpatient Benefits

Benefits	In-Network	Out-of-Network	International
Eligible Medical Expenses	90%	80%	100%
Physician Visits/Services Maximum Visits per day: 1 Surgery is not subject to the Maximum visit limit	90%	80%	100%
Hospital Emergency Room Injury: Not subject to Emergency Room Deductible Illness: Subject to a $250 Deductible for each Emergency Room visit for Treatment that does not result in a direct Hospital admission.	90%	80%	100%
Teleconsultation (Groups only)	Not subject to Deductible and Coinsurance Mental or Nervous Disorders are not covered Coverage for a Teleconsultation is not a determination that any specific condition discussed, raised or identified during such consultation is covered under this insurance. The Company reserves the right to decline future claims relating to or arising from any condition discussed, raised or identified during a Teleconsultation where the Illness or Injury is directly or indirectly related to any Pre-existing Condition or is otherwise excluded under this Certificate of Insurance
Hospitalization / Room & Board Average semi-private room rate Includes nursing, miscellaneous and Ancillary Services	90%	80%	100%
Intensive Care	90%	80%	100%
Outpatient Surgical / Hospital Facility	90%	80%	100%
Laboratory	90%	80%	100%
Radiology / X-ray	90%	80%	100%
Chemotherapy / Radiation Therapy	90%	80%	100%
Pre-admission Testing	90%	80%	100%
Surgery	90%	80%	100%
Reconstructive Surgery Surgery is incidental to and follows Surgery that was covered under the plan	90%	80%	100%
Assistant Surgeon 20% of the primary surgeon’s eligible fee	90%	80%	100%
Anesthesia	90%	80%	100%
Durable Medical Equipment	90%	80%	100%
Chiropractic Care Medical order or Treatment plan required	90%	80%	100%
Physical Therapy Maximum Visits per day: 1 Medical order or Treatment plan required	90%	80%	100%
Extended Care Facility Upon direct transfer from an acute care Hospital	90%	80%	100%
Home Nursing Care Provided by a Home Health Care Agency Upon direct transfer from an acute care Hospital	90%	80%	100%

Prescription Drugs and Medication - The following Prescription Drugs and Medication Period of Coverage limit accumulates toward the Maximum Limit

Benefits	In-Network	Out-of-Network	International
Period of Coverage limit Subject to the Coinsurance amounts listed below	Student: $250,000 per person Dependents: Up to the Maximum Limit ($100,000)	Student: $250,000 per person Dependents: Up to the Maximum Limit ($100,000)	Student: $250,000 per person Dependents: Up to the Maximum Limit ($100,000)
Inpatient and Outpatient Surgery Prescription Drugs and Medication	90%	80%	100%
Emergency Room and Outpatient Office Visits Prescription Drugs and Medication	90%	80%	100%
Retail Pharmacy Prescripton Drugs and Medication Dispensing maximum for Retail Pharmacy: 90 days per prescription	N/A	50%	50%

Mental or Nervous / Substance Abuse

Benefits	In-Network	Out-of-Network	International
Inpatient Mental or Nervous / Substance Abuse Maximum Limit: $10,000 Not covered if incurred at the Student Health Center	90%	80%	100%
Outpatient Mental or Nervous / Substance Abuse Maximum Limit per day: $50 Maximum Limit: $500 Not covered if incurred at the Student Health Center	90%	80%	100%

