Collegiate Care Gold

Detail

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

Eligibility: Non US Citizen Student age 12 to 64 studying in USA.
Coverage: Minimum 1 month and Maximum up to 1 year.
Treatment must begin no later than 30 days after the onset to be covered
Renew- Renew online, by phone, by email, by fax.
ID card & Visa Letter comes in email instantly.

Benefit

Collegiate Care Silver	In Network	Out of Network
Maximum for all Medical Expense Per Injury or Sickness	$250,000 per Sickness or Injury $600,000 Annual Maximum (Motor Vehicle Accident Maximum: $10,000 per Period of Insurance)	$250,000 per Sickness or Injury $600,000 Annual Maximum (Motor Vehicle Accident Maximum: $10,000 per Period of Insurance)
Deductible - Per Injury or Sickness	$40 if first treated by the Student Health Center $90 if not first treated by the Student Health Center	$40 if first treated by the Student Health Center $90 if not first treated by the Student Health Center
Coinsurance	Refer to below for specifics	Refer to below for specifics
Maximum Benefit Period	13 weeks from the date first treated	13 weeks from the date first treated
1) Physician Visit (Inpatient) or Outpatient	100% of the Preferred Allowance up to $60 maximum; 1 visit per day 30 visits maximum	60% of URC up to $60 maximum; 1 visit per day 30 visits maximum
2) Specialist Visits	Same as any other Sickness	Same as any other Sickness
3) Consultation Fee	100% of the Preferred Allowance up to $400 maximum benefit	60% of URC up to $400 maximum benefit
4) Hospital Room & Board	100% of the Preferred Allowance up to $1,300 per day, maximum 30 days per Occurrence, subject to a $100 Co-Pay	60% of URC up to $1,300 per day, maximum 30 days per Occurrence, subject to a $100 Co-Pay
5) ICU Room and Board Charges	100% of the Preferred Allowance up to $1,825 per day maximum 30 days per Occurrence subject to a $100 Co-Pay	60% of URC up to $1,825 per day maximum 30 days per Occurrence subject to a $100 Co-Pay
6) Hospital Miscellaneous	100% of the Preferred Allowance up to $500 maximum; 30 days maximum per Occurrence	60% of URC up to $500 maximum; 30 days maximum per Occurrence
7a) Surgeon (In or Outpatient)	100% of the Preferred Allowance up to $4,000 maximum	60% of URC up to $4,000 maximum
7b) Day Surgery – Outpatient	100% of the Preferred Allowance up to $1,000 maximum	60% of URC up to $1,000 maximum
8) Assistant Surgeon	100% of the Preferred Allowance up to 25% of the Surgeon Allowance	60% of URC up to 25% of the Surgeon Allowance
9) Emergency Room	80% of the Preferred Allowance, $300 Co-Pay waived if admitted	60% of URC $300 Co-Pay waived if admitted
10) Pre-Admission Testing – within 3 days of admission	100% of the Preferred Allowance up to $900 maximum	60% of URC up to $900 maximum
11) Anesthesia	100% of the Preferred Allowance up to 25% of the Surgeon Allowance	60% of URC up to 25% of the Surgeon Allowance
12) Diagnostic X-Ray and Lab	100% of the Preferred Allowance up to $500 maximum; Cat Scan, PET Scan or MRI up to $850	60% of URC up to $500 maximum; Cat Scan, PET Scan or MRI up to $850
13) Physiotherapy – Inpatient or Outpatient	100% of the Preferred Allowance up to $35 per visit, 1 visit per day, 12 visits maximum	60% of URC up to $35 per visit, 1 visit per day, 12 visits maximum
14) Ambulance Benefit	100% of the Preferred Allowance up to $400 maximum	60% of URC up to $400 maximum
15a) Mental & Nervous Conditions Inpatient	100% of the Preferred Allowance 30 days maximum	60% of URC 30 days maximum
15b) Mental & Nervous Conditions Outpatient	40 visits per year at 100% of the Preferred Allowance up to $5,000 maximum, per Period of Insurance	40 visits per year at 60% of URC up to $5,000 maximum, per Period of Insurance
16) Alcohol and Drug Abuse In- Patient or Outpatient	100% of Preferred Allowance Same as any other Sickness	60% of URC Same as any other Sickness
17) Emergency Dental	100% of Preferred Allowance up to $500 maximum	60% of URC up to $500 maximum
18) Prescriptions	$100 per Period of Insurance
19) Durable Medical Equipment	100% of the Preferred Allowance up to $1,000 maximum	60% of URC up to $1,000 maximum
20a) Emergency Medical Evacuation or Repatriation	100% of actual expense up to $120,000
20b) Return of Mortal Remains	100% of actual expense up to $60,000
21) Emergency Reunion	100% of actual expense up to $10,000
22) Maternity and Prenatal Care (Conception must occur while covered under the current policy)	100% of Preferred Allowance up to $7,500 maximum for normal delivery; $10,00 for c section delivery	60% of UCR up to $7,500 maximum for normal delivery; $10,000 for c section delivery
23) Radiation/Chemotherapy	100% of Preferred Allowance $1,000 maximum	60% of URC up to $1,000 maximum

