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Student Health Advantage - Platinum

Limited Coverage
AM Best Rating
A (Excellent)
Carrier/Underwriter
IMG
Administrator
Sirius International
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Renewable & Cancelable
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Basic Coverage Plan
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Coverage from 5 days to 365 days
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Urgent Care
  • Cannot accept an address in Maryland (MD).
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Student Health Advantage - Platinum is designed to meet the needs of international students, scholars, and faculty, their families, and groups of two or more involved in long-term educational programs. In addition to meeting the requirements of the J1 Visa, this plan includes benefits for maternity, mental health and organized sports. After a period of 12 months, pre-existing conditions will be covered as well.


Please review Student Health Advantage - Platinum Insurance Brochure brochure for complete and accurate coverage information.

Out-Patient

Dr. / Physician Visit

Inside PPO Network or Student Health Center: Insurance pays 100 % after deductible, to coverage maximum.
Outside PPO Network : Insurance company will pay 80% of $5,000 of Eligible Expenses after deductible, then 100% to coverage maximum.

Prescription Drugs / Medicines

Inside PPO Network or Student Health Center: Insurance pays 100 % after deductible, to coverage maximum.
Outside PPO Network : Insurance company will pay 80% of $5,000 of Eligible Expenses after deductible, then 100% to coverage maximum.
(For Outpatient Perscription insurance pays 50% of Actual Charges)

Lab & X-rays

Inside PPO Network or Student Health Center: Insurance pays 100 % after deductible, to coverage maximum.
Outside PPO Network : Insurance company will pay 80% of $5,000 of Eligible Expenses after deductible, then 100% to coverage maximum.

Physical Therapy

Inside PPO Network or Student Health Center: Insurance pays 100 % after deductible, to coverage maximum.(Limit Once per day)
Outside PPO Network : Insurance company will pay 80% of $5,000 of Eligible Expenses after deductible, then 100% to coverage maximum. (Limit Once per day)

In-Patient

Hospital Room

Inside PPO Network or Student Health Center: Insurance pays 100 % after deductible, to coverage maximum.
Outside PPO Network : Insurance company will pay 80% of $5,000 of Eligible Expenses after deductible, then 100% to coverage maximum.

Hospital Intensive Care Unit

Inside PPO Network or Student Health Center: Insurance pays 100 % after deductible, to coverage maximum.
Outside PPO Network : Insurance company will pay 80% of $5,000 of Eligible Expenses after deductible, then 100% to coverage maximum.

Emergency Services

Ambulance Expenses

Up to $750 per injury
Up to $750 per illness (only if admitted as in-patient)

Dental

Acute, spontaneous and unexpected pain

Up to $350 (Not Available for Basic Short Term Plan )

Accidental emergency

Up to $500 (Not Available for Basic Short Term Plan )

Travel

Emergency Medical Evacuation / Repatriation

Up to $500,000 life maximum (independent of Maximum limit)

Return of Remains

Up to $50,000 Maximum

Emergency Reunion

Up to $50,000 Maximum

Return of minor Child(ren)

Not Covered

Loss of checked Baggage

Covered under Optional Add-On plan

Life

AD&D

Student : $25,000
Dependent Spouse :$10,000
Dependent Child :$5000

Other

Pre-Existing Conditions

Covered after 6 months of continuous coverage( Rider Available for certain states resident . See policy details)

Maternity

Up to $5,000 and includes newborn care for the first 31 days of life

Incidental Home Country Coverage

Available only for non-US citizens

General Physical full Checkup

Not Covered

Terrorism Coverage

Up to $50,000 Life Time Maximum

Brochure

Support

24-Hrs Emergency Assistance

Yes. Contact number and details can be found on the ID card.

Plan Administrator Company

IMG

Carrier / Underwriter

Sirius International

Deductible Content

Deductible Per Incident
What is Deductible?

Deductible is the amount that you are responsible for, before insurance company starts paying for any covered expenses. Deductible for this type of plan is applicable once per incident.


For example: If you visit a doctor for a medical problem, and after consultation, the doctor prescribes Medicines, X-rays, and Lab tests, then since all these services are part of one incident, your deductible will be applicable for these services only once. If you visit a doctor again after a few days for a new problem, the deductible will be applicable again for that new incident.
What deductible to choose with this Plan?

Since deductible is per incident for these type of plans. It is a good idea to select a lower deductible such as “0“.

Note : For Age 70 and above, lower deductible like Zero “0“ is not available.

Plan Type

Comprehensive Coverage Plan

AM Best Rating

A (Excellent)

Coverage in U.S.A.

Covered

Coverage outside U.S.A.

Covered

Co-Pay

$5 per visit for Student Health Center

Co-Insurance

Inside PPO Network or Student Health Center: Insurance company will pay 100 % after deductible, to coverage maximum.
Outside PPO Network: Insurance company will pay 80% of $5,000 of Eligible Expenses after deductible, then 100% to coverage maximum.

Coverage Type

Per Illness or Injury

Deductible Type

$100 per Illness or Injury

Renewability

Renewable (Only if initially purchased for 3 month) provided there is no break in coverage , up to a maximum period of 5 years.