Emergency Services

Benefits	In-Network	Out-of-Network	International
Emergency Local Ambulance Period of Coverage Limit per Injury $350 Period of Coverage Limit per Illness $350 (resulting in an Inpatient Hospitalization)	100%	100%	100%
Emergency Medical Evacuation Maximum Limit: $500,000 Must be approved in advance and coordinated by the Company	100%	100%	100%
Emergency Reunion Maximum Limit: $50,000 Maximum Days: 15 Meal Maximum per day: $25 Reasonable and necessary travel costs and accommodations Must be approved in advance by the Company	100%	100%	100%
Interfacility Ambulance Transfer Up to the per Injury or Illness limit Services rendered in the United States Transfer must be a result of an Inpatient Hospital admission	100%	100%	N/A
Political Evacuation and Repatriation Maximum Limit: $10,000 Must be approved in advance by the Company	100%	100%	100%
Repatriation for Medical Treatment Maximum Benefit: $100,000. This is in addition to the plan maximum limit/per injury or illness maximum limit Approved in advance and coordinated by the Company Refer to the REPATRIATION FOR MEDICAL TREATMENT provision for further details	100%	100%	100%
Return of Mortal Remains Maximum Limit: $50,000 Local Burial / Cremation at place of death Maximum Limit: $5,000 Return of Insured Person’s Mortal Remains to Country of Residence Must be approved in advance by the Company	100%	100%	100%

Other Services

Benefits

In-Network

Out-of-Network

International

Terrorism

Not subject to Deductible and Coinsurance
Maximum Limit: $50,000

100%

Dental Treatment

Period of Coverage Limit: $350
(Treatment due to Unexpected pain to sound, natural teeth)
Period of Coverage Limit per Injury: $500

(Non-emergency Treatment at a Dental Provider due to an Accident)

N/A

90%

100%

Traumatic Dental Injury

Treatment at a Hospital Facility due to an Accident
Additional Treatment for the same Injury rendered by a Dental Provider will be paid at 100%

90%

80%

100%

Intercollegiate, Interscholastic, Intramural, or Club Sports

Period of Coverage Limit per illness or injury: $5,000

90%

80%

100%

Accidental Death & Dismemberment

Not subject to Deductible and Coinsurance
Death must occur within 90 days of the Accident

Accidental Death: 100% of Principal Sum Student: $25,000 Spouse: $10,000 Child: $5,000
Accidental Dismemberment:
Loss	Percent of Principal Sum
Sight of 1 eye	50%
1 hand or 1 foot	50%
1 hand and loss of sight of 1 eye	100%
1 foot and loss of sight of 1 eye	100%
1 hand and 1 foot	100%
Both hands or both feet	100%
Sight of both eyes	100%

Incidental Trip

Maximum days: 14
Country of Residence is outside the United States
Refer to the INCIDENTAL TRIP provision for further details

90%

80%

100%

Personal Liability

Secondary to any other insurance
No coverage for Injury to a related Third Party or damage to related Third Person’s property
Refer to the PERSONAL LIABILITY provision for further details and requirements

Combined Maximum Limit: $10,000

Injury to Third Person:
Per Injury Deductible: $100

Damage to Third Person’s property: Per damage Deductible: $100

Made for...

Students / Scholars

personas :

Student

Tags :

Student Health Advantage

Categories :

Student / Scholar
Travel Medical Insurance

Student Health Advantage Brochure

Related pages : Student Health Advantage Quote

Group Quote :

Platinum Quote :

Platinum Group Quote :

Product Overview Page : Student Health Advantage

Breadcrumb Page :

Policy Wording :

Policy Wording 2 :

Policy Wording 3 :

Policy Wording 4 :

Student Health Advantage

Feb 16, 2017, 10:27 AM

Title : Student Health Advantage

Subtitle : Comprehensive medical insurance for international students or scholars

Short Title :

Other plans summary : Comprehensive medical insurance for international students or scholars participating in a sponsored study abroad program.

Plan type class : plan_type__student plan_type__travel_medical_insurance

Hero quote 1 text :

Hero quote 2 text :

Quote button 1 text : Get Quote

Quote button 2 text :

Quote button 3 text :

Quote button 4 text :

Most popular : Yes

Recommended : No

Medical Coverage - not used : 4

Ranking - Price - Not Used : 3

Sort order : 80

Highlights

Comprehensive medical insurance for international students or scholars participating in a sponsored study abroad program
Coinsurance in PPO network or student health center within the U.S.: Company pays 100%
Deductible of $250
Maximum limit for student: $500,000
Provides coverage for mental health, organized sports, and preexisting conditions

Summary of Benefits

All amounts shown are in U.S. dollars.