Exclusion

No benefits will be paid for loss or expense caused by or resulting from:

Suicide, attempted suicide (including drug overdose) self-destruction, attempted self- destruction or intentional self-inflicted Injury while sane or insane;
War or any act of war, declared or undeclared;
Injury sustained while in the service of the armed forces of any country;
Voluntary, active participation in a riot or insurrection;
Medical expenses resulting from a motor vehicle accident in excess of that which is payable under any other valid and collectible insurance;
Treatment for an Injury or Sickness resulting from the Covered Person’s intoxication or use of illegal drugs or any drugs or medication that is intentionally not taken in the dosage recommended by the manufacturer or for the purpose prescribed by the Covered Person’s Physician;
Commission or attempt to commit an assault or felony, or that occurs while being engaged in an illegal occupation; 8. Eligible Expenses for which the Covered Person would not be responsible in the absence of the Policy; 9. Treatment of acne;
Charges which are in excess of Usual, Reasonable and Customary charges;
Charges that are incurred outside of the Period of Insurance either prior to coverage commencing after coverage has terminated;
Charges that are not Medically Necessary; charges provided at no cost to the Covered Person;
Expenses incurred for treatment while in Your Home Country which exceed 30 days or $1000;
Expenses incurred for an Accident or Sickness after the termination date of coverage;
Regular health checkups, routine physical, immunizations or other examination where there are no objective indications or impairment in normal health;
Injuries paid under Workers’ Compensation, Employer’s liability laws or similar occupational benefits or while engaging in an occupation for monetary gain from sources;
Pre-existing conditions; however a Pre-Existing condition will be covered after the Covered Person has been continuously insured for 6 months under the same insurance plan;
Unless covered herein, Pregnancy or childbirth, elective abortion, or any complications of any of these conditions;
Dental care or treatment other than care, of sound Natural Teeth and gums, required for Injury resulting from an Accident while covered under the Policy, and rendered within 6 months of the Accident;
Eyeglasses, contact lenses, hearing aids braces, appliances, or examinations or prescriptions therefore;
Travel in or upon a snowmobile, a water jet ski, any two or three wheeled motor vehicle, other than a motorcycle registered for on-road travel, or any off road motorized vehicle not requiring licensing as a motor vehicle;
Injury sustained while taking part in: mountaineering; hang gliding; parachuting; bungee jumping; racing by horse, motor vehicle or motorcycle; snowmobiling; motorcycle/motor scooter riding; scuba diving, involving underwater breathing apparatus; snorkeling; water skiing; snow skiing; spelunking; parasailing; white water rafting; surfing, and snowboarding; or other hazardous activities as determined by the insurance company;
Practice or play in any amateur, club, intramural, interscholastic, intercollegiate, professional or semiprofessional sports, contest or competition;
Rest cures or custodial care;
Elective or Cosmetic surgery and Elective Treatment or treatment for congenital anomalies (except as specifically provided), except for reconstructive surgery on a diseased or injured part of the body. Correction of a deviated nasal septum is considered Cosmetic Surgery unless it results from a covered Injury or Sickness.