Cancellation

Full refund available if cancelled before start date. Only Monthly refund available after start date if no claims have been made( $50 Cancellation Fee Applicable)

PPO Network

UnitedHealthcare Network

Coverage Length

Min 1 month to Max 5 years

Available Deductibles

For treatment received within US/Canada :
With PPO provider :$25 Per Injury or Illness Deductible
Non PPO Provider : $50 Per Injury or Illness Deductible
Student Health Center : $ 5
For treatment received outside US/Canada :$25 Per Injury or Illness Deductible

Available Coverage

Ages 14 days - 64 years
Student: $500,000 (Lifetime Maximum :$1,000,000)
Dependent: $100,000 (Lifetime Maximum :$100,000)

Provider Directory

By Provider, 24 hours Worldwide, Phone Nos. : 866-281-1688

Plan Brochure

Student Health Advantage - Platinum Insurance Brochure brochure

Untitled Document

Q1: Am I eligible for the Student Health Advantage Platinum program? 

You must meet the following criteria to be eligible for Student Health Advantage program: 
The individual applicant or group member must be a full time student or scholar at a college ,university or educational institution. 
The individual applicant or group member must residing outside his/her home country for the purpose of pursuing international, educational activities. 
Must not have obtained residency status in host country. 
Dependents have to be legal dependents, travelling with individual applicant or group member and traveling outside theirÃ?  home country
Family members do not constitute a group.

Q2: Are a student's dependents eligible for coverage? 

Yes, this plan provides coverage for the participants spouse and unmarried dependent children travelling with them.

Q3. What does the optional Adventure Sports Rider cover? 

The Adventure Sports Rider is available for those up to the age of 65. The following activities are covered to the lifetime maximum amounts listed below as long as they are engaged solely for leisure, recreation, or entertainment purposes: abseiling, BMX, bobsledding, bungee jumping, canyoning, caving, hang gliding, heli-skiing, high diving, hot air ballooning, inline skating, jet skiing, jungle zip lining, kayaking, mountain biking, parachuting, paragliding, parascending, piloting a non-commercial aircraft, rappelling, rock climbing or mountaineering (ropes and guides to 4500m from ground level), scuba diving (to 50m), skydiving, snorkeling, snow boarding, snowmobiling, snow skiing, spelunking, surfing, trekking, whitewater rafting (to Class V), and wildlife safaris, and windsurfing.  All such activities must be carried out in strict accordance with the rules, regulations and guidelines of the applicable Governing Body or Authority of each such activity. Certain sports activities are never covered, regardless of whether or not you purchase the Adventure Sports Rider. Please see exclusion 8 in the exclusions page. Please note this is only a summary of Adventure Sports and exclusions. For additional information, please refer to the Certificate of Insurance.



Age

Lifetime Maximum

0-49

$50,000

50-59

$30,000

60-64

$15,000

Q4: Can I renew the Student Health Advantage Platinum plan? 

Yes, if you purchase the plan for a minimum of three months, coverage may be renewed for a total of up to 12 months from the initial effective date. Provided there is no break inÃ?  coverage, the plan may be renewed up to 5 years.

Q5: Can I cancel the Student Health Advantage  platinum plan? 

Yes, you can cancel this plan. Full refund is available if you request for cancellation before the start date. Only monthly is refund available, if cancellation is requested after start date and no claims have been made. $50 Cancellation fee is applicable.

Q6: Does this plan cover any pre-existing conditions? 

Yes, after 6 months of continuous coverage.
For more details & exclusions regarding the pre-existing conditions, please check the plan brochure.

Q7. Does Student Health Advantage platinum program cover pregnancy? 

Yes, this plan does cover for pregnancy.

Q8. Which doctor or hospital can I go to? 

Within USA, the network provider for this plan is UnitedHealthcare Network. Or you can go to any doctor of your choice.

Q9: What information do I need to purchase this insurance? 

Name(s), date of birth, and passport number of the visitor(s).

Q10: When will I receive my ID card? 

The print out of the on-line confirmation /virtual ID card is the proof of insurance and can be used when you visit the doctor or hospital. While filling out the online application, if you select online fulfillment you will not receive anything in snail mail but in your email. If you select the snail mail option then you won't receive your ID card in email but to your mailing address within 5-10 business days.

Q11: Where can I find answers to other questions I have? 

Please refer to Visitors Insurance FAQs section.
Learn more from informative articles at Visitor Insurance Information section.
If you still have questions, please email us at support@visitorscoverage.com or call our support line toll free: 1.866.384.9104. Business Hours: Mon - Fri 8:30am- 5:30pm PST.

Disclaimer

Plan features listed here are high level, provided for your convenience and information purpose only. Please review the Evidence of Coverage and Plan Contract (Policy) for a detailed description of Coverage Benefits, Limitations and Exclusions. Must read the Policy Brochure and Plan Details for complete and accurate details. Only the Terms and Conditions of Coverage Benefits listed in the policy are binding.