Coverage Limit / Maximum Amount for Eligible Medical Expenses

Benefits	In-Network	Out-of-Network	International
Maximum Limit	Student: $500,000 Dependent: $100,000	Student: $500,000 Dependent: $100,000	Student: $500,000 Dependent: $100,000
Per Illness or Injury limit	Student: $300,000 Dependent: $100,000	Student: $300,000 Dependent: $100,000	Student: $300,000 Dependent: $100,000
Deductible Per Illness or Injury	$250	$250	$250

Coinsurance for Eligible Medical Expenses

Benefits	In-Network	Out-of-Network	International
Coinsurance In addition to Deductible	Plan pays 90% Insured pays 10%	Plan pays 80% Insured pays 20%	Plan pays 100% Insured pays 0%
Out of Pocket Maximum	$1,000	Up to the Maximum Limit	$0

Precertification

Benefits	In-Network	Out-of-Network	International
Interfacility Ambulance Transfer, Emergency Medical Evacuation	No coverage if Pre-certification requirements are not met	No coverage if Pre-certification requirements are not met	No coverage if Pre-certification requirements are not met
All other Treatments & supplies	50% reduction of Eligible Medical Expenses if Pre-certification requirements are not met	50% reduction of Eligible Medical Expenses if Pre-certification requirements are not met	50% reduction of Eligible Medical Expenses if Pre-certification requirements are not met

Pre-existing Conditions

Student Health Center

Benefits	In-Network	Out-of-Network	International
Copayment per visit Not subject to the per Illness or Injury Deductible	$5	$5	$5
Coinsurance	Plan pays 100% Insured pays 0%	Plan pays 100% Insured pays 0%	Plan pays 100% Insured pays 0%

Inpatient/Outpatient Benefits

Benefits	In-Network	Out-of-Network	International
Eligible Medical Expenses	90%	80%	100%
Physician Visits/Services Maximum Visits per day: 1 Surgery is not subject to the Maximum visit limit	90%	80%	100%
Hospital Emergency Room Injury: Not subject to Emergency Room Deductible Illness: Subject to a $250 Deductible for each Emergency Room visit for Treatment that does not result in a direct Hospital admission.	90%	80%	100%
Teleconsultation (Groups only)	Not subject to Deductible and Coinsurance Mental or Nervous Disorders are not covered Coverage for a Teleconsultation is not a determination that any specific condition discussed, raised or identified during such consultation is covered under this insurance. The Company reserves the right to decline future claims relating to or arising from any condition discussed, raised or identified during a Teleconsultation where the Illness or Injury is directly or indirectly related to any Pre-existing Condition or is otherwise excluded under this Certificate of Insurance
Hospitalization / Room & Board Average semi-private room rate Includes nursing, miscellaneous and Ancillary Services	90%	80%	100%
Intensive Care	90%	80%	100%
Outpatient Surgical / Hospital Facility	90%	80%	100%
Laboratory	90%	80%	100%
Radiology / X-ray	90%	80%	100%
Chemotherapy / Radiation Therapy	90%	80%	100%
Pre-admission Testing	90%	80%	100%
Surgery	90%	80%	100%
Reconstructive Surgery Surgery is incidental to and follows Surgery that was covered under the plan	90%	80%	100%
Assistant Surgeon 20% of the primary surgeon’s eligible fee	90%	80%	100%
Anesthesia	90%	80%	100%
Durable Medical Equipment	90%	80%	100%
Chiropractic Care Medical order or Treatment plan required	90%	80%	100%
Physical Therapy Maximum Visits per day: 1 Medical order or Treatment plan required	90%	80%	100%
Extended Care Facility Upon direct transfer from an acute care Hospital	90%	80%	100%
Home Nursing Care Provided by a Home Health Care Agency Upon direct transfer from an acute care Hospital	90%	80%	100%

Prescription Drugs and Medication - The following Prescription Drugs and Medication Period of Coverage limit accumulates toward the Maximum Limit

