LeMoyne College - Athletes
Syracuse, NY

For F-1 student athletes studying at LeMoyne College, the following plans are an ideal solution that will meet your school's insurance requirements. All of the plans below include intercollegiate athletic coverage.

重要日期 — 留学生必须购买这整段时间的保险覆盖

Fall & Spring: August 1-May 31
Summer: June 1-July 31
Annual: August 1-July 31

		最高保额	免赔额	每月保费 *
在线投保	Select	$1,000,000	$0	$104
在线投保	Elite	$5,000,000	$0	$178
在线投保	Business Class	$1,000,000	$0 每宗疾病/受伤 (医疗网络内的机构就医)	$100
在线投保	First Class	$5,000,000	$0 每宗疾病/受伤 (医疗网络内的机构就医)	$177
在线投保	Standard	$500,000	$100 每宗疾病/受伤 (医疗网络内的机构就医)	$94 rate for ages 19-23
在线投保	Platinum	$1,000,000	$25 每宗疾病/受伤 (医疗网络内的机构就医)	$288 rate for ages 19-23

* 以上保费是24岁或以下人士年龄层的保费。

并列比较所有的保障

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 days of coverage.
Inpatient: Max. 30 visits.
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 days of coverage.
Inpatient: Max. 40 visits.
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

Business
最高医疗保额 100万美元
每宗伤害或疾病的最高保额 30万美元
免赔额 $0 (co-pays apply)
共同保险额度 In-Network: 80% of Eligible Expenses up to $5,000, then 100% up to the Maximum Benefit

Out-Network: 80% of Eligible Expenses up to Maximum Benefit
已存在状况/疾病 (急性发作) $15,000 lifetime maximum for eligible medical expenses for the acute onset of pre-existing condition during waiting period
已存在状况/疾病 12-month waiting period
怀孕生育保障 In Network: Plan pays 80% to $10,000 for a covered pregnancy.
Out-of-Network: Plan pays 60% to $10,000 for a covered pregnancy.
心理健康保障 Outpatient: Max. 30 days of URC coverage.
Inpatient: Max. 30 visits of URC coverage.
Coverage includes substance 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 No Coverage
Optional Adventure Sports rider available, please select that option to view pricing.
紧急医疗运送/遗体运送回国 $300,000/ $50,000

First Class
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: 100% of Eligible Expenses up to the Maximum Benefit

Out-Network: 90% of Eligible Expenses up to Maximum Benefit
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 during waiting period
已存在状况/疾病 6-month waiting period
怀孕生育保障 In Network: Plan pays 80% to Maximum Benefit for a covered pregnancy.
Out-of-Network: Plan pays 60% to Maximum Benefit for a covered pregnancy.
心理健康保障 Outpatient: Max. 30 days of URC coverage.
Inpatient: Max. 30 visits of URC coverage.
Coverage includes substance 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 No Coverage
Optional Adventure Sports rider available, please select that option to view pricing.
紧急医疗运送/遗体运送回国 $500,000/ $50,000

Standard
最高医疗保额 50万美元
每宗伤害或疾病的最高保额 30万美元
免赔额 $100
共同保险额度 In-Network: The plan pays 100% of eligible expenses up to Maximum Limit
Out-Network:The plan pays 80% of eligible expenses up to $5,000, then 100% up to Maximum Limit
已存在状况/疾病 (急性发作) 不理赔
已存在状况/疾病 连续覆盖12个月后
怀孕生育保障 不理赔
心理健康保障 住院治疗: 终身最高1万美元
门诊治疗: 每天最高$50美元；终身最高$500美元
*学校健康中心接受治疗不获理赔
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 No Coverage
Optional Adventure Sports rider available, please select that option to view pricing.
紧急医疗运送/遗体运送回国 $50万美元 / $5万美元

Platinum
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 $25
共同保险额度 In-Network: 100% of eligible expenses up to Maximum Limit
Out-Network: 80% up to $5,000, then 100% up to Maximum Limit
已存在状况/疾病 (急性发作) 不理赔
已存在状况/疾病 连续覆盖6个月后
怀孕生育保障 最高上限$5,000
心理健康保障 住院治疗: 终身最高1万美元
门诊治疗: 每天最高$50美元；终身最高$500美元
*学校健康中心接受治疗不获理赔
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 No Coverage
Optional Adventure Sports rider available, please select that option to view pricing.
紧急医疗运送/遗体运送回国 $50万美元 / $5万美元