Hello. Hola. Hallo. Hej. Nin Hao.
You can greet someone in a foreign country in many ways. When you travel, stay safe and secure by saying hello to Student Health AdvantageSM, a one-of-a-kind international medical insurance plan that brings you Global Peace of Mind® when you're traveling abroad.
Secure, Reliable Medical Insurance
As an international student or scholar, the thrill of studying abroad is extraordinary. Your new surroundings are amazing and you're involved in new and exciting experiences. You're seeing and visiting places for the first time, while receiving the benefits of a long-term education.
Caught up in all of the excitement, you may not think about falling ill or becoming injured during your studies. Without warning, your experience abroad can quickly become frightening and risky if you're not prepared for a medical emergency. As an international student, peace of mind is a priority when you study abroad.
Your educational adventure or cultural exchange program should be enjoyable and gratifying. Maintaining the ability to be flexible and responsive, Student Health AdvantageSM is an international medical plan designed to specifically meet the needs of international students, scholars, and people involved in long-term educational and cultural exchange programs. The plan offers a complete package of benefits while outside your home country available 24-hours a day, providing you with Global Peace of Mind®. After all, you are global. Your medical insurance should be too.
Student Health AdvantageSM
- Meets U.S. student, scholar and cultural exchange program visa requirements
- Coverage for individuals or groups of five or more participants and their dependents
- Mental & nervous disorders and substance abuse coverage
- Intercollegiate/interscholastic/intramural or club sports coverage
- Maternity coverage (Platinum only)
- International emergency care
How Does the United States Affordable Care Act (ACA) Affect My Coverage?
Non-U.S. Citizens: As non-resident aliens, international students, scholars, and people involved in cultural exchange programs on F, J, M and Q visas (and certain family members) are not subject to the individual mandate for their first five years in the U.S. All other J categories (teacher, trainee, work and travel, au pair, high school, etc.) are not subject to the individual mandate for two years (out of the past six). Since international students are not subject to the mandate, they are eligible to purchase Student Health Advantage.
U.S. Citizens: Under ACA, all U.S. citizens, nationals and resident aliens are required to purchase minimum essential coverage (ACA compliant coverage), unless they are exempt. Exempt U.S. citizens include U.S. citizens who reside outside of the U.S. for 330 of any 365-day period, or have a tax home (main place of work or employment, or if you don't have a main place of work or employment, your main residence) in a foreign country, and is a bona fide resident of a foreign country.
Please note that this insurance is not subject to, and does not provide benefits required by, ACA. Since January 1, 2014, ACA requires U.S. citizens, U.S. nationals and resident-aliens to obtain ACA compliant insurance coverage unless they are exempt from ACA (international students on F, J, M and Q visas (and certain family members of students) are not subject to the individual mandate for their first 5 years in the U.S. All other J categories - teacher, trainee, work and travel, au pair, high school, etc. - are not subject to the individual mandate for 2 years out of the past six). Penalties may be imposed on persons who are required to maintain ACA compliant coverage but do not do so. Eligibility to purchase or renew this product, or its terms and conditions, may be modified or amended based upon changes to applicable law, including ACA. Please note that it is solely your responsibility to determine if ACA is applicable to you and the Company and the administrator shall have no liability whatsoever, including for any penalties that you may incur, for your failure to obtain required ACA compliant coverage. For information on whether ACA applies to you or whether you are eligible to purchase Student Health Advantage, you should contact your attorney to obtain advice with respect to any particular issue or problem.The materials available on this website are for informational purposes only and not for the purpose of providing legal advice.
Global Assistance Services
We know that the reasons for traveling abroad are many and varied - that's why our products are too. Our full-service approach to providing international medical insurance products includes servicing vacationers, those working or living abroad for short or extended periods, people traveling frequently between countries, and those who maintain multiple countries of residence.
But providing insurance coverage is not enough. It's the service and support that matters the most. Since 1990, We've served millions of people around the globe with customer service that's second to none. We provide on-site medical staff who are available 24 hours a day for emergencies, multilingual customer service professionals and dedicated claims administrators who process tens of thousands of claims each year from all over the world. We're with you, providing you Global Peace of Mind®.