Benefits	In-Network	Out-of-Network	International
Period of Coverage limit Subject to the Coinsurance amounts listed below	Student: $250,000 per person Dependents: Up to the Maximum Limit ($100,000)	Student: $250,000 per person Dependents: Up to the Maximum Limit ($100,000)	Student: $250,000 per person Dependents: Up to the Maximum Limit ($100,000)
Inpatient and Outpatient Surgery Prescription Drugs and Medication	90%	80%	100%
Emergency Room and Outpatient Office Visits Prescription Drugs and Medication	90%	80%	100%
Retail Pharmacy Prescripton Drugs and Medication Dispensing maximum for Retail Pharmacy: 90 days per prescription	N/A	50%	50%

Mental or Nervous / Substance Abuse

Benefits	In-Network	Out-of-Network	International
Inpatient Mental or Nervous / Substance Abuse Maximum Limit: $10,000 Not covered if incurred at the Student Health Center	90%	80%	100%
Outpatient Mental or Nervous / Substance Abuse Maximum Limit per day: $50 Maximum Limit: $500 Not covered if incurred at the Student Health Center	90%	80%	100%

Emergency Services

Benefits	In-Network	Out-of-Network	International
Emergency Local Ambulance Period of Coverage Limit per Injury $350 Period of Coverage Limit per Illness $350 (resulting in an Inpatient Hospitalization)	100%	100%	100%
Emergency Medical Evacuation Maximum Limit: $500,000 Must be approved in advance and coordinated by the Company	100%	100%	100%
Emergency Reunion Maximum Limit: $50,000 Maximum Days: 15 Meal Maximum per day: $25 Reasonable and necessary travel costs and accommodations Must be approved in advance by the Company	100%	100%	100%
Interfacility Ambulance Transfer Up to the per Injury or Illness limit Services rendered in the United States Transfer must be a result of an Inpatient Hospital admission	100%	100%	N/A
Political Evacuation and Repatriation Maximum Limit: $10,000 Must be approved in advance by the Company	100%	100%	100%
Repatriation for Medical Treatment Maximum Benefit: $100,000. This is in addition to the plan maximum limit/per injury or illness maximum limit Approved in advance and coordinated by the Company Refer to the REPATRIATION FOR MEDICAL TREATMENT provision for further details	100%	100%	100%
Return of Mortal Remains Maximum Limit: $50,000 Local Burial / Cremation at place of death Maximum Limit: $5,000 Return of Insured Person’s Mortal Remains to Country of Residence Must be approved in advance by the Company	100%	100%	100%

Other Services

Benefits

In-Network

Out-of-Network

International

Terrorism

Not subject to Deductible and Coinsurance
Maximum Limit: $50,000

100%

Dental Treatment

Period of Coverage Limit: $350
(Treatment due to Unexpected pain to sound, natural teeth)
Period of Coverage Limit per Injury: $500

(Non-emergency Treatment at a Dental Provider due to an Accident)

N/A

90%

100%

Traumatic Dental Injury

Treatment at a Hospital Facility due to an Accident
Additional Treatment for the same Injury rendered by a Dental Provider will be paid at 100%

90%

80%

100%

Intercollegiate, Interscholastic, Intramural, or Club Sports

Period of Coverage Limit per illness or injury: $5,000

90%

80%

100%

Accidental Death & Dismemberment

Not subject to Deductible and Coinsurance
Death must occur within 90 days of the Accident

Accidental Death: 100% of Principal Sum Student: $25,000 Spouse: $10,000 Child: $5,000
Accidental Dismemberment:
Loss	Percent of Principal Sum
Sight of 1 eye	50%
1 hand or 1 foot	50%
1 hand and loss of sight of 1 eye	100%
1 foot and loss of sight of 1 eye	100%
1 hand and 1 foot	100%
Both hands or both feet	100%
Sight of both eyes	100%

Incidental Trip

Maximum days: 14
Country of Residence is outside the United States
Refer to the INCIDENTAL TRIP provision for further details

90%

80%

100%

Personal Liability

Secondary to any other insurance
No coverage for Injury to a related Third Party or damage to related Third Person’s property
Refer to the PERSONAL LIABILITY provision for further details and requirements

Combined Maximum Limit: $10,000

Injury to Third Person:
Per Injury Deductible: $100

Damage to Third Person’s property: Per damage Deductible: $100

Made for...

