Plan Administrator: Trawick International | AM Best Rating: A "Excellent" | Underwriter: GBG Insurance Limited

  • Eligibility: A registered full time undergraduate or a graduate student attending classes who is a minimum age of 12 years and maximum of 64 years
  • Coverage length: Worldwide Basis and Home Country
  • Renew Online:Collegiate Care policies will still be able to extend coverage up to a total of 365 days. Once they reach 365 days no extensions will be allowed.
  • Pre-Existing Conditions: Lifetime Maximum: $20,000 (Covered after 6 months for student only, dependents 24 months): 80% of the Preferred Allowance
  • ID Card & Visa Letter comes in email instantly
  • PPO Network: United Healthcare PPO Network

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Pre-Existing Conditions (Covered after 6 months)

In Network: 80% of the Preferred Allowance(up to $20,000 Lifetime Limit)

Out of Network: 70% of UCR (up to $20,000 Lifetime Limit)

Doctor Visit

In Network: 100% of the Preferred Allowance up to $50 Max Benefit/30 Visits

Out of Network: 75% of UCR up to $50 Max Benefit/30 Visits

Ambulance Benefit

In Network: 100% of the Preferred Allowance Up to $400 Max

Out of Network: 75% of UCR up to $400 Max

Hospital Room and Board

In Network: 100% of the Preferred Allowance (up to $1,000/day/30 days per admission)

Out of Network: 75% of the Semi-Private Room Rate (up to $1,000/day/30 days per

 admission)

Emergency Room

In Network: 100% of the Preferred Allowance (subject to a $300 copayment per visit,

waived if admitted)

Out of Network: 75% of UCR (subject to a $300 copayment per visit,

waived if admitted)

 

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Exclusion

  • Breast reduction: All services and treatments
  • Alcohol and Substance Abuse
  • Cosmetic and Elective Surgery for Non-Medical Reasons
  • Fertility/Infertility Treatments and Birth Control
  • Hernia
  • Self-Inflicted Illnesses, Injuries, or Exceptional Danger
  • Sports and Hazardous Activities
  • War and Terrorism

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United States only:
  • In-Network Preferred Provider: This tier consists of Preferred Providers and Hospitals who have a contract with the Preferred Provider Organization to provide specific medical care and that have agreed to accept a Preferred Allowance as payment in full for the specific service. The Medical Identification Card contains the logo for the network. Present it to the Physician or Hospital.
  • Out-of-Network Provider: Utilizing Providers that are Out-of-Network is a more costly financial option for the Insured Person. The Insurer reimburses such Providers up to an Allowable Charge as determined by the Insurer. The Provider may bill the Insured Person the difference between the amounts reimbursed by the Insurer and the Provider’s billed charge. Additionally, the Insured Person will pay a Coinsurance amount that is higher than if an In-Network Provider were used.
  • Out-of-Network Area: When there are no network Providers located within a 30-mile radius ofYour local residence, charges from such Providers will be treated the same as a U.S. In-Network Preferred Provider.

The Insurer retains the right to limit or prohibit the use of Providers which significantly exceed Allowable Charges.

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The Insurer may at any time terminate an Insured Person, or modify coverage to different terms, if the Insured Person has at any time:

• Misled the Insurer by misstatement or concealment,

• Knowingly claimed benefits for any purpose other than are provided for under this Plan,

 • Agreed to any attempt by a third party to obtain an unreasonable pecuniary advantage to the Insurer’s detriment,

 • Failed to observe the terms and conditions of this Plan or failed to act with utmost good faith.

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The insurance coverage term begins on the Effective Date as shown on the Medical Identification Card and ends at midnight on the date shown, but no longer than 365 days later. The coverage is not subject to guaranteed issuance or renewal.

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Claims must be filed within 180 days of treatment to be eligible for reimbursement of covered expenses. Claim forms should be submitted only when the medical service Provider does not bill the Insurer directly, and when you have out-of-pocket expenses to submit for reimbursement. All claims worldwide are subject to Usual, Customary, and Reasonable charges as determined by GBG and are processed in the order in which they are received. In order for claims payment to be made, claims must be submitted in a form acceptable to Insurer.

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