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Plan A for under age of 30


American International Education Foundation - Plan A

Customized plan for students of age 18 - 30

Medical Summary

The following is a schedule of benefits for American International Education Foundation Plan A. The plan covers the Usual, Reasonable and Customary (URC) charges for eligible expenses in the area where you receive treatment. All amounts shown are in U.S. dollars. This is only a summary of proposed benefits and coverage. Please refer to the Certificate Wording for specific terms, conditions and other details regarding the benefits, limitations, eligibility, and exclusions outlined in this summary. The certificate wording prevails over any information provided in this summary and is available upon request prior to purchase.

Schedule of Benefits Benefit Description
Platinum
Coverage Area
Worldwide
Excluding Home Country
Rate Guarantee 12 months
Maximum Limit
Period of Coverage Maximum:
Student: $500,000
Dependent: $100,000
 
* Note: for 18 and under
Per Illness or Injury Maximum:
Student: $300,000
Deductible
Outside of US/Canada: $100 per Policy Period
US PPO Provider: $100 per Policy Period
US NON PPO Provider: $200 per Policy Period
Student Health Center: $100 per Policy Period
Coinsurance
(following the applicable Deductible)
Outside of US/Canada:
Plan pays 80% up to $10,000 of Eligible Expenses
Student Health Center:
Plan pays 80% up to $10,000 of Eligible Expenses
US PPO Provider:
Plan pays 80% up to $10,000 of Eligible Expenses
US Non PPO Provider:
Plan pays 60% of the first $10,000 of Eligible Expenses, then 100% thereafter
Hospital Services
Inpatient Room & Board URC
Intensive Care URC
Emergency Room Injury URC
Emergency Room Illness
Subject to an additional $250 deductible if treatment does not require admittance to the hospital
Physician Visit URC
Prescription Drugs URC
Physical Therapy URC Limited to 1 per day
Mental & Nervous Disorders
(including Substance Abuse)
URC limited to $10,000 LTM
Outpatient Services
Physician Visit URC
Prescription Drugs 50% of actual charges
Physical Therapy URC -Limited to 1 per day
Mental & Nervous Disorders
(including Substance Abuse)
Outpatient-$50 per visit (limited to 1 visit per day) with a $500 Per Period of Coverage Maximum
Other Services
Eligible Medical Expenses URC
Durable Medical Equipment URC
Local Ambulance
Per Injury: Up to $750
Per Illness (only if admitted Inpatient): Up to $750
Maternity
(subject to special Pre-Certification Requirements)
URC
Routine Newborn Care $750 maximum per Period of Coverage
Dental
For Injury due to covered Accident: $500
For Sudden & Unexpected Pain: $350
Terrorism Coverage Up to $50,000 Lifetime Maximum
Wellness
(subject to a 12 month waiting period)
Up to $1,000 per Calendar Year for Routine Physical Exams and Immunizations
Accidental Death & Dismemberment
Monthly Enrollees-$10,000 Student, Spouse-$5,000, Dependent Child-$1,000
Short Term Enrollees-Student-$70,000, Spouse-$0, Dependent Child-$0
Interscholastic/Intercollegiate Sports Coverage
URC for eligible expenses incurred while participating in organized interscholastic/intercollegiate
or club sporting activities (nonprofessional) to a maximum of $5,000 per Injury/Illness
Incidental Home Country Trip Coverage Up to two (2) weeks accumulated
Pre-existing Conditions After six (6) months of continuous coverage
Benefit Period 60 Days
Emergency Services
Emergency Medical Evacuation
Up to $250,000 Lifetime Maximum
(independent of the Maximum Limit)
Emergency Reunion Up to $50,000 Maximum
Return of Mortal Remains Up to $50,000 Maximum

Pre- Certification:
The following treatments and/or supplies must always be pre-certified for medical necessity by the company through the plan administrator:

- Inpatient treatment and/or supplies of any kind
- Any surgery or surgical procedure
- Durable medical equipment
- Computerized Axial Tomography (CAT scan)
- Magnetic Resonance Imaging
- Home nursing care - Maternity

 

To see plan EXCLUSIONS (Click Here)

 

 


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