IMG Student Journey Insurance

• Student Journey Lite	Student Journey Plus	Student Journey Platinum
  Maximum Limit
  $400,000	Unlimited	Unlimited
  Per Illness or Injury limit
  $150,000	$300,000	$500,000
  Deductible
  $100 per injury or illness	$500 per period of coverage In network /$750 out of network	$250 per period of coverage In network/$400 out of network
  Student Health Center Deductible/Copay
  $45	$25	$15
  Eligible Medical Expenses help
  In-Network: 80% up to policy maximum Out-Network: 60% up to policy maximum	covers 100% of eligible medical expenses	In-Network: 80% up to policy maximum Out-Network: 60% up to policy maximum
  Physician Visits help
  $40 copay Specialist $50 copay	$50 per visit, 1 visit per day, 30 days max	$15 copay Specialist $50 copay
  Urgent Care Clinic help
  $50 copay 80% In-Network / 60% Out-of-Network	Covers up to 100%	$50 copay 80% In-Network / 60% Out-of-Network
  Walk-In Clinic help
  In-Network: 80% up to policy maximum Out-Network: 60% up to policy maximum	covers 100% of eligible medical expenses	In-Network: 80% up to policy maximum Out-Network: 60% up to policy maximum
  Hospital emergency room help
  $350 illness deductible if not admitted	$350 illness deductible if not admitted	$300 illness deductible if not admitted
  Hospital room and board help
  $350 deductible per confinement	$1,000 per day, 30 days max	$350 deductible per confinement
  Intensive care unit help
  80% In-Network / 60% Out-of-Network	$1,525 per day, 8 days max	80% In-Network / 60% Out-of-Network
  Hospital Miscellaneous Expenses
  80% In-Network / 60% Out-of-Network	$500 per day, 30 days max	80% In-Network / 60% Out-of-Network
  Scheduled Outpatient or Day Surgery
  80% In-Network / 60% Out-of-Network	$1,000 max	80% In-Network / 60% Out-of-Network
  Chemotherapy / Radiation Therapy help
  In-Network: 80% up to policy maximum Out-Network: 60% up to policy maximum	$1,000 max Inpatient and Outpatient combined	In-Network: 80% up to policy maximum Out-Network: 60% up to policy maximum
  Pre-Admission Testing
  In-Network: 80% up to policy maximum Out-Network: 60% up to policy maximum	$900 max	In-Network: 80% up to policy maximum Out-Network: 60% up to policy maximum
  Assistant Surgeon help
  25% of Surgeon's payable benefit (20% of primary surgeon’s eligible fee)
  Anesthesia help
  100%	100%	100%
  Durable Medical Equipment help
  In-Network: 80% up to policy maximum Out-Network: 60% up to policy maximum	$1,000 max Inpatient and Outpatient combined	In-Network: 80% up to policy maximum Out-Network: 60% up to policy maximum
  Chiropractic Care help
  Included (medical order or treatment plan required)	Included (medical order or treatment plan required)	Included (medical order or treatment plan required)
  Physical Therapy help
  $30 copay per visit, 1 visit per day, 12 visit max	Outpatient $35 per visit, 1 visit per day, 12 visit max	$30 copay per visit, 1 visit per day, 12 visit max
  Maternity & Newborn Care
  Maternity: $5,000 normal delivery $7,500 for c-section delivery Newborn: $500 maximum	Maternity: $5,000 normal delivery $7,500 for c-section delivery Newborn: $500 maximum	Maternity: $5,000 normal delivery $7,500 for c-section delivery Newborn: $500 maximum
  Traumatic Dental Injury help
  80% In-Network / 60% Out-of-Network	100%	100%
  Dental Treatment
  $500 max (unexpected pain or non-emergent accidents only)	$500 max (unexpected pain or non-emergent accidents only)	$500 max (unexpected pain or non-emergent accidents only)
  Child Preventive Care
  Not Available	Not Available	$200 max
  Mental/Nervous help
  Outpatient: 50 copay up to $150 per session Inpatient: 80% In-Network / 60% Out-of-Network	Outpatient: 80% up to 40 visits or $5,000 max per policy period Inpatient: 80% up to 30 days max	Outpatient: 50 copay up to $150 per session Inpatient: 80% In-Network / 60% Out-of-Network

• Student Journey Lite	Student Journey Plus	Student Journey Platinum
  Emergency medical evacuation help
  Up to $120,000	Up to $60,000	Up to Unlimited
  Return of mortal remains or cremation/burial help
  $60,000 max with $5,000 max for cremation/burial	$50,000 max with $5,000 max for cremation/burial	Unlimited with $5,000 max for cremation/burial
  Emergency local ambulance help
  Up to 100%
  Interfacility Ambulance Transfer help
  Up to 100%	Up to $400	Up to 100%
  Repatriation for Medical Treatment help
  $50,000	$25,000	$50,000

• Student Journey Lite	Student Journey Plus	Student Journey Platinum
  Accidental Death & Dismemberment help
  Principal Sum Maximum: $10,000 Death must occur within 90 days of the Accident

• Student Journey Lite	Student Journey Plus	Student Journey Platinum
  Pre-Existing Conditions help
  Covered after 6 months of waiting period

The Student can purchase an optional rider at the time of application. The optional riders provide additional coverage for a minimal charge.