 Pre-existing conditions |
Sudden & Unexpected Recurrence of a Pre-existing Condition (U.S. Citizens plan only)
- Eligible Medical Expenses: $5,000 lifetime maximum
- Emergency Medical Evacuation: $25,000 lifetime maximum
|
Covered after 12 months of waiting period
|
Covered after 6 months of waiting period
|
 Coinsurance - for treatment received inside the U.S. & Canada: |
No Coinsurance |
In the PPO Network or Student Health Center
No Coinsurance
Out of the PPO Network
The plan pays 80% of the first $5,000 of the eligible charges, then 100% thereafter |
In the PPO Network or Student Health Center
No Coinsurance
Out of the PPO Network
The plan pays 80% of the first $5,000 of the eligible charges, then 100% thereafter |
 Hospital Room and Board |
Up to average semi-private room rate |
Up to average semi-private room rate, including nursing service |
Up to average semi-private room rate, including nursing service |
 Dental Treatment |
- Due to Accident - $500 maximum per accident
- Due to Sudden Pain - Up to $350 maximum
|
- Due to Accident - $500 maximum per accident
- Due to Sudden Pain - Up to $350 maximum
|
- Due to Accident - $500 maximum per accident
- Due to Sudden Pain - Up to $350 maximum
|
 Emergency Medical Evacuation |
Up to $50,000 lifetime maximum |
Up to $500,000 lifetime maximum |
Up to $500,000 lifetime maximum |
 Terrorism |
Up to $50,000 lifetime maximum |
Up to $50,000 lifetime maximum |
Up to $50,000 lifetime maximum |
 Return of Mortal Remains or Cremation / Burial: |
Up to $25,000 for Return of Mortal Remains or $5,000 for Cremation/Burial |
Up to $50,000 for Return of Mortal Remains |
Up to $50,000 for Return of Mortal Remains |
 Accidental Death and Dismemberment |
Accidental Death - $25,000
Dismemberment - $25,000 (two limbs); $12,500 (one limb) |
Accidental Death - Student: $25,000; Spouse: $10,000; Dependent: $5,000
Dismemberment - Accidental dismemberment percentage of principle sum |
Accidental Death - Student: $25,000; Spouse: $10,000; Dependent: $5,000
Dismemberment - Accidental dismemberment percentage of principle sum |
 Maternity Coinsurance |
-
|
No Coverage |
Outside the US: 100% of eligible expenses
In US and PPO Network: 80% of the eligible expenses
Non-PPO Network: 60% of the eligible expenses
|
 Routine newborn care |
| - |
No Coverage |
$750 maximum per period of coverage |
 Ambulance |
| - |
Per injury- up to $350
$350 per illness only if admitted as inpatient |
Per injury- up to $750
$750 per illness only if admitted as inpatient |
 Underwriter |
Sirius International Insurance Corporation |
Sirius International Insurance Corporation |
Sirius International Insurance Corporation |