Students / Scholars

personas :

Student

Tags :

Student Health Advantage

Categories :

Student / Scholar
Travel Medical Insurance

Student Health Advantage Brochure

Related pages : Student Health Advantage Quote

Group Quote :

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Student Health Advantage

Feb 16, 2017, 10:27 AM

Title : Student Health Advantage

Subtitle : Comprehensive medical insurance for international students or scholars

Short Title :

Other plans summary : Comprehensive medical insurance for international students or scholars participating in a sponsored study abroad program.

Plan type class : plan_type__student plan_type__travel_medical_insurance

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Most popular : Yes

Recommended : No

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Highlights

Comprehensive medical insurance for international students or scholars participating in a sponsored study abroad program
Coinsurance in PPO network or student health center within the U.S.: Company pays 100%
Deductible of $250
Maximum limit for student: $500,000
Provides coverage for mental health, organized sports, and preexisting conditions

Summary of Benefits

All amounts shown are in U.S. dollars.

Coverage Limit / Maximum Amount for Eligible Medical Expenses

Benefits	In-Network	Out-of-Network	International
Maximum Limit	Student: $500,000 Dependent: $100,000	Student: $500,000 Dependent: $100,000	Student: $500,000 Dependent: $100,000
Per Illness or Injury limit	Student: $300,000 Dependent: $100,000	Student: $300,000 Dependent: $100,000	Student: $300,000 Dependent: $100,000
Deductible Per Illness or Injury	$250	$250	$250

Coinsurance for Eligible Medical Expenses

Benefits	In-Network	Out-of-Network	International
Coinsurance In addition to Deductible	Plan pays 90% Insured pays 10%	Plan pays 80% Insured pays 20%	Plan pays 100% Insured pays 0%
Out of Pocket Maximum	$1,000	Up to the Maximum Limit	$0

Precertification

Benefits	In-Network	Out-of-Network	International
Interfacility Ambulance Transfer, Emergency Medical Evacuation	No coverage if Pre-certification requirements are not met	No coverage if Pre-certification requirements are not met	No coverage if Pre-certification requirements are not met
All other Treatments & supplies	50% reduction of Eligible Medical Expenses if Pre-certification requirements are not met	50% reduction of Eligible Medical Expenses if Pre-certification requirements are not met	50% reduction of Eligible Medical Expenses if Pre-certification requirements are not met

Pre-existing Conditions

Student Health Center

Benefits	In-Network	Out-of-Network	International
Copayment per visit Not subject to the per Illness or Injury Deductible	$5	$5	$5
Coinsurance	Plan pays 100% Insured pays 0%	Plan pays 100% Insured pays 0%	Plan pays 100% Insured pays 0%

Inpatient/Outpatient Benefits

Benefits	In-Network	Out-of-Network	International
Eligible Medical Expenses	90%	80%	100%
Physician Visits/Services Maximum Visits per day: 1 Surgery is not subject to the Maximum visit limit	90%	80%	100%
Hospital Emergency Room Injury: Not subject to Emergency Room Deductible Illness: Subject to a $250 Deductible for each Emergency Room visit for Treatment that does not result in a direct Hospital admission.	90%	80%	100%
Teleconsultation (Groups only)	Not subject to Deductible and Coinsurance Mental or Nervous Disorders are not covered Coverage for a Teleconsultation is not a determination that any specific condition discussed, raised or identified during such consultation is covered under this insurance. The Company reserves the right to decline future claims relating to or arising from any condition discussed, raised or identified during a Teleconsultation where the Illness or Injury is directly or indirectly related to any Pre-existing Condition or is otherwise excluded under this Certificate of Insurance
Hospitalization / Room & Board Average semi-private room rate Includes nursing, miscellaneous and Ancillary Services	90%	80%	100%
Intensive Care	90%	80%	100%
Outpatient Surgical / Hospital Facility	90%	80%	100%
Laboratory	90%	80%	100%
Radiology / X-ray	90%	80%	100%
Chemotherapy / Radiation Therapy	90%	80%	100%
Pre-admission Testing	90%	80%	100%
Surgery	90%	80%	100%
Reconstructive Surgery Surgery is incidental to and follows Surgery that was covered under the plan	90%	80%	100%
Assistant Surgeon 20% of the primary surgeon’s eligible fee	90%	80%	100%
Anesthesia	90%	80%	100%
Durable Medical Equipment	90%	80%	100%
Chiropractic Care Medical order or Treatment plan required	90%	80%	100%
Physical Therapy Maximum Visits per day: 1 Medical order or Treatment plan required	90%	80%	100%
Extended Care Facility Upon direct transfer from an acute care Hospital	90%	80%	100%
Home Nursing Care Provided by a Home Health Care Agency Upon direct transfer from an acute care Hospital	90%	80%	100%

