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Student Health Advantage

International Student Health Insurance

The Student Health advantage plan is available in two levels: Standard and Platinum. Please see the list of benefits below to compare the benefits specific to each plan level.

Standard Platinum
Lifetime Maximum
Student $500,000 $1,000,000
Dependent Spouse and Child $100,000 $100,000
Per Illness/Injury Maximum
Student $300,000 $500,000
Each eligible dependent Spouse and Child $100,000 $100,000
Deductible
For Treatment received outside the US $100 per Illness or Injury $25 per Illness or Injury
For Treatment received inside the US $100 per Illness or Injury PPO: $25 per Illness or Injury
Non-PPO: $50 per Illness or Injury
Student Health Center
$5 co-pay per visit if Treatment received in Student Health Center (not subject to deductible)
Coinsurance
For Treatment received outside the US After the deductible, the plan pays 100% of eligible expenses up to Maximum Limit.
For Treatment received within the US In the PPO Network or Student Health Center:

After the deductible, the plan pays 100% of eligible expenses up to Maximum Limit

Outside of the PPO Network:

After the deductible, the plan pays 80% of eligible expenses up to $5,000, then 100% up to Maximum Limit

Provider Network

Inpatient or Outpatient Services Subject to Deductible and Coinsurance unless otherwise noted.
Eligible Medical Expenses are limited to Usual, Reasonable and Customary
Limits per Period of Coverage unless stated as Maximum Limit
Eligible Medical Expenses Up to the maximum limit
Physician Visits / Services Up to the maximum limit 1 visit per day
Surgery is not subject to the maximum visit limit
Hospital Emergency Room

Up to the maximum limit.

Illness: Subject to a $250 deductible for each ER visit for treatment that does not result in direct inpatient hospital admission.

Injury: Not subject to emergency room deductible.
Hospitalization / Room & Board Average semi-private room rate up to the maximum limit. Includes nursing service, miscellaneous and Ancillary services.
Intensive Care Unit (ICU) Up to the maximum limit
Outpatient Surgical / Hospital Facility Up to the maximum limit
Laboratory Up to the maximum limit
Radiology / X-ray Up to the maximum limit
Chemotherapy / Radiation Therapy Up to the maximum limit
Pre-admission Testing Up to the maximum limit
Surgery Up to the maximum limit
Reconstructive Surgery Surgery is incidental to and follows surgery that was covered under the plan Up to the maximum limit
Assistant Surgeon 20% of the primary surgeon’s eligible fee
Anesthesia Up to the maximum limit
Durable Medical Equipment Up to the maximum limit Standard basic hospital bed and/or a standard basic wheelchair
Chiropractic Care Up to the maximum limit Medical order or treatment plan required
Physical Therapy Up to the maximum limit Medical order or treatment plan required
1 visit per day
Pre-Existing Conditions Eligible expenses covered after 12 continuous months of coverage Eligible expenses covered after 6 continuous months of coverage
Maternity Pre-natal care, delivery of a Newborn, and post-natal care of an Insured Person, including complications No Coverage

In the US:

In-Network: 80% up to $5,000

Out-of-Network: 60% up to $5,000

Outside the US: 100% up to $5,000
Routine Newborn Care No Coverage Included in Maternity Benefit during the first 31 days of life
Extended Care Facility Up to the maximum limit Upon direct transfer from an acute care facility
Home Nursing Care Up to the maximum limit Provided by a Home Health Care Agency
Upon direct transfer from an acute care facility
COVID-19 Coverage COVID-19/SARS-CoV-2 shall be considered the same as any other illness or injury, subject to all other terms and conditions.
Prescription Medication

Period of Coverage Limit:

Primary Insured Person: $250,000 maximum

Spouse and Child: $100,000 maximum

Inpatient and Outpatient Surgery, Emergency Room, and Outpatient Office Visits Prescription Drugs and Medication: Up to the Period of Coverage Limit

Retail Pharmacy Prescription Drugs and Medication: 50% coverage, 90 day dispensing maximum
Mental or Nervous / Substance Abuse

Inpatient: $10,000 maximum

Outpatient: $50 limit per day, $500 maximum limit Not covered if incurred at Student Health Center
Emergency Services NOT subject to Deductible and Coinsurance unless otherwise noted
Eligible Medical Expenses are limited to Usual, Reasonable and Customary
Limits per Period of Coverage unless stated as Maximum Limit
Emergency Local Ambulance

Per Injury: $350

Per Illness resulting in Inpatient Hospitalization: $350

Per Injury: $750

Per Illness resulting in Inpatient Hospitalization: $750
Emergency Medical Evacuation $500,000 lifetime maximum Must be approved in advance and coordinated by the Company
Emergency Reunion

$50,000 lifetime maximum

15 day maximum, $25 per day meal maximum Must be approved in advance by the Company
Interfacility Ambulance Transfer Up to the maximum limit Transfer must be a result of an Inpatient Hospital admission
Services rendered in the United States
Political Evacuation and Repatriation $10,000 lifetime maximum Must be approved in advance by the Company
Return of Mortal Remains

$50,000 lifetime maximum

Local Burial/Cremation: $5,000 maximum Must be approved in advance by the Company
Other Services Subject to Deductible and Coinsurance unless otherwise noted
Eligible Medical Expenses are limited to Usual, Reasonable and Customary
Limits per Period of Coverage unless stated as Maximum Limit
Accidental Death & Dismemberment Death must occur within 90 days of the accident Principal Sum:
  • Insured Person: $25,000
  • Spouse: $10,000
  • Child: $5,000
Not subject to deductible or coinsurance
Dental Treatment Treatment due to Unexpected Pain to Sound, Natural Teeth: $350 maximum
Non-Emergency Treatment due to an Accident: $500 maximum
Traumatic Dental Injury Up to the maximum limit. Additional treatment for the same injury rendered by a dental provider will be paid at 100%. Subject to deductible and coinsurance.
Incidental Trip Up to a cumulative 14 days Insured Person’s Country of Residence is not the United States
Intercollegiate, Interscholastic, Intramural, and Club Sports $5,000 per injury or illness
Personal Liability Secondary to any other insurance

$10,000 combined maximum limit.

Injury to a third person: $100 per injury deductible.

Damage to a third person’s property: $100 per damage deductible. No coverage for injury to a related third party or damage to related third person’s property.
Terrorism $50,000 Lifetime Maximum Not subject to deductible or coinsurance

Optional Riders

Adventure Sports Rider (Available to insureds up to age 64)
Certain activities designated as adventure sports can be covered up to the maximums listed below if the optional rider is purchased. Certain activities are never covered, regardless of whether the Adventure Sports Rider is purchased. For a list of activities considered to be adventure sports, please contact us.
Age Lifetime Maximum
0–49 $50,000
50–59 $30,000
60–64 $15,000

This website contains only a consolidated and summary description of all current Student Health Advantage benefits, conditions, limitations and exclusions. A certificate containing the complete Certificate Wording with all terms, conditions and exclusions will be included in the fulfillment kit. IMG reserves the right to issue the most current Certificate Wording for this insurance plan in the event this application and/or brochure has expired, is modified, or is replaced with a newer version. Please view the plan certificate ( Standard | Platinum ) for the full benefits and limitations of the plan.