High School Plan
Comprehensive Plan for High School Students
Annual maximum $1,500,000
$0 deductible in-network
$25 co-pay at primary care physician
What the plan covers?
|Annual deductible in-network||$0|
|Annual deductible out-of-network||$125|
|Co-pay urgent care||$50|
|Emergency room co-pay||$150|
|Co-insurance in-network||80% of PPO allowance|
|Co-insurance out-of-network||70% of Reasonable and Customary charges|
|Prescription deductible per fill||$30|
|Wellness & preventative care||Covered at 100% in-network|
|Pre-existing conditions||Covered after 6 months|
|Repatriation of remains||$50,000|
You are eligible if you are a participant of ISO – International Student Organization are a non United States Citizen, have a current passport or visa, hold a J1 visa and are temporarily residing outside your home country/country of permanent residence, while actively engaged in education or research activities.
Your non-U.S. spouse and eligible dependent children are also eligible for coverage if accompanying you. For purposes of this insurance, if your home country (passport country) is different from your country of permanent residence (location in which you permanently reside), you will not be covered in either location. Permanent residents or persons who have applied for permanent residency are not eligible for coverage under the master policy.