Plan Administrator: Tokio Marine HCC Medical Insurance Services Group | AM Best Rating: A "Excellent" | Underwriter: Lloyd's

  • In PPO network (USA): Underwriters will pay 100% of the eligible expenses after deductible
  • In PPO network (Outside USA): 100% to the certificate period maximum.
  • Eligibility: US students Age up to 64 studying outside their home country.
  • Provider Network: Direct Billing through First Health Network
  • Coverage length: Minimum 15 days to maximum 1 year.
  • Renew Online: You may renew your coverage as long as you continue to meet the eligibility requirements.
  • ID card & Visa Letter comes in email instantly.

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Age and Policy Maximum

Age (0-64)- $5,000,000

Doctor Visit Up to Policy Maximum
Urgent Care Up to Policy Maximum
Hospital Room and Board Average semi-private room rate, including nursing services.
Ambulance Up to $750 per injury or illness, when covered illness or injury results in hospitalization as inpatient
Prescription

Generic Drugs: 100% coinsurance

Brand Name Drugs: 50% coinsurance.

Specialty Drugs: No coverage.

Complete details are given in certificate of insurance.

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Exclusion

  • Routine physical exams
  • Chiropractic treatment, unless ordered in advance by a physician for medically necessary treatment
  • related to a covered injury or illness, and not obtained at a student health center.
  • Elective termination of pregnancy
  • Orthoptics and visual eye training.
  • Investigational, experimental or for research purposes.
  • Psychometric, intelligence, competency, behavioral and educational testing.

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Acute Onset of Pre-existing Condition (excludes chronic and congenital conditions)

Up to $25,000 lifetime maximum for eligible medical expenses

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Complete details are given in certificate of insurance

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You may renew your coverage as long as you continue to meet the eligibility requirements. Renewal may be completed within the last 6 months of a certificate period. Deductible and coinsurance must be re-satisfied as of each renewal date. After four years of continuous coverage or any break in coverage, a new plan must be purchased. A new application is required and you must re-satisfy your deductible, coinsurance, pre-existing condition provisions, and all other benefit limits. Extensions and renewals must be made online with payment by credit card.

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Premiums may be refunded after the certificate effective date subject to the following provisions:

  • A $25 cancellation fee will apply for administrative costs incurred by us; and
  • Only the unused portion of the plan cost will be refunded; and
  • You cannot have filed any claims to be eligible for premium refund.

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  • You must submit a claim for any expenses to be paid by us. This includes treatment or services for
  • which the medical provider will bill us directly. No payments will be made by us without you first
  • submitting a claim.

Notice of claim, Claimant’s Statement and Authorization, and proof of claim must be mailed to:

Tokio Marine HCC - MIS Group
P.O. Box 2005
Farmington Hills, MI 48333-2005
USA

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