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INTERNATIONAL - PPO DOCTOR/HOSPITAL
RENEWAL/EXTENSION LINKS
PGH Global strives to offer plans that are comprehensive and meet a multitude of minimum requirements. However, requirements differ by institution.
Who is eligible to enroll International Student Insurance Global Care Plus?
All international students, scholars or other persons with a current passport who: 1) are engaged in educational activities; and 2) are temporarily located outside his/her home country as a non resident alien; and 3) have not obtained permanent residency status in the U.S. are eligible to enroll in this plan. Those enrolled in an English language or similar program or an Optional Practical Training Program or with an F or J visa are also eligible to enroll in this plan. Students must actively attend classes for at least the first 31 days after the date for which coverage is purchased with the exception of those with a J visa or those engaged in an Optional Practical Training Program. Eligible students may also insure their Dependents. Eligible Dependents are the student’s spouse and dependent children under 26 years of age.US Citizens are not eligible for coverage as a student or a dependent.
Choice of Plan
Eligible students have a choice of one of the three Deductible options depending on which of the Global Care Plans they select:
Basic Plan - $100 Deductible for Preferred Providers Per Insured Person, Per Policy Year and $500 Deductible for Out-of-Network Providers Per Insured Person, Per Policy Year.
Plus Plan - $100 Deductible for Preferred Providers Per Insured Person, Per Policy Year and $300 Deductible for Out-of-Network Providers Per Insured Person, Per Policy Year.
Preferred Plan - $50 Deductible for Preferred Providers Per Insured Person, Per Policy Year and $300 Deductible for Out-of-Network Providers Per Insured Person, Per Policy Year.
Highlights of the Coverage and Services offered by Student Resources (SPC) Ltd.,a UnitedHealth Group Company | ||
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Preferred Providers | Out-of-Network Providers | |
Overall Plan Maximum | There is no overall maximum dollar limit on the policy | |
Plan Deductible | $100 per Insured Person, per Policy Year | $300 per Insured Person, per Policy Year |
Out-of-Pocket Maximum After the Out-of-Pocket Maximum has been satisfied, Covered Medical Expenses will be paid at 100% for the remainder of the Policy Year subject to any applicable benefit maximums. Refer to th e plan brochure for details about how the Out-of-Pocket Maximum applies. | $6,350 Per Insured Person, Per Policy Year $12,700 for all insured in a Family, per Policy Year | $8,000 Per Insured Person, Per Policy Year $16,000 for all insured in a Family, per Policy Year |
Coinsurance All benefits are subject to satisfaction of the Deductible, specific benefit limitations, maximums and Copays as described in the plan brochure. | 80% of Preferred Allowance for Covered Medical Expenses | 70% of Usual and Customary Charges for Covered Medical Expenses |
Prescription Drugs Prescriptions must be filled at a UHCP network pharmacy. Mail order through UHCP at 2.5 times the retail Copay up to a 90 day supply. | $15 Copay for Tier 1 20% Coinsurance for Tier 2 30% Coinsurance for Tier 3 Up to a 31-day supply per prescription filled at a UnitedHealthcare Pharmacy (UHCP | No Benefits |
Preventive Care Services Including but not limited to: annual physicals, GYN exams, routine screenings and immunizations. No Copay or Deductible when the services are received from a Preferred Provider. Preventive care limits apply based on age and risk group factors. | 100% of Preferred Allowance | No Benefits |
The following services have per Service Copays/Deductibles This list is not all inclusive. Please read the plan brochure for complete listing of Copays/Deductibles. | Physician Visits: $25 Medical Emergency: $200 | Medical Emergency: $200 |
Pediatric Dental and Vision Benefits | Refer to the plan brochure for details (age limits apply). | |
UnitedHealthcare Global: Global Emergency Services | International Students are covered worldwide except in their home country. |
How much does the plan cost?
Rates | 30-Day Rates * |
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Student 24 & Under | $102.60 |
Student 25-30 | $143.70 |
Student 31-40 | $256.50 |
Student 41+ | $455.40 |
Spouse | $536.40 |
Each Child | $350.70 |
*30 Day Rates are for illustrative purposes only, minimum purchase period is 90 days.
*Refunds of premium are allowed only upon entry into the armed forces or ineligibility.
No benefits will be paid for: |
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a) loss or expense caused by,
contributed to, or resulting from; or
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You can call us toll-free at 1-800-344-9540 or 1-847-897-5120
WhatsApp us at 1-847-897-5120
Our email is info@visitorsinsurance.com
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(Monday – Friday)