SHA Summary of Benefits - Standard Plan
| Maximum Limit |
Student- $500,000 Dependent- $100,000 |
| Maximum Limit per Illness or Injury | Student- $300,000 Dependent- $100,000 |
| Deductible | $100 per illness or injury Student health center: $5 copay per visit |
| Coinsurance | Outside of the U.S.: Company pays 100% In PPO network or student health center within the U.S.: Company pays 100% Out of PPO network if within the U.S.: Company pays 80% of eligible expenses up to $5,000; then 100% thereafter |
| Hospital Room and Board | Average semi-private room rate, including nursing service |
| Intensive Care | After deductible is met, company pays 80% of expenses out-of- network (U.S.) or 100% in-network (U.S.) and internationally |
| Emergency Room Injury | AAfter deductible is met, company pays 80% of expenses out-of- network (U.S.) or 100% in-network (U.S.) and internationally |
| Emergency Room Illness resulting in Hospitalization | After deductible is met, company pays 80% of expenses out-of- network (U.S.) or 100% in-network (U.S.) and internationally |
| Emergency Room Illness without Inpatient Admission | After deductible is met, company pays 80% of expenses out-of- network (U.S.) or 100% in-network (U.S.) and internationally; Subject to additional $250 deductible |
| Mental or Nervous / Substance Abuse | Outpatient: $50 per day; $500 maximum limit; Inpatient: After deductible is met, company pays 80% of expenses out-of- network (U.S.) or 100% in-network (U.S.) and internationally up to $10,000 maximum limit; Student health center treatment: $0 |
| Prescription Drugs | Inpatient: After deductible is met, company pays 80% of expenses out-of- network (U.S.) or 100% in-network (U.S.) and internationally Outpatient: 50% of actual charges 90 day dispensing maximum |
| Physical Therapy (Medical order or treatment plan required) | After deductible is met, company pays 80% of expenses out-of- network (U.S.) or 100% in-network (U.S.) and internationally; limit one visit per day |
| Local Ambulance | $350 per illness resulting in an inpatient hospitalization or injury |
| Dental | Non-emergency treatment at a dental provider due to an accident - $500 period of coverage limit per injury; Unexpected pain to sound, natural teeth - $350 period of coverage limit |
| Eligible Medical Expenses | After deductible is met, company pays 80% of expenses out-of- network (U.S.) or 100% in-network (U.S.) and internationally |
| Interfacility Ambulance Transfer (For services rendered in the U.S.) | Company pays 100%. Transfer must be a result of an inpatient hospital admission |
| Emergency Medical Evacuation | $500,000 maximum limit |
| Emergency Reunion | $50,000 maximum limit |
| Return of Mortal Remains | $50,000 maximum limit |
| Political Evacuation and Repatriation | $10,000 maximum limit |
| Intercollegiate / Interscholastic / Intramural or Club Sports | $5,000 period of coverage limit per illness or injury |
| Incidental Trip Coverage | Up to a cumulative 14 days (available for non-U.S. residents only) |
| Pre-existing Conditions | Charges excluded until after 12 months of continuous coverage |
| Terrorism | $50,000 maximum limit |
| AD&D | Student: $25,000 principal sum; Spouse: $10,000 principal sum; Dependent child: $5,000 principal sum Accidental dismemberment percentage of principal sum |
| Personal Liability (Secondary to any other insurance) | $10,000 combined maximum limit Injury to third person: subject to a $100 per injury deductible Damage to third person's property: subject to a $100 per damage deductible |
All coverage and benefits in this Policy are in United States (U.S.) dollars. Benefits are subject to the exclusions and limitations and are payable only at Usual, Reasonable and Customary charges. This is a summary and does not supersede in anyway the Certificate of Insurance and governing policy documents (together the "Insurance Contract"). The Insurance Contract is the only source of the actual benefits provided. Eligible medical expenses are limited to usual, reasonable and customary.
