InternationalStudent.com InternationalStudent.com
Sign in to Your Account Done
Forgot account info?

Don't have an Account?

Register Now!

Done USA School Search

Major Medical

padlock

The table below shows the plan benefits for the Global Medical insurance plan across all plans:

Benefits Bronze Silver Gold
(1st 36 months of continuous coverage)
Gold
(Beginning the 1st day of the 37th month)
Gold Plus Platinum
Lifetime Maximum Limit $1 million per individual $5 million per individual $8 million per individual
Deductible
Per Period of Coverage
$250 to $10,000 $250 to $25,000 $100 to $25,000
Provider Network UnitedHealthcare Network
Treatment outside the U.S. Deductible waived 50%, up to a $2,500
No coinsurance
Treatment inside the U.S.
Using Medical Concierge
Deductible waived 50%, up to a $2,500
No coinsurance
Treatment inside the U.S.
PPO Network
Subject to deductible
No coinsurance
Treatment inside the U.S.
Non-PPO Network
Subject to deductible — Plan pays 80% of the next $5,000 of eligible expenses, then 100% to the overall maximum per period of coverage
Coinsurance International – 100%
U.S. In-Network – 100%
U.S. Out of Network – 80%
Hospitalization / Room & Board Subject to deductible and coinsurance for average semi-private room rate. Subject to deductible and coinsurance for average semi-private room rate. All subject to $600 per day / 240 day max. Subject to deductible and coinsurance for average semi-private room rate. Subject to deductible and coinsurance for average semi-private room rate – $2,250 limit per day. Subject to deductible and coinsurance for average semi-private room rate. Subject to deductible and coinsurance for average private room rate.
Hospital Emergency Room Injury Subject to deductible and coinsurance
Hospital Emergency Room Illness
Additional $250 deductible if not admitted
Subject to deductible and coinsurance. Covered only if admitted as inpatient. Subject to deductible and coinsurance
Local Ambulance
due to injury or illness resulting in hospitalization
$1,500 max limit per event
– not subject to deductible or coinsurance
Subject to deductible and coinsurance $100 max limit per event
– not subject to deductible or coinsurance
Subject to deductible or coinsurance Not subject to deductible or coinsurance
Supplemental Accident NA $300 of eligible medical expenses following an accident.
– Not subject to deductible or coinsurance.
$500 max limit per accident – Not subject to deductible or coinsurance.
Intensive Care Unit Subject to deductible and coinsurance Subject to deductible and coinsurance. $1,500 limit per day – 180 days of coverage per event Subject to deductible and coinsurance Subject to deductible and coinsurance. $4,500 limit per day Subject to deductible and coinsurance
CAT Scans, MRI, Echocardiography, Endoscopy, Gastroscopy, Cystoscopy Subject to deductible and coinsurance. $600 max limit per exam Subject to deductible and coinsurance Subject to deductible and coinsurance. $5,000 max limit for outpatient labs Subject to deductible and coinsurance
Surgery Subject to deductible and coinsurance.
Assistant Surgeon 20% of primary surgeon’s charge
Transplants $250k lifetime max. $1 million lifetime max. $500k lifetime max. $1 million lifetime max. $2 million lifetime max.
Chemotherapy or Radiation Therapy Subject to deductible and coinsurance $10,000 max per period of coverage, $50,000 lifetime max Subject to deductible and coinsurance
Out-patient

$500 max limit – specialists/physician charges (pre-inpatient / post-inpatient)

$300 max per visit – lab tests; $250 max per visit – diagnostic x-rays

$70 max limit; $25 visit limit – specialists/physician charges

$50 max limit – chiropractor charges

$500 max limit – surgery intervention consultation charges

$300 max per visit – lab tests; $250 max per visit – diagnostic x-rays
Subject to deductible and coinsurance

Physician charges - $150 per visit; Hospital charge - $100 co-pay unless admitted; Urgent care facility - $25 co-pay

