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

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VISIT^® Travel & Medical Insurance Program
for International Students, Scholars, Spouses, Families and Visitors

Call Us Today 1-800-247-5575 or 1-703-660-9062 or

The Trusted Name in International Travel and Medical Insurance for over 30 Years!

Student Insurance Plans

VISIT^® International Student Plans Are Ideal For:

International students
OPT/AT students

ESL
Visiting faculty

Scholars & researchers
High school foreign students

Choose from 8 different International Student Insurance Plans:


Choose $100K or $250K Medical Maternity included up to $10,000 $100 deductible per illness/injury (reduced to $50 if Student Health) 80/20 co-insurance to $10,000 As low as $36 per month	Choose $100K or $250K Medical Maternity included up to $10,000 $100 deductible per illness/injury (reduced to $50 if Student Health) 80/20 co-insurance to $5000 As low as $40 per month	Choose $100K or $250K Medical Maternity covered to policy max $100 deductible per illness/injury (reduced to $50 if Student Health) 80/20 co-insurance to $5000 As low as $45 per month	Choose $100K Medical No maternity coverage $100 deductible per policy period 80/20 co-insurance to $5000 As low as $43 per month	Choose $100K Medical No maternity coverage $100 annual deductible 80/20 co-insurance to $5000 As low as $50 per month

Economy, Standard and Super Plan Benefits
Underwritten by Virginia Surety Company, Inc. (VSC), rated A- “Excellent” by A.M. Best. The VSC Master Policies are filed under form numbers IN/OUT-EOC (01/2004) and Liability AIFS LIAB (IL 09/98R)

Economy, Standard and Super plans meet or exceed U.S. State Department DS2019 requirements
Choose your own doctor or hospital; you are not required to use doctors within a specific network
Deductible reduced to $50 per occurrence if the university student health center is used first
Maternity coverage included - limits vary by plan
Pre-existing conditions covered after 12 months of continuous coverage
Sports & hazardous sports coverage included

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

Economy Plan Monthly Rates

Age	Economy $100K	Economy $250K
12-18	$36	$39
19-23	$39	$41
24-30	$78	$83
31-40	$121	$128
41-49	$195	$207
50-64	$266	$282

Economy Plan Coverages
Coverage	Economy $100K	Economy $250K
Accident & Sickness Medical	$100,000 per injury or illness maximum	$250,000 per injury or illness maximum
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 $10,000, 100% thereafter to policy maximum	80% to $10,000, 100% thereafter to policy maximum
Lifetime Maximum	$1,000,000	$1,000,000
Emergency Medical Evacuation	$100,000	$100,000
Repatriation of mortal remains	$25,000	$25,000
Pre-existing condition coverage	Pre-existing Conditions 12 months prior to Effective Date, waived after 12 consecutive months of coverage	Pre-existing Conditions 12 months prior to Effective Date, waived after 12 consecutive months of coverage
AD&D - Accidental Death & Dismemberment	$10,000	$10,000
Maternity Coverage	up to $10,000	up to $10,000
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

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

Standard Plan Monthly Rates

Age	Standard $100K	Standard $250K
12-18	$40	$42
19-23	$43	$45
24-30	$86	$90
31-40	$133	$140
41-49	$215	$226
50-64	$293	$308

Standard Plan Coverages

Coverage	Standard $100K	Standard $250K
Accident & Sickness Medical	$100,000 per injury or illness maximum	$250,000 per injury or illness maximum
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
Lifetime Maximum	$1,000,000	$1,000,000
Emergency Medical Evacuation	$100,000	$100,000
Repatriation of mortal remains	$25,000	$25,000
Pre-existing condition coverage	Pre-existing Conditions 12 months prior to Effective Date, waived after 12 consecutive months of coverage	Pre-existing Conditions 12 months prior to Effective Date, waived after 12 consecutive months of coverage
AD&D - Accidental Death & Dismemberment	$10,000	$10,000
Maternity Coverage	up to $10,000	up to $10,000
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