SHA Summary of Benefits - Platinum Plan
| Maximum Limit | Student: $1,000,000 Dependent: $100,000 |
| Maximum Limit per Illness or Injury | Student: $500,000 Dependent: $100,000 |
| Deductible | For treatment received outside of the U.S.: $25 per illness or injury For treatment received within the U.S.: PPO provider: $25 per illness or injury; Non-PPO provider: $50 per illness or injury; Student health center: $5 copay per visit |
| Coinsurance | Outside of the U.S.: Company pays 100%; In PPO network or student health center within the U.S.: Company pays 100%; Out of PPO network if within the U.S.: Company pays 80% of eligible expenses up to $5,000; then 100% thereafter |
| Hospital Room & Board | Average semi-private room rate, including nursing service |
| Intensive Care | After deductible is met, company pays 80% of expenses out-of- network (U.S.) or 100% in-network (U.S.) and internationally |
| Maternity and Newborn Care | $5,000 maximum limit. Benefit includes newborn routine care during the first 31 days of life After deductible is met, company pays 60% of eligible expenses out-of-network (U.S.), 80% in-network (U.S.) and 100% internationally |
| Emergency Room Injury | After deductible is met, company pays 80% of expenses out-of- network (U.S.) or 100% in-network (U.S.) and internationally |
| Emergency Room Illness resulting in Hospitalization | After deductible is met, company pays 80% of expenses out-of- network (U.S.) or 100% in-network (U.S.) and internationally |
| Emergency Room Illness without Inpatient Admission | After deductible is met, company pays 80% of expenses out-of- network (U.S.) or 100% in-network (U.S.) and internationally; Subject to additional $250 deductible |
| Mental or Nervous / Substance Abuse | Outpatient: $50 per day; $500 maximum limit; Inpatient: After deductible is met, company pays 80% of expenses out-of- network (U.S.) or 100% in-network (U.S.) and internationally up to $10,000 maximum limit; Student health center treatment: $0 |
| Prescription Drugs | Inpatient: After deductible is met, company pays 80% of expenses out-of- network (U.S.) or 100% innetwork (U.S.) and internationally Outpatient: 50% of actual charges 90 day dispensing maximum |
| Physical Therapy (Medical order or treatment plan required) | After deductible is met, company pays 80% of expenses out-of- network (U.S.) or 100% in-network (U.S.) and internationally; limit one visit per day |
| Local Ambulance | $750 per illness resulting in an inpatient hospitalization or injury |
| Dental | Non-emergency treatment at a dental provider due to an accident - $500 period of coverage limit per injury; Unexpected pain to sound, natural teeth - $350 period of coverage limit |
| Eligible Medical Expenses | After deductible is met, company pays 80% of expenses out-of- network (U.S.) or 100% in-network (U.S.) and internationally |
| Interfacility Ambulance Transfer (For services rendered in the U.S.) | Company pays 100%. Transfer must be a result of an inpatient hospital admission |
| Emergency Medical Evacuation | $500,000 maximum limit |
| Emergency Reunion | $50,000 maximum limit |
| Return of Mortal Remains | $50,000 maximum limit |
| Political Evacuation and Repatriation | $10,000 maximum limit |
| Intercollegiate / Interscholastic / Intramural or Club Sports | $5,000 period of coverage limit per illness or injury |
| Incidental Trip Coverage | Up to a cumulative 14 days (available for non-U.S. residents only) |
| Pre-existing Conditions | Charges excluded until after six months of continuous coverage |
| Terrorism | $50,000 maximum limit |
| AD&D | Student: $25,000 principal sum; Spouse: $10,000 principal sum; Dependent child: $5,000 principal sum; Accidental dismemberment percentage of principal sum |
| Personal Liability (Secondary to any other insurance) | $10,000 combined maximum limit Injury to third person: subject to a $100 per injury deductible Damage to third person's property: subject to a $100 per damage deductible |
All coverage and benefits in this Policy are in United States (U.S.) dollars. Benefits are subject to the exclusions and limitations and are payable only at Usual, Reasonable and Customary charges. This is a summary and does not supersede in anyway the Certificate of Insurance and governing policy documents (together the "Insurance Contract"). The Insurance Contract is the only source of the actual benefits provided. Eligible medical expenses are limited to usual, reasonable and customary.
SHA Premium Rates
SHA Standard
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SHA Platinum
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New premium rates per insured person effective June 20, 2018 for eligible individuals whose applications are approved by the administrator. The administrator reserves the right to modify or replace these rates at any time.
