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Liaison Student

International Student Health Insurance

Benefits Economy Choice Elite
Lifetime Medical Maximum $5,000,000
Maximum Benefit options  
Per injury/illness $100,000; $250,000; $500,000; $1,000,000
Deductible options  
Per injury/illness $0, $50, $100, $250, $500, $1,000
Student Health Center
Copay per visit
*not subject to the deductible
$5
Coinsurance  
In-network, inside the US 80% of expenses up to $5,000, then 100% up to the Medical Maximum 90% of expenses up to $5,000, then 100% up to the Medical Maximum 100% of expenses up to the Medical Maximum
Out-of-network, inside the US 70% of expenses up to $5,000, then 100% up to the Medical Maximum 80% of expenses up to $5,000, then 100% up to the Medical Maximum 90% of expenses up to $5,000, then 100% up to the Medical Maximum
Outside the US 100% up to the medical maximum
Subject to deductible and coinsurance unless otherwise stated
Hospital Services  
Hospital Room & Board Up to Medical maximum
Inpatient Up to Medical maximum
Outpatient Up to Medical maximum
Emergency Room Up to Medical maximum
Doctor Office Visits Up to Medical maximum
Coma Benefit
*separate from the Medical Maximum
$10,000 $25,000 $50,000
Local Ambulance  
Inside the US $350 per Displacement $500 per Displacement $750 per Displacement
Outside the US Up to Medical maximum
Prescription Drugs  
Inside the US
*not subject to Deductible
$10 Copay for generic; $20 Copay for brand name $5 Copay for generic; $10 Copay for brand name $0 Copay
Outside the US $0 Copay, deductible applies
Vaccinations  
In the US only, as required by school, University or Visa program $100 per 364 days of continuous coverage $150 per 364 days of continuous coverage $200 per 364 days of continuous coverage
Mental Health
Includes Alcohol & Substance Abuse
 
Outpatient Treatment
Maximum 45 days
80% up to $500 80% up to $1,000 100% up to $2,000
Inpatient Treatment
Maximum 45 days
Up to $5,000 Up to $10,000 Up to $20,000
Emergency Dental Treatment  
Due to an accident $500 maximum $1,000 maximum $2,500 maximum
Alleviate onset of pain $150 maximum $250 maximum $350 maximum
Pre-existing Conditions  
Coverage for pre-existing conditions Up to Medical Maximum After
12-month waiting period
Acute Onset of a pre-existing condition
Inside the US
$5,000 maximum for eligible expenses for the acute onset of pre-existing condition only $10,000 maximum for eligible expenses for the acute onset of pre-existing condition only $25,000 maximum for eligible expenses for the acute onset of pre-existing condition only
Maternity
6-month waiting period
 
In-network, inside the US Up to $500 80% up to $10,000 80% up to $25,000
Out-of-network, inside the US Up to $500 60% up to $10,000 60% up to $25,000
Outside the US Up to $500 80% up to $10,000 100% up to $25,000
Benefits are reduced an additional 25% for failure to notify the company within the first 90 days of pregnancy
Newborn Care  
Routine nursery care $250 maximum $500 maximum $750 maximum
High School, Interscholastic, intercollegiate, intramural or club sports  
Only available for an exclusive list of covered sports. Please refer to the certificate at the end of the page. $2,500 $5,000 $10,000
Physical Therapy and Chiropractic Care  
Physical Therapy $25 per day; 60 days max $50 per day; 60 days max $75 per day; 60 days max
Spinal Manipulation $25 per day; 60 days max when prescribed by a Physician $50 per day; 60 days max when prescribed by a Physician $75 per day; 60 days max when prescribed by a Physician
Incidental Home Country Coverage  
Incidental Trips to Home Country: minimum purchase of 30 days $1,000 $5,000 $10,000
Extension of Benefits $1,000 $5,000 $10,000
Motor Vehicle Accident  
Inside the US 50% up to $100,000 75% up to $100,000 100% up to $100,000
Outside the US Up to Medical Maximum
International Emergency Care  
Emergency Medical Evacuation $100,000 $500,000 $750,000
Emergency Reunion Up to $200 per day/ $15,000 maximum limit Up to $200 per day/ $25,000 maximum limit Up to $200 per day/ $50,000 maximum limit
Return of Child(ren) $25,000 $40,000 $50,000
Return of Mortal Remains $50,000
Political Evacuation and Repatriation $10,000
Local Burial or Cremation $5,000
Natural Disaster  
Evacuation $5,000 $10,000 $10,000
Daily Benefit $25 per day; 5 day limit $50 per day; 5 day limit $75 per day; 5 day limit
Accidental Death and Dismemberment  
Primary Participant $25,000
Spouse $10,000
Child $5,000
Total for Insureds $250,000
Personal Liability $25,000 $50,000 $100,000
Additional Benefits  
24/7 Travel Assistant Included
Non-contact Amateur Sports $2,500 $5,000 $10,000
Terrorism $25,000 $50,000 $100,000
Felonious Assault $10,000 $15,000 $20,000