Choose a Medical Insurance Coverage that Suits You!

Student Plan
Annual Deductible 

$100 Annually

• Medical Expenses (UCR)
  for injury or illness occurring during the Period of Coverage.
  
  *The Plan does not cover routine office visits, routine vaccinations or pre-existing conditions.

• Medical Evacuation

• Prescription Drugs
  80% of UCR

• Dental Treatment as a result of injury to natural teeth caused by an accident only. 80% of UCR.

• Physiotherapy
  Accident only, when prescribed by the attending physician, limited to one visit per day, $25 per visit, to a maximum of $500 per policy year

• Psychotherapy
  The treatment of mental disorders, nervous disorders, alcoholism, and drug addiction, up to $30 per visit, one visit per day, to a maximum of 10 visits per policy year.

• Organ Transplant
  Organ transplant, bone marrow transplant, skin grafts, kidney dialysis or similar treatments limited to $10,000 all UCR charges combined per policy year.

• Surgery fees for a surgical procedure 

• Anesthetist Services:

• Outpatient Day Surgery Miscellaneous Expenses when surgery is performed in a hospital emergency room, trauma center, physician's office, outpatient surgical center or clinic, for covered services and supplies all UCR charges combined to a maximum of $1,500 per day.

• Outpatient Miscellaneous Expenses - including medical emergency room expenses, diagnostic X-ray and laboratory expenses, MRIs, CAT Scans, Ultrasound, Amniocentesis, AFP Screening and Fetal Stress/Non Stress Tests, or similar procedures, when prescribed by the attending physician, to a $1,000 maximum per policy year.  Fertility testing is excluded and not a covered expense.

• In-Patient Hospital Miscellaneous Expenses for covered services and supplies, all UCR charges combined to a maximum of $1,500 per day.

• Ambulance Service, for transportation to or from a hospital, $400 per trip maximum

• Motor Vehicle Accidents, excess to the motor vehicle insurance to a maximum of $2,000 per policy year.

 Click Here for Answers to Frequently Asked Questions

What is Covered?

MEDICAL BENEFITS - ACCIDENT AND SICKNESS 

1. Charges made by a hospital for room and board, floor nursing and other services exclusive of charges for professional service and with the exception of personal services of a non-medical nature; provided, however, that expenses do not exceed the hospital's average charge for semiprivate room and board accommodation or intensive care when medically necessary.

2. Charges made for diagnosis, treatment and surgery by a physician.

3. Charges made for the cost and administration of anesthetics.   

4. Charges for medication, x-ray services, laboratory tests and services, the use of radium and       radioactive isotopes, oxygen, blood transfusion, iron lungs, and medical treatment.  

5. Charges for physiotherapy, if recommended by a physician for the treatment of a specific disablement and administered by a licensed physiotherapist.  

6. Dressings, drugs, and medicines that can only be obtained upon a written prescription of a physician.  

Usual, Customary and Reasonable Charge (UCR) means the payment amount, as determined by the Company, for services rendered by a professional provider.  The Company reserves the right of final determination of the amount payable for any service or supply.  

The following is the basis for determination of UCR:  

Usual - an amount a professional provider usually charged for a given service.
Customary – an amount which falls within the range of charges for a given service billed by most professional providers in the same locality who have similar training and experience.
Reasonable – am amount which is usual and customary or which would not be considered excessive in a particular case because of unusual circumstances.  

If the charge is in excess of UCR, no payment will be made with respect to the excess, and the excess will not qualify as a Covered Expense under the Policy.  All charges shall be deemed to be incurred on the date such services or supplies which give rise to the expense or charge are rendered or obtained.

1. suicide or any attempt thereat by the Insured Person while sane or self destruction or any 
                           attempt thereat by the Insured Person while insane;  
    

2. disease of any kind;
    

3. bacterial infections except pyogenic infection which shall occur through an accidental cut or wound;
    

4. hernia of any kind;  
    

5. injury sustained in consequence of riding as a passenger or otherwise in any vehicle or device for aerial navigation, except as provided in Part B of Section II, Definition of Injury and Scope  of Coverage;  
   
6. declared or undeclared war or any act thereof; 
   
7. service in the military, naval or air service of any country.

No benefits shall be payable for medical expenses provided by the Plan with respect to expenses incurred for:

 (1)      Pre-existing conditions, defined as any injury or illness which was contracted or which
            manifested itself, or for which a licensed physician was consulted, or for which treatment or
            medication was prescribed prior to the effective date of this insurance;

(2)       For services, supplies or treatment, including any period of hospital confinement, which
            were not recommended, approved and certified as necessary and reasonable by a physician;  

(3)       For suicide or any attempt thereat while sane or self destruction or any attempt thereat
            while insane;  

(4)       Declared or undeclared war or any act thereof;  

(5)       For Injury sustained while participating in professional, interscholastic, sponsored scholastic, amateur, intercollegiate, community athletics;

(6)       For fertility testing, pregnancy, childbirth, miscarriage or abortion;

(7)       For routine physical or other examinations where there are no objective indications or
            impairment in normal health, and laboratory diagnostic or X-ray examinations except in
            the course of a disability established by the prior call or attendance of a physician;  

(8)       For cosmetic or plastic surgery, except as the result of an accident;  

(9)       For elective surgery which can be postponed until the Insured returns to his/her country of
            residence;  

(10)     For any mental and nervous disorders or rest cures except as provided;  

(11)     For dental care, except as the result of injury to natural teeth caused by accident;  

(12)     For eye refractions or eye examinations for the purpose of prescribing corrective lenses for
            eye glasses or for the fitting thereof, unless caused by accidental bodily injury incurred
            while insured hereunder;  

(13)     In connection with alcoholism and drug addiction, or use of any drug or narcotic agent;  

(14)     For congenital anomalies and conditions arising out of or resulting there from;  

(15)     For expenses which are non medical in nature;  

(16)     For the ordinary cost of a one-way airplane ticket used in the transportation back to the
            Insured's country where an air ambulance benefit is provided;  

(17)     For expenses as a result or in connection with intentionally self-inflicted injury;  

(18)     For expenses as a result of or in connection with the commission of a felony offense;  

 (19)    For specific named hazards: scuba diving; snow sports, including but not limiting to skiing of any kind and snowboarding; mountain climbing; sky diving; professional or amateur racing; piloting any aircraft; rock-climbing; caving; ice-climbing; parasailing; paragliding; bungee jumping; hot air ballooning; trampoline jumping; extreme sports; motorcycle riding;

(20)     Treatment paid for or furnished under any other individual or group policy, or other
            service or medical pre-payment plan arranged through the employer to the extent so
            furnished or paid, or under any mandatory government program or facility set up for
            treatment without cost to any individual.