Prescription Drugs and Medication - The following Prescription Drugs and Medication Period of Coverage limit accumulates toward the Maximum Limit

Benefits	In-Network	Out-of-Network	International
Period of Coverage limit Subject to the Coinsurance amounts listed below	Student: $250,000 per person Dependents: Up to the Maximum Limit ($100,000)	Student: $250,000 per person Dependents: Up to the Maximum Limit ($100,000)	Student: $250,000 per person Dependents: Up to the Maximum Limit ($100,000)
Inpatient and Outpatient Surgery Prescription Drugs and Medication	90%	80%	100%
Emergency Room and Outpatient Office Visits Prescription Drugs and Medication	90%	80%	100%
Retail Pharmacy Prescripton Drugs and Medication Dispensing maximum for Retail Pharmacy: 90 days per prescription	N/A	50%	50%

Mental or Nervous / Substance Abuse

Benefits	In-Network	Out-of-Network	International
Inpatient Mental or Nervous / Substance Abuse Maximum Limit: $10,000 Not covered if incurred at the Student Health Center	90%	80%	100%
Outpatient Mental or Nervous / Substance Abuse Maximum Limit per day: $50 Maximum Limit: $500 Not covered if incurred at the Student Health Center	90%	80%	100%

Emergency Services

Benefits	In-Network	Out-of-Network	International
Emergency Local Ambulance Period of Coverage Limit per Injury $350 Period of Coverage Limit per Illness $350 (resulting in an Inpatient Hospitalization)	100%	100%	100%
Emergency Medical Evacuation Maximum Limit: $500,000 Must be approved in advance and coordinated by the Company	100%	100%	100%
Emergency Reunion Maximum Limit: $50,000 Maximum Days: 15 Meal Maximum per day: $25 Reasonable and necessary travel costs and accommodations Must be approved in advance by the Company	100%	100%	100%
Interfacility Ambulance Transfer Up to the per Injury or Illness limit Services rendered in the United States Transfer must be a result of an Inpatient Hospital admission	100%	100%	N/A
Political Evacuation and Repatriation Maximum Limit: $10,000 Must be approved in advance by the Company	100%	100%	100%
Repatriation for Medical Treatment Maximum Benefit: $100,000. This is in addition to the plan maximum limit/per injury or illness maximum limit Approved in advance and coordinated by the Company Refer to the REPATRIATION FOR MEDICAL TREATMENT provision for further details	100%	100%	100%
Return of Mortal Remains Maximum Limit: $50,000 Local Burial / Cremation at place of death Maximum Limit: $5,000 Return of Insured Person’s Mortal Remains to Country of Residence Must be approved in advance by the Company	100%	100%	100%

Other Services

Benefits

In-Network

Out-of-Network

International

Terrorism

Not subject to Deductible and Coinsurance
Maximum Limit: $50,000

100%

Dental Treatment

Period of Coverage Limit: $350
(Treatment due to Unexpected pain to sound, natural teeth)
Period of Coverage Limit per Injury: $500

(Non-emergency Treatment at a Dental Provider due to an Accident)

N/A

90%

100%

Traumatic Dental Injury

Treatment at a Hospital Facility due to an Accident
Additional Treatment for the same Injury rendered by a Dental Provider will be paid at 100%

