Student Health Advantage Platinum - Including USA

Plan Detail

Plan Administrator:  International Medical Group | AM Best Rating: A "Excellent" | Underwriter: Sirius International

  • PPO Network(Within USA or Canada): 80% of Eligible Expenses after the Deductible up to $5,000, then 100% up to policy max.
  • Eligibility:  A Full time Student & Non US Citizen  Age 14-64 travelling USA to study
  • Coverage length: Min 3months to 12months
  • Provider Network: PPO Providers are contracted separately through First Health Group Corp
  • Renew Online: Provided there is no break in coverage, the plan may be renewed for up to five years
  • Cancel: Before effective date full refund and after policy effective date unused portion of premium minus $50 cancellation fees.
  • ID card & Visa Letter comes in email instantly.

Description


ELIGIBILITY: If an Insured Person is not eligible, this Certificate is void ab initio and all Premium paid will be refunded. In order to be eligible and qualified for coverage under this insurance, a person must meet all of the following requirements:

SPECIFIC REQUIREMENTS: The following must always be Pre-certified for Medical Necessity by the Company through the Plan Administrator before admission or receiving the Treatments and/or supplies:

(a) Chemotherapy
(b) Extended Care Facility
(c) Home Nursing Care
(d) Inpatient Hospitalization
(e) Interfacility Ambulance Transfer
(f) Maternity
(g) Radiation Therapy
(h) Surgery or Surgical procedure

GENERAL REQUIREMENTS: To comply with the Pre-certification requirements of this insurance for the Treatments and/or supplies or services listed in the SPECIFIC REQUIREMENTS provision, above, the Insured Person or his/her Physician or healthcare provider must perform all of the following:

(a) contact the Company through the Plan Administrator at the contact information below and on the Insured Person's ID card, as soon as possible and before the Treatment or supply is to be obtained.

Inside the United States: +1.800.628.4664

Outside the United States: +1.317.655.4500 (Collect if necessary)

E-mail: acm@imglobal.com

Website: www.imglobal.com/member/precertification

(b) comply with the instructions of the Company and submit any information or documents required by the Company
(c) notify all Physicians, Hospitals and other healthcare providers that this insurance contains Pre-certification requirements and ask them to fully cooperate with the Company.
(3) MATERNITY PRE-CERTIFICATION REQUIREMENTS: To comply with the Maternity Pre-certification requirements, the Insured Person must:
(a) contact the Company as soon as possible but always within sixty (60) days of expected delivery
(b) comply with the instructions of the Company and submit any information or documents required by the Company
(c) notify all Physicians, Hospitals and other healthcare providers that this insurance contains Pre-certification requirements and ask them to fully cooperate with the Company
(d) If the Insured Person complies with the Maternity Pre-certification requirements and the expenses are Pre-certified, the Company will pay Maternity and Newborn Care benefits, subject to all Terms, conditions, provisions and exclusions herein. If the Insured Person does not comply with the Maternity Pre-certification requirements, or if the expenses are not Pre-certified, all Maternity and Newborn Care benefits are reduced by the amount shown in the BENEFIT SUMMARY, the Deductible will be subtracted from the remaining amount; and Coinsurance will be applied. If for any reason after initial Maternity Pre-certification the Insured Person shall become aware of complications during Pregnancy, the Insured Person must Pre-certify again, in accordance with the General Requirements for Pre-certification.