Acute Pre-Ex Coverage

Pre-Existing Condition means an Injury, Sickness, disease, or other condition during the 365 day period immediately prior to the date the Covered Person’s coverage is effective for which the Covered Person : 1) received or received a recommendation for a test, examination, or medical treatment for a condition which first manifested itself, worsened or became acute or had symptoms which would have prompted a reasonable person to seek diagnosis, care or treatment; or 2) took or received a prescription for drugs or medicine. Item (2) of this definition does not apply to a condition which is treated or controlled solely through the taking of prescription drugs or medicine and remains treated or controlled without any adjustment or change in the required prescription throughout the 180 day period before coverage is effective under the Covered Person’s Plan.

PPO Network

Click here for PPO Network

Renew

Upon effective date, this plan is fully earned and non-refundable. There are no partial refunds.

Online Form

Claim

All claims, regardless of submission date, must be received in our office within 90 days of treatment or they will be denied. Initial treatment must occur within 90 days of the Accident or Sickness.

Once a claim has been reviewed, additional documentation may be required for processing. This request will be made in writing to the address on file or via email.

Please make sure your mailing address and email address are current

Offline Form

Scenario	Coverage Under Full Pre-Existing Plan
My father had a heart attack a few years ago. After his travel to the US, he started experiencing heart pain. I took him to the cardiologist. Is this covered?	Yes. Cardiologist visits are covered underneath a Full Pre-Existing coverage plan.
My mother-in-law has been experiencing heart pain for last few days, and had a heart attack on the last day. Is this covered?	Yes. Under a Full Pre-Existing Plan, there is not time limitation between symptoms and seeking care.
My uncle had cancer a few years ago. He is on a Green Card and has been living in the US. Recently, the cancer has come back. Is this covered?	Yes. Chemotherapy & Radiation treatment are covered under this plan. One note- the recurring cancer diagnosis must occur after the effective date.
My cousin had a back injury a few years back. He recently starting feeling back pain and went to seek the advise of a Chiropractor & get physical therapy. Is this covered?	Yes. Chiropractic care & physical therapy regarding pre-existing conditions are covered underneath full pre-existing plans.
My aunt had a sudden heart attack. After staying a few days in the hospital, she needs prescription drugs, follow up blood tests, and doctors visits. Are these covered?	Yes. Any sudden medical event, along with any follow up visits, i.e. blood tests, x-rays, EKG, etc., will be covered by full pre-existing plans.
My mother is diabetic. She was prescribed medication but often forgets to take it often. She experienced a diabetic shock and needed to visit the emergency room. Will this emergency visit be covered?	Yes. Our plans cover you no matter whether your visitor was taking their prescribed medication or not. Full pre-existing plans will cover no matter what happens.

Scenario	Coverage Under INF Acute Onset Plan
My father had a heart attack a few years ago. After his travel to the US, he started experiencing heart pain. I took him immediately to the emergency room. Is this covered?	Yes. Cardiologist visits are covered underneath a Full Pre-Existing coverage plan.
My mother-in-law had a sudden drop in blood sugar. I took her to the Urgent Care clinic. Is this covered?	Yes, as long as you seek medical attention within 12 hours you are covered.
My uncle was playing a game of cricket in the neighborhood and started to experience chest pain. He was hospitalized for 3 days and required several blood tests, and heart scans. Will this be covered?	Yes. Our plans will cover any sudden recurrence caused by a pre-existing conditions. Our plans have no pre-authorization, meaning the hospital can get the treatment your visitors needs faster.
My father-in-law had several kidney issues over the past few years. After several hours of pain, we took him to the hospital to have kidney stones removed. Is this covered?	Yes. As long as the treatment is sought within the first 12 hours of first exhibiting symptoms, any pre-existing condition will be covered. Our plans have no look back period for pre-existing conditions.
My cousin has diabetes. After a few days in the US, she contracted a Urinary Tract Infection which required hospitalization. Is this covered?	Yes. Under our plans, Urinary Tract Infections are considered new sicknesses and are covered by Acute Onset coverage plans.
My mother is a heart patient. She was prescribed medication but often forgets to take it often. She experienced a sudden heart attack and needed to visit the emergency room. Will this emergency visit be covered?	Yes, our plans cover any incident regardless if your visitor was taking their prescribed medication.