$5,000 max per period of coverage for diagnostic lab and x-rays
Subject to deductible and coinsurance
Mental/ Nervous NA Subject to deductible and coinsurance. Out-patient only after 12 months of continuous coverage Subject to deductible and coinsurance. $10,000 max -Available after 12 months of continuous coverage Inpatient: Subject to deductible and coinsurance.
Outpatient: International – 70%
U.S. in-network – 70%
U.S. out-of-network – 70%
Additional Outpatient Sub-limit - $75 max limit per visit; $2,500 max per period of coverage.
Subject to deductible and coinsurance. $10,000 max per period - $50,000 lifetime max. -Available after 12 months of continuous coverage. Subject to deductible and coinsurance. $50,000 lifetime max. - Available after 12 months of continuous coverage.
Maternity
Delivery, preventative care, newborn care & congenital disorders, Family Matters Maternity Program (available after 10 months of coverage)
N/A $2,500 additional deductible per pregnancy.
$50,000 lifetime maximum.
$200 newborn preventative care benefit for the first 31 days – 12 months after birth.
$250,000 maximum for newborn care & congenital disorders for the first 31 days after birth.
Podiatry Care NA $750 max limit
Physical Therapy Subject to deductible and coinsurance. $40 max per visit – 10 visit limit per event. Available for 90 days following inpatient treatment or outpatient surgery Subject to deductible and coinsurance. $40 max per visit – 30 visit limit Subject to deductible and coinsurance. $50 max per visit Subject to deductible and coinsurance. $50 max per visit - $1,000 max per period of coverage; $10,000 lifetime max Subject to deductible and coinsurance. $50 maximum per visit
Prescription Coverage Subject to deductible and coinsurance. Available for 90 days following related inpatient treatment or outpatient surgery. $600 outpatient maximum limit per event Subject to deductible and coinsurance. 90 day supply per prescription following related covered event Subject to deductible and coinsurance. 90 day supply per prescription. Outpatient only Subject to deductible and coinsurance. $5,000 per period of coverage – outpatient only. 90 day supply per prescription Subject to deductible and coinsurance. 90 day supply per prescription International – 100%
Inside U.S. – Prescription drug card copay: $20 for generic / $40 for brand name where generic is not available. 90 day supply per prescription
Child Preventative Care
(Through age 18)
NA 3 visits per period of coverage - $70 max. per visit – Not subject to deductible or coinsurance - Available after 12 months of continuous coverage $200 max. per period of coverage - not subject to deductible or coinsurance Available after 12 months of continuous coverage $200 max. per period of coverage - not subject to deductible or coinsurance $200 max. per period of coverage - not subject to deductible or coinsurance Available after 12 months of continuous coverage $400 max. per period of coverage - not subject to deductible or coinsurance Available after 6 months of continuous coverage
Adult Preventative Care
(Age 19 or older)
NA $250 per period of coverage - not subject to deductible or coinsurance - Available after 12 months of continuous coverage $250 per period of coverage. Not subject to deductible or coinsurance $250 per period of coverage. Not subject to deductible or coinsurance – Available after 12 months of continuous coverage $500 per period of coverage - not subject to deductible or coinsurance - Available after 6 months of continuous coverage
Emergency Evacuation $50,000 max per period of coverage - not subject to deductible or coinsurance Up to max. limit - not subject to deductible or coinsurance $250k limit period of coverage – not subject to deductible or coinsurance Up to max. limit - not subject to deductible or coinsurance
Emergency Reunion $10,000 lifetime max. Not subject to deductible or coinsurance. NA $10,000 lifetime max. Not subject to deductible or coinsurance.
Interfacility Ambulance Transfer
(Transfer from one licensed health care facility to another licensed health care facility- Applies only in the U.S.)
$1,500 max limit per event – Not subject to deductible or coinsurance Subject to deductible and coinsurance $100 max limit per event – Not subject to deductible or coinsurance Not subject to deductible or coinsurance
Return of Mortal Remains $10,000 lifetime max – not subject to deductible or coinsurance $25,000 lifetime max – not subject to deductible or coinsurance $15,000 lifetime max – not subject to deductible or coinsurance $25,000 lifetime max – not subject to deductible or coinsurance $50,000 lifetime max – not subject to deductible or coinsurance
Remote Transportation NA Limited to $5,000 per certificate period up to $20,000 lifetime max. Not subject to deductible or coinsurance
Political Evacuation and Repatriation NA Limited to $10,000 lifetime max.
Complementary Medicine NA $500 max limit per period of coverage
Traumatic Dental Injury
(Treatment at a hospital facility)
$1,000 per period of coverage Up to the lifetime max limit $5,000 per period of coverage Up to the lifetime max limit
Non-Emergency Treatment at a Dental Provider due to an Accident NA $500 per period of coverage See Non-Emergency Dental benefit
Treatment Due to Unexpected Pain to Sound, Natural Teeth NA $100 per period of coverage 100%
Non-Emergency Dental

Optional Vision & Dental Rider*

$750 per calendar year maximum
$50 deductible (max 2 per family)
Routine Services – 90% (deducible is waived)
Minor restorative – 70%
Major restorative -50%
(6 month waiting period)
$750 max per period of coverage; $50 individual deductible, applies to minor restorative and major restorative services
Vision

Optional Vision & Dental Rider*

Exams – up to $100 per 24 months for Routine Eye Exam
Materials – up to $150 per 24 months
Exams: up to $100 max per 24 months
Materials: up to $150 max per 24 months
Hospital Indemnity
(Outside the U.S. only)
Private Hospital: $400 per overnight and $4,000 max. per period of coverage
Public Hospital: $500 per overnight and $5,000 max. per period of coverage
Not subject to deductible or coinsurance

Pre-existing Conditions

Pre-existing condition coverage is excluded from the Bronze level of the plan. On the Silver, Gold, Gold Plus, and Platinum plan options, conditions that are fully disclosed on the application and have not been excluded or restricted by a rider will be covered the same as any illness. Conditions, including any complications therefrom, that are known and not fully disclosed on the application will not be covered.

On the Silver, Gold, Gold Plus, and Platinum plan options, unknown pre-existing conditions that existed at or prior to the effective date can be covered after 24 months of continuous coverage. These levels will provide a $50,000 lifetime benefit for eligible pre-existing conditions, subject to a maximum of $5,000 per period of coverage.

The following illnesses which existed, manifest themselves, or are treated, or have treatment recommended prior to or during the first 180 days of coverage from the initial effective date are considered pre-existing conditions and are subject to the waiting period and other limitation of coverage described above: acne, asthma, allergies, tonsillectomy, back conditions, adenoidectomy, hemorrhoids or hemorrhoidectomy, disorders or the reproductive system, hysterectomy, hernia, gall bladder or gall stones and kidney stones, any condition of the breast, and any condition of the prostate.

The above is a summary schedule of benefits. Benefits are subject to the deductible and coinsurance unless otherwise noted. NA (Not Applicable); URC (Usual, Reasonable and Customary); SAAI (Same As Any Illness). For a further description of benefits, please refer to the Global Medical Brochure.

For more information about the Global Medical Insurance plan, or to apply over the phone:
Call Now

For more information about the Global Medical Insurance plan, please see below:

Benefits | Exclusions | Apply Online | Brochure

Get the International Student Newsletter!