Study USA Plan

The Study USA plan is an affordable comprehensive plan for International students in the US below age 66 on valid visas. The plan meets most university requirements and ideal for F1 & J1 visa holders. Study USA Preferred offers additional coverage with no sublimits per day for hospital room, ICU and outpatient surgery.

Plan Benefits

Study USA Insurance offers medical maximum coverage up to $250,000 (Plan A) and $300,000 (Plan B):

• In-patient hospitalization, medical diagnostic expenses, surgery
• Out-patient doctor office expenses
• Intensive care
• Prescription Drugs
• Emergency Medical Evacuation (up to $500,000)
• Repatriation (up to $100,000)
• Pregnancy Coverage
• Pre-existing condition coverage after 6 months of continuous coverage
• Mental or Nervous Disorders & Alcohol & Substance Abuse (up to $10,000)
• Coverage during initial purchase is available for periods from 1 month up to 10 months of coverage for the inbound students while the outbound student or international travelers will be limited to 364 days

See the chart below for some of the benefits that Study USA-HealthCare includes.

	Study USA-HealthCare™		Study USA-HealthCare™ Preferred
Medical Expense, per incident	Plan A: $250,000	Plan B: $300,000	Plan A: $250,000	Plan B: $300,000
Intensive Care Unit (ICU)	Limited to $500 per day		Included (no per day limit)
Newborn Baby Hospital Nursery	Limited to $500 per day		Included (no per day limit)
Outpatient Surgery Facility	Limited to $250 per day		Included (no per day limit)
Semi-Private Room and Board	Limited to $300 per day		Included (no per day limit)
Emergency Medical Evacuation	$500,000		$500,000
Accidental Death and Dismemberment	$5,000		$5,000
Repatriation of Remains	$100,000		$100,000

	Plan A	Plan B
Medical Expenses, per incident	$250,000	$300,000
Emergency Medical Evacuation	$500,000	$500,000
Mental or Nervous Disorders and Alcohol & Substance Abuse	*$10,000	*$10,000
Repatriation of Remains	$100,000	$100,000
Accidental Death and Dismemberment	$5,000	$5,000

* This benefit is $5,000 for U.S. students studying abroad.

MEDICAL BENEFITS SCHEDULE	IN THE PPO NETWORK OR OUTSIDE THE US	OUT OF THE PPO NETWORK
	After a $50 deductible* /incident	After a $150 deductible* /incident
Up to $25,000	Program Pays Covered Medical Expenses
	80%	70%
Plan A $25,000.01 - $250,000 Plan B $25,000.01 - $300,000	Program Pays Covered Medical Expenses
	100%	70%
Prescription Copay**	Insured Pays
	$10 for generic	$20 for brand names

*The deductible will be waived if medical service is first received from the Student Health Center. Otherwise, the Covered Person must pay the deductible. The deductible shall not exceed $250 per Covered Person per Program year. If there is no Student Health Center, the deductible will be waived only if medical services are received from a Preferred Provider Network member.
**The prescription copay is in addition to the deductible above.

Eligibility

A foreign student under the age of 66, holding a valid US study visa, and enrolled in academic activities at a US school, college or university.
he spouse and children, aged 18 and under, of the above mentioned students can also be enrolled in the plan along with the student, or within 31 days of birth, marriage, legal adoption or arrival in the country. The student must be covered under the plan if coverage is required for the dependants.

Study USA Insurance Monthly Rates

AGE	Plan A (for schools/universities in FL, USA)	Plan A (for schools/universities in other US states or outside USA)	Plan B (for schools/universities in FL, USA)	Plan B (for schools/universities in other US states or outside USA)
					0 - 24	$48	$45	$51	$47
25 - 29	$70	$64	$74	$68
30 - 34	$89	$82	$94	$86
35 - 39	$125	$115	$132	$129
40 - 44	$158	$146	$166	$153
45 - 49	$171	$157	$180	$165
50 - 54	$316	$291	$332	$306
55 - 65	$379	$349	$398	$366
Spouse	$568	$523	$597	$550
Child	$114	$105	$120	$111

*Please check the brochure for the most accurate rates.

Remarks:

• PPO Network: With the Patriot America plan, one may seek treatment with the hospital or doctor of one's choice. When seeking treatment in the U.S., the out-of-pocket costs may be reduced by using the independent First Health Network PPO
• Renewal: Renewals are available in whole month or daily increments and may be completed online or by using a paper application, however, renewals of less than one month are available only online. For each renewal of less than one month completed online, an additional US$5 processing fee will be charged.
• Cancellation: In order to be considered for a full refund, the request for cancellation for Patriot America Insurance must be received prior to the effective date. If any claims have not been filed, the plan may be cancelled after the effective date, however US $50 will be charged as cancellation fee and only full month premiums will be considered for refunds. If claims have been filed, then premium is non refundable.