International Student Health Insurance, OPT Health Insurance, AT Health Insurance, Visiting Faculty Health Insurance, Scholar Health Insurance

VISIT^® International Health Insurance Program
for International Students, Scholars, Spouses, Families and Visitors

Contact Us info@visitinsurance.com or 1-800-247-5575 or 1-703-660-9062 or

The Trusted Name in International Health and Travel Medical Insurance for over 35 Years!
International Health, Travel Medical, Medical Evacuation & Trip Cancellation Plans for Any International Travel

PLATINUM International Student Insurance Plans
Choose $100K or $250K (maternity included)

PLATINUM Plan Monthly Rates

Age	Platinum $100K	Platinum $100K Spouse	Platinum $250K	Platinum $250K Spouse
12-18	$91.06	$254.71	$100.90	$285.48
19-23	$116.90	$452.82	$130.43	$506.97
24-30	$242.41	$642.32	$271.94	$719.84
31-40	$376.53	$781.37	$420.83	$876.12
41-49	$479.90	$965.94	$537.73	$1,081.61
50-64	$674.31	$965.94	n/a	n/a
Dependent Child 30 days to 18 years old (or 25 if a full-time student)	$253.48		$284.25
VISIT STUDENT Plans (Economy, Standard, Super & Platinum) are open to International Students, visiting Faculty, Scholars, or other persons over the age of twelve (12) up to and including age sixty-four (64), who are temporarily residing outside their Home Country. The Insured must remain engaged in educational or research activities outside their Home Country during the Period of Coverage. Education or research activities shall mean the Insured: 1) is enrolled and participating in an educational, vocational, cultural exchange, or training program; and 2) has a valid J-1, H-3, F, M, or Q Visa. A Student must be the primary insured in order for the Spouse and Child to be eligible for the ECONOMY, STANDARD, SUPER, PLATINUM, PGH Global Basic, Plus and Preferred, Student Health Advantage & Liaison Student Plans.

PLATINUM Plan Coverages

Coverages	Platinum $100K	Platinum $250K
Accident & Sickness Medical Routine physical exams and vaccinations are not covered	$100,000 per injury or illness medical maximum Student - $50,000 (Age 50-64)	$250,000 per injury or illness maximum Student - $100,000 (Age 50-64)
Deductible	$50 Student Health / $100 non-Student Health per injury or illness	$50 Student Health / $100 non-Student Health per injury or illness
Co-insurance	80% to $5000, 100% thereafter to policy maximum	80% to $5000, 100% thereafter to policy maximum
Medical Lifetime Maximum	$1,000,000	$1,000,000
Emergency Medical Evacuation	Unlimited	Unlimited
Repatriation of mortal remains	unlimited	unlimited
Pre-existing condition coverage	6 months prior to Effective Date, waived after 6 consecutive months of coverage	6 months prior to Effective Date, waived after 6 consecutive months of coverage
AD&D - Accidental Death & Dismemberment	$10,000	$10,000
Maternity coverage	Covered as any other Illness (must be insured for a minimum of 30 days prior to conception to receive maternity benefits)	Covered as any other Illness (must be insured for a minimum of 30 days prior to conception to receive maternity benefits)
Home Country coverage	30 days of coverage up to a max. of $25,000 per policy period	30 days of coverage up to a max. of $25,000 per policy period
Sports Coverage (non-interscholastic sports)	$10,000 per policy period	$10,000 per policy period
Hazardous sports coverage	$10,000 per policy period	$10,000 per policy period
View Policy Details

Review All VISIT^® Health Insurance Plans

Plan E PLUS

VISIT Lite

VITAL

Patriot Exchange

Essential & Basic

ACA Equivalent

GeoBlue

Student Secure

Student Health
Advantage

Liaison Student

Economy

Standard

Super

Platinum

Starting at $33.90
ANY VISA Accepted
$50K to $1 Million
No Maternity
$100K or Higher meets J-visa requirements
Dependents are eligible to purchase individually

Starting at
$50K or $500K Medical
Mental Health Coverage

Starting at
$66.00
$500,000 Medical
Mental Health Coverage
Pre-Ex after 12 months
Dependent Coverage

Starting at $48.62
$50K to $500K
No coinsurance
Meets J-visa requirements
No Maternity

Starting at $42.00
$100K to $500K
Meets J-vis requirements
Preventive Care
Mental Health
Pre-Ex after 6 months

Starting at $84.90
Maternity Coverage
Preventive Care
Mental Health Coverage
Pre-Ex no waiting period
Dependent Coverage

Starting at $222
Unlimited Plan
Preventive Care
Mental Health
Pre-Ex after 12 months

Starting at $84.63
$200K-$500K Medical
Maternity Coverage
Mental Health Coverage
Pre-Ex after 6 months
Student Coverage only

Starting at
$69
$300,000 Medical
Maternity Coverage
Mental Health Coverage
Pre-Ex after 12 months
Dependent Coverage

Starting at $70.10
$250,000 Medical
Maternity Coverage
Mental Health Coverage
Pre-Ex after 12 months
Dependent Coverage

Starting at $61.53
$100K or $250K Medical
Maternity Coverage
Mental Health Coverage
Pre-Ex after 12 months
Dependent Coverage

Starting at $65.22
$100K or $250K Medical
Maternity Coverage
Mental Health Coverage
Pre-Ex after 12 months
Dependent Coverage

Starting at $79.98
$100K or $250K Medical
Maternity Coverage
Mental Health Coverage
Pre-Ex after 12 months
Dependent Coverage

Starting at $91.06
$100K or $250K Medical
Maternity Coverage
Mental Health Coverage
Pre-Ex after 6 months
Dependent Coverage

CANCELLATION POLICY
All premiums are fully earned upon Application, and are Non-Refundable. Please apply only for the term of coverage you need, and re-apply as necessary as your plans may change.

VISIT International Health Insurance Program, an Insurance program of PENTECO, LLC
www.visitinsurance.com
Correspondence: P.O. Box 210, Mount Vernon, VA 22121 (703) 660-9062/ (800) 247-5575/ (703) 991-9164 fax
email: info@visitinsurance.com

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