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

Super Plan Monthly Rates

Age	Super $100K	Super $250K
12-18	$45	$48
19-23	$47	$52
24-30	$95	$105
31-40	$148	$162
41-49	$240	$261
50-64	$326	$355

Super Plan Coverages

Coverages	Super $100K	Super $250K
Accident & Sickness Medical	$100,000 per injury or illness medical maximum	$250,000 per injury or illness maximum
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
Lifetime Maximum	$1,000,000	$1,000,000
Emergency Medical Evacuation	$100,000	$100,000
Repatriation of mortal remains	$25,000	$25,000
Pre-existing condition coverage	Pre-existing Conditions 12 months prior to Effective Date, waived after 12 consecutive months of coverage	Pre-existing Conditions 12 months prior to Effective Date, waived after 12 consecutive months of coverage
AD&D - Accidental Death & Dismemberment	$10,000	$10,000
Maternity coverage	up to policy maximum	up to policy maximum
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

Plan E^PLUS
Underwritten by Virginia Surety Company, Inc. (VSC), rated A- “Excellent” by A.M. Best. The VSC Master Policies are filed under form numbers IN/OUT-EOC (01/2004) and Liability AIFS LIAB (IL 09/98R)

Plan E^PLUS Monthly Rates

Age	Plan E^PLUS	Plan E^PLUSHazardous Sports
0-29	$43	$50
30-39	$57	$66
40-49	$90	$95
50-59	$135	$155
60-64	$169	$195
65-69	$210	$242
70-79	$265	$305

Plan E^PLUS Coverages

Coverages	E^PLUS	E^PLUS Hazardous Sport Coverage
Accident & Sickness Medical	$100,000 per injury or illness medical maximum	$100,000 per injury or illness medical maximum
Deductible	$100 per policy period	$100 per policy period
Co-insurance	80% to $5000, 100% thereafter to policy maximum	80% to $5000, 100% thereafter to policy maximum
Lifetime Maximum	$100,000 Age 0-69 / $50,000 Age 70-79	$100,000 Age 0-69 / $50,000 Age 70-79
Emergency Medical Evacuation	up to $100,000	up to $100,000
Repatriation of mortal remains	up to $25,000	up to $25,000
Pre-existing condition coverage	no coverage	no coverage
AD&D - Accidental Death & Dismemberment	$25,000 per Insured/Spouse $5000 per Dependent Child	$25,000 per Insured/Spouse $5000 per Dependent Child
Maternity coverage	no coverage	no coverage
Home Country coverage	60 days per 12 months of coverage up to $50,000	60 days per 12 months of coverage up to $50,000
Sports Coverage (non-interscholastic sports)	up to policy maximum	up to policy maximum
Hazardous Sports coverage	no coverage	included
Trip Interruption	up to $5000	up to $5000
Return of minor child	up to $10,000	up to $10,000
Lost baggage	up to $250	up to $250
View Policy Details

Plan "S" International Student Insurance Plan
Underwritten by the Insurance Company of the State of Pennsylvania, a member company of AIU Holdings, rated A "Excellent" by A.M. Best

Plan "S" Monthly Rates

Age	Plan "S"
17-26, inclusive	$50 per month

Plan "S" Coverages

Coverages	Plan S
Accident & Sickness Medical	$100,000 per injury or illness medical maximum
Deductible	$100 annual deductible
Co-insurance	80% to $5000, 100% thereafter to policy maximum
Lifetime Maximum	$100,000
Emergency Medical Evacuation	$50,000
Repatriation of mortal remains	$10,000
Pre-existing condition coverage	no coverage
AD&D - Accidental Death & Dismemberment	$15,000
Maternity coverage	no coverage
Home Country coverage	no coverage
Sports coverage (non-interscholastic sports)	included
Hazardous Sports coverage	no coverage
View Policy Details

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 Travel & Medical 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