SHA Optional Riders
ADVENTURE SPORTS RIDER: The Adventure Sports Rider is available for eligible participants. Certain activities designated as adventure sports can be covered up to the maximums listed below. Certain activities are never covered regardless of whether or not the Adventure Sports Rider is issued. For a list of activities which can be considered to be adventure sports, please look at Adventure Sports Rider. (Available to insureds through age 64)
| Age | Maximum limit per injury or illness |
|---|---|
| Through age 49 | $50,000 |
| 50-59 | $30,000 |
| 60-64 | $15,000 |
SHA Plan Information
Eligibility
To be eligible to apply to the Student Health Advantage plan, you must:
- Be a participant: a student, scholar, intern, teacher or trainee enrolled in an educational or cultural exchange program for the purposes of teaching, study, research or receiving on the job training for a temporary period of time
- Be the spouse of a participant or children of a participant and residing outside his/her primary country of residence for a temporary period of time. Primary applicant must hold a J1, M1 or F1 visa, and spouse must apply with primary applicant - they cannot apply alone
- Be at least 31 days old but not yet 65 years old
- Be physically and legally residing in the destination country with the intent to reside there for at least 30 days on the effective date and at renewal
- Not be hospitalized, disabled, pregnant or HIV+ on the initial effective date
Enrollment Process
Before you begin your travel, simply apply online or fill out the application and calculate the estimated premium for the time period you, your group, and/or your dependents will be traveling. Once you have completed the application, return it to us.
Eligible individuals listed on the application and for whom premiums have been paid will be covered from the latest of the following dates:
- The date the administrator approves your completed application and receives the appropriate premium
- The date you depart from your primary country of residence
- The date requested on your application
Eligible individuals may pay their rates on a monthly basis, but will incur a 4% admin fee.
Fulfillment Kits
We process applications in a quick, timely manner. Once processing is complete, we will mail and/or email the fulfillment kit(s) to the address/email listed in the Application. The fulfillment kit(s) will include an identification card(s), and the insurance certificate providing a complete description of the rights and benefits under the contract. For your convenience, you will get emailed this information and may also access it from Client Center.
If you do not choose online fulfillment, we will mail your fulfillment materials. This may cause delays. We recommend online fulfillment for immediate access to your coverage information.
Conditions of Coverage
1) Coverage and benefits are subject to the deductible limits, and coinsurance, and all terms of the insurance contract, which includes the master policy and all governing documents, as summarized in the certificate of insurance. 2) Coverage under a Student Health Advantage plan is secondary to any other coverage. 3) Coverage and benefits are for eligible medical expenses which are medically necessary and usual, reasonable and customary. 4) Charges must be administered or ordered by a licensed physician. 5) Charges must be incurred during the period of coverage.
Renewal of Coverage
Eligible insureds whose initial coverage is at least three months can request coverage under the plan be renewed monthly for up to 12 month periods, for a maximum of 60 continuous months, as long as the premium is paid when due and the insured continues to meet the eligibility requirements of the plan.
*Benefits are subject to exclusions and limitations. This is only a summary and does not supersede in any way the Certificate of Insurance and governing policy documents (together the "Insurance Contract"). The Insurance Contract is the only source of the actual benefits provided.
SHA Claims Procedure
Precertification:
Certain treatment and supplies including hospital admission, inpatient or out-patient surgery, and other procedures as noted in the certificate wording must be precertified for medical necessity, which means the insured person or their attending physician must communicate with a representative at the number listed on the ID card prior to admission to a hospital, before receiving certain treatments and supplies, or performance of a surgery. In case of an emergency admission, the precertification must be made within 48 hours of the admission, or as soon as reasonably possible. If a hospital admission or a surgery is not precertified, eligible claims and expenses will be reduced by 50%. It is important to note that precertification is only a determination of medical necessity, not an assurance of coverage, verification of benefits or a guarantee of payment. All medical expenses eligible for reimbursement must be medically necessary and will be paid or reimbursed at usual, reasonable and customary rates. Please refer to the certificate wording for full details of the precertification requirements.
For Precertification, emergency evacuation and repatriation, please call: In the U.S.: 1-800-628-4664 (toll free) or 1-317-655-4500. Outside the U.S.: 001-317-655-4500 (collect if necessary). This information will also be provided on your ID card.
Note: You may begin the precertification process through the Client Center. Simply look for the precertification option. You will be asked to provide the required information, which can then be submitted electronically. Once we have received all required information and medical records, our utilization management and review team will review the information provided and normally responds to the insured person or the provider within two business days. Please note that this online service will only initiate the process for treatment and supplies outlined in the contract, and it should not be used to request precertification for emergency admissions, procedures or evacuations.
