Southern Illinois University Edwardsville - Dependents and OPT
Edwardsville, IL
Southern Illinois University - Edwardsville recommends the Student Secure, Atlas Travel, or GeoBlue Navigator Plan as a health insurance option for students and their dependents on OPT and STEM. These plans provide comprehensive coverage allowing you to choose the best plan to meet your needs. Each student who is outside their home country should purchase coverage for the entire duration of their stay in the event they have an accident or illness.
共同保险额度
In-Network: 80% of the next $100,000 of eligible expenses after applicable co-pays, then 100% to the overall maximum.
Out-Network: Usual, Reasonable, and Customary (URC)
已存在状况/疾病 (急性发作)
$25,000 lifetime maximum for eligible medical expenses for the acute onset of pre-existing condition only
See policy wording for full benefit description
已存在状况/疾病
不理赔
怀孕生育保障
不理赔
心理健康保障
Outpatient: $50 per day, $500 Inpatient: Up to $5,000
学校团队运动保障
不理赔
休闲、娱乐、健身等活动/运动
按保障条款覆盖
极限运动
Some exclusions apply
紧急医疗运送/遗体运送回国
$50,000 / $25,000
Budget
最高医疗保额
50万美元
每宗伤害或疾病的最高保额
25万美元
免赔额
$0 (co-pays apply)
共同保险额度
In-Network: 80% of the next $45,000 of eligible expenses after applicable co-pays, then 100% to the overall maximum.
Out-Network: Usual, Reasonable, and Customary (URC)
已存在状况/疾病 (急性发作)
Additional $25,000 lifetime maximum for eligible medical expenses for the acute onset of pre-existing condition during waiting period
See policy wording for full benefit description
已存在状况/疾病
12-month waiting period
怀孕生育保障
最高上限$5,000
心理健康保障
Outpatient: Max. 30 visits. Inpatient: Max. 30 days of coverage. Coverage includes drug and alcohol abuse.
学校团队运动保障
不理赔
休闲、娱乐、健身等活动/运动
按保障条款覆盖
极限运动
Some exclusions apply
紧急医疗运送/遗体运送回国
25万美元 / $25,000美元
Select
最高医疗保额
100万美元
每宗伤害或疾病的最高保额
50万美元
免赔额
$0 (co-pays apply)
共同保险额度
In-Network: 80% of the next $25,000 of eligible expenses after applicable co-pays, then 100% to the overall maximum.
Out-Network: Usual, Reasonable, and Customary (URC)
已存在状况/疾病 (急性发作)
Additional $25,000 lifetime maximum for eligible medical expenses for the acute onset of pre-existing condition during waiting period
See policy wording for full benefit description
已存在状况/疾病
6-month waiting period
怀孕生育保障
最高上限$10,000
心理健康保障
Outpatient: Max. 30 visits. Inpatient: Max. 30 days of coverage. Coverage includes drug and alcohol abuse.
学校团队运动保障
Coverage up to $5,000 coverage per injury / illness — medical expenses only for intercollegiate, interscholastic, intramural, or club sports
休闲、娱乐、健身等活动/运动
按保障条款覆盖
极限运动
Some exclusions apply
紧急医疗运送/遗体运送回国
$300,000 / $50,000
Elite
最高医疗保额
$5,000,000
每宗伤害或疾病的最高保额
50万美元
免赔额
$0 (co-pays apply)
共同保险额度
In-Network: 80% of the next $10,000 of eligible expenses after applicable co-pays, then 100% to the overall maximum.
Out-Network: Usual, Reasonable, and Customary (URC)
已存在状况/疾病 (急性发作)
Additional $25,000 lifetime maximum for eligible medical expenses for the acute onset of pre-existing condition during waiting period
See policy wording for full benefit description
已存在状况/疾病
6-month waiting period
怀孕生育保障
Up to $15,000
心理健康保障
Outpatient: Max. 40 visits. Inpatient: Max. 40 days of coverage. Coverage includes drug and alcohol abuse.
学校团队运动保障
Coverage up to $5,000 coverage per injury / illness — medical expenses only for intercollegiate, interscholastic, intramural, or club sports
休闲、娱乐、健身等活动/运动
按保障条款覆盖
极限运动
Some exclusions apply
紧急医疗运送/遗体运送回国
$50万美元 / $5万美元
America
最高医疗保额
$50,000, $100,000, $250,000, $500,000 $1,000,000, or $2,000,000 (Ages 70 to 79: $50,000 or $100,000 limit; Ages 80+: $10,000 limit)
每宗伤害或疾病的最高保额
保障直至最高保额
免赔额
$0, $100, $250, $500, $1,000, $2,500 or $5,000
共同保险额度
扣除免赔额后，计划承担100%的合资格医疗费用直至最高保额
已存在状况/疾病 (急性发作)
Only charges resulting from an Acute Onset of a Pre-existing Condition can be eligible for coverage. Coverage is for those under age 80 and is up to the policy maximum of the plan. For Emergency Medical Evacuation, an Acute Onset of a Pre-existing Condition is covered up to a $25,000 lifetime maximum.
See policy wording for full benefit description
已存在状况/疾病
不理赔
怀孕生育保障
只覆盖怀孕头第26周妊娠合并症的治疗费用
心理健康保障
不理赔
学校团队运动保障
不理赔
休闲、娱乐、健身等活动/运动
按保障条款覆盖
极限运动
Some exclusions apply
紧急医疗运送/遗体运送回国
$1,000,000 / Equal to the elected overall maximum limit
