StudentSecure Smart Excluding USA

Plan Detail

Plan Administrator: Tokio Marine HCC - Medical Insurance Services Group | AM Best Rating: A "Excellent" | Underwriter: Lloyd's

Pre-existing Coverage


Acute onset of pre-existing condition (excludes chronic and congenital conditions)

$25,000 lifetime maximum for eligible expenses

ACUTE ONSET OF PRE-EXISTING CONDITION

Acute Onset of Pre-existing Condition means a sudden and unexpected outbreak or recurrence of a preexisting condition(s) which occurs spontaneously and without advance warning either in the form of physician recommendations or symptoms, is of short duration, is rapidly progressive, and requires urgent care. The Acute Onset of a Pre-existing Condition(s) must occur after the certificate effective date. Treatment must be obtained within 24 hours of the sudden and unexpected outbreak or recurrence. A pre-existing condition that is a chronic or congenital condition or that gradually becomes worse over time will not be considered Acute Onset.

This benefit does not include coverage for known, scheduled, required, or expected medical care, drugs or treatments existent or necessary prior to the certificate effective date.

YOU ARE COVERED:

1. Charges for a sudden and unexpected outbreak or recurrence of a pre-existing condition(s) which:

a. Occurs spontaneously and without advance warning either in the form of physician recommendations or symptoms; and

b. Is of short duration; and

c. Is rapidly progressive; and

d. Requires urgent care

YOU ARE NOT COVERED unless you fulfill the following condition:

 1. Treatment must be obtained within 24 hours of the sudden and unexpected outbreak or recurrence

YOU ARE NOT COVERED IF:

1. The Acute Onset of a Pre-existing Condition(s) occurs before the certificate effective date; or

2. The pre-existing condition is a chronic or congenital condition or that gradually becomes worse over time; or

3. The charges are for known, scheduled, required, or expected medical care, drugs or treatments existent or necessary prior to the certificate effective date; or

 4. Expenses arise directly or indirectly from anything in the General Exclusions

Acute Onset of Pre-existing Condition (Excludes chronic and congenital conditions)

Up to $25,000 lifetime maximum for eligible medical expenses

PRE-EXISTING CONDITIONS EXCLUSION

Pre-existing Conditions, except charges resulting directly from an Acute Onset of Pre-existing Condition,an Emergency Medical Evacuation, or Repatriation of Remains, subject to the limits set forth in the Schedule of Benefits and Limits.

PRE-EXISTING MEDICAL CONDITIONS

Charges resulting directly or indirectly from any pre-existing conditions are excluded from this insurance, except charges resulting directly from an Acute Onset of Pre-existing Condition, an Emergency Medical Evacuation, or Repatriation of Remains, subject to the limits set forth in the Schedule of Benefits and Limits.

Pre-existing Condition means any

(1) condition for which medical advice, diagnosis, care, or treatment (includes receiving services and supplies, consultations, diagnostic tests or prescription medicines) was recommended or received during the 12 months immediately preceding the certificate effective date;

 (2) condition that had manifested itself in such a manner that would have caused a reasonably prudent person to seek medical advice, diagnosis, care, or treatment (includes receiving services and supplies, consultations, diagnostic tests or prescription medicines) within the 12 months immediately preceding the certificate effective date;

(3) injury, illness, sickness, disease, or other physical, medical, mental, or nervous conditions, disorder or ailment (whether known or unknown) that, with reasonable medical certainty, existed at the time of application or within the 12 months immediately preceding the certificate effective date.