Claims Payment:
All benefits payable under Student Health Advantage are subject to the terms and conditions in the certificate of insurance. To make claim processing efficient, claims for eligible medical expenses may be paid in two ways:
- Eligible expenses that have been paid by or on behalf of the insured person may be reimbursed by check directly to the insured person
- Eligible expenses that have not yet been paid by the insured person may, at the option of the administrator, be paid either to the insured person or directly to the provider
Claims must be presented to the claims department for payment within 180 days from the date the claim was incurred.
Claim forms can be accessed in the Client Center and mailed to the address on the claim form. All contact numbers, claim forms and Certificate of Insurance are included in the fulfillment kit. May also be contacted by fax at 1-317-655-4505.
SHA Services
Client Center
An online service located in our Client Center that allows you to manage your accounts, 24 hours a day, seven days a week, from anywhere in the world. Some features include:
- Submission and management of claims
- Access to explanation of benefits (EOBs)
- Initiate precertification
- Access customer care via email or telephone
- Locate and recommend a provider/ facility
- Obtain ID cards and other insurance documents
Locating a Provider
With the Student Health Advantage Plan you may seek treatment while outside your home country with the hospital or doctor of your choice. When seeking treatment in the U.S., you have access to Preferred Provider Organizations (PPO), which are separately organized networks of hundreds of thousands of established, highly qualified health care physicians and many well recognized hospitals in the U.S. You can quickly search the network. Additionally, to help you locate health care providers outside the U.S., we provide online International Provider AccessSM (IPA), a database of over 17,000 providers.
Our goal is to provide quality medical coverage wherever you may be while outisde your home country. The PPO and our IPA enable us to do just that, and our online directories put the information at your fingertips - anytime, anywhere.
Universal Rx Pharmacy Discount Savings
This discount savings program allows you to purchase prescriptions at one of over 35,000 participating pharmacies in the U.S. and receive the lower of 1) Universal Rx contract price or 2) the pharmacy regular retail price. This program is not insurance coverage; it is purely a discount program.
Akeso Care Management®(AkesoCare℠)
The ability to access quality health care is of paramount importance when a medical emergency arises abroad. To coordinate care and provide U.S. and internationally based medical management services, the administrator formed AkesoCare, an on-site specialized division devoted entirely to medical management.
The clinical staff consists of qualified physicians and registered nurses who are experts at assessing the need for medical services and ensuring those services are delivered in a timely, cost-effective manner. AkesoCare has international medical experience, providing services in more than 170 countries worldwide.
AkesoCare is accredited by URAC, an independent, nonprofit organization that is internationally recognized for promoting continuous improvement in the quality and efficiency of health care management. Through a rigorous and comprehensive review that ensures ongoing compliance, AkesoCare earned its URAC accreditation in Health Utilization Management.
From routine medical care to complex case management, from check-ups to emergency medical evacuations, AkesoCare is there for you. They are committed to patient protection and empowerment, quality operations and provider compliance. This translates into better care for you - around the world, around the clock.
*Benefits are subject to exclusions and limitations. This is only a summary and does not supersede in any way the Certificate of Insurance and governing policy documents (together the "Insurance Contract"). The Insurance Contract is the only source of the actual benefits provided.
Administrator
IMGP.O. Box 88509
2960 North Meridian Street
Indianapolis, IN 46208-0509 USA
Underwriter
Coverage is underwritten and issued by Sirius International Insurance Corporation, rated A (excellent) by A.M. Best and A- by Standard & Poor's (at the time of printing).
FOR ADDITIONAL INFORMATION
Insubuy®, Inc.4200 Mapleshade Ln, Suite 200
Plano, TX 75093
Toll Free:
(866) INSUBUY
Phone:
(972) 985-4400
Fax:
(972) 767-4470
Website:
www.insubuy.com
This invitation to inquire allows eligible applicants an opportunity to seek information about the insurance offered and is limited to a brief description of any loss for which benefits may be payable. Benefits are offered as described in the insurance contract. Benefits are subject to all deductibles, coinsurance, provisions, terms, conditions, limitations and exclusions in the insurance contract.
The contract does contain a pre-existing condition exclusion and do not cover losses or expenses related to a pre-existing condition.
This brochure contains many of the valuable trademarks, names, titles, logos, images, designs, copyrights and other proprietary materials owned and registered and used by International Medical Group, Inc. and its representatives throughout the world. © 2007-2018 International Medical Group, Inc. All rights reserved.
Version:
04/2018
Release: 06/20/2018