90%

80%

100%

Intercollegiate, Interscholastic, Intramural, or Club Sports

Period of Coverage Limit per illness or injury: $5,000

90%

80%

100%

Accidental Death & Dismemberment

Not subject to Deductible and Coinsurance
Death must occur within 90 days of the Accident

Accidental Death: 100% of Principal Sum Student: $25,000 Spouse: $10,000 Child: $5,000
Accidental Dismemberment:
Loss	Percent of Principal Sum
Sight of 1 eye	50%
1 hand or 1 foot	50%
1 hand and loss of sight of 1 eye	100%
1 foot and loss of sight of 1 eye	100%
1 hand and 1 foot	100%
Both hands or both feet	100%
Sight of both eyes	100%

Incidental Trip

Maximum days: 14
Country of Residence is outside the United States
Refer to the INCIDENTAL TRIP provision for further details

90%

80%

100%

Personal Liability

Secondary to any other insurance
No coverage for Injury to a related Third Party or damage to related Third Person’s property
Refer to the PERSONAL LIABILITY provision for further details and requirements

Combined Maximum Limit: $10,000

Injury to Third Person:
Per Injury Deductible: $100

Damage to Third Person’s property: Per damage Deductible: $100

Made for...

Students / Scholars

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Student

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Travel Medical Insurance

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Coverage Information

Conditions of Coverage

Coverage and benefits are subject to the deductible and coinsurance, and all terms of the Certificate of Insurance and Master Policy
Coverage under this plan is secondary to any other coverage
Coverage and benefits are for medically necessary, usual, reasonable, and customary charges only
Charges must be administered or ordered by a physician
Charges must be incurred during the period of coverage or benefit period
Claims must be presented to IMG for payment within ninety (90) days from the date the claim was incurred

Eligibility

To be eligible to apply to the Student Health Advantage plan, you must:

Be a full-time student or scholar, the spouse of the full-time student or scholar, or a dependent traveling with the full-time student or scholar
Reside outside the country of residence for the purpose of pursing international educational activities including college course work, research, or teaching for a temporary period of time.
Be physically and legally residing in host country with the intent to reside there for at least 30 days on the effective date and at renewal.
Not be hospitalized, disabled, or HIV+ on the initial effective date.

Renewal of Coverage

Eligible insureds whose initial coverage is at least 3 months can request coverage under the plan be renewed monthly for up to 12 month periods, for a maximum of 60 continuous months, as long as the premium is paid when due and the insured continues to meet the eligibility requirements of the plan.

How Does the Affordable Care Act (ACA) Affect My Coverage?

Non-U.S. citizens: As non-resident aliens, international students, scholars, and people involved in cultural exchange programs on F, J, M and Q visas (and certain family members) are not subject to the individual mandate for their first five years in the U.S. All other J categories (teacher, trainee, work and travel, au pair, high school, etc.) are not subject to the individual mandate for two years (out of the past six). Since international students are not subject to the mandate, they are not required to purchase a plan that meets PPACA requirements and can purchase Student Health Advantage.

U.S. citizens: Under ACA, all U.S. citizens, nationals and resident aliens are required to purchase minimum essential coverage (ACA compliant coverage), unless they are exempt. Exempt U.S. citizens include U.S. citizens who reside outside of the U.S. for 330 of any 365-day period, or have a tax home (main place of work or employment, or if you don’t have a main place of work or employment, your main residence) in a foreign country, and is a bona fide resident of a foreign country.

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Joan D. United States

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Student Health Advantage

Highlights

Summary of Benefits

Made for...

Student Health Advantage

Highlights

Summary of Benefits

Made for...

Student Health Advantage

Highlights

Summary of Benefits

Made for...

Student Health Advantage

Highlights

Summary of Benefits

Made for...

Coverage Information

Conditions of Coverage

Eligibility

Renewal of Coverage

How Does the Affordable Care Act (ACA) Affect My Coverage?

Looking for a Provider?

Search our database for medical, dental, and other care providers.

What type of coverage
do you need?

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