The Collegiate Care J-1 plan is an International Travel Medical and Evacuation & Repatriation Insurance Plan created specifically for J1 Visa International Students, Scholars, and their families studying or teaching in the US, ages 12-64, and enrolled in an associate, bachelor, master, or Ph.D. program at a university or other accredited higher education institution outside of their Home Country. All other visa types are not eligible. This plan is not available to US citizens.

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Plan Highlights

  • United Healthcare PPO Network
  • $100,000 maximum per covered Illness or Injury
  • $100 per Insured Person In Network Deductible
  • $100 per Insured Person Out of Network Deductible
  • Student Health Center Copayment $0
  • Copayments- Physican/Specialist $0 Emergency Room Visit $250 Urgent Care $0 Emergency Room $250 per visit
  • Plan covers 100% of the Preferred Allowance
  • Maternity - Not covered
  • Prescription Medications 80% of charges
  • Medical Evacuation and Repatriation - Covered
  • COVID-19 EXPENSES are covered and treated as any other sickness
  • Pre-existing Conditions are covered after a 12 month Waiting Period
  • See plan documents for full details

Benefits of Coverage

Medical Benefits
Medical Maximum
$100,000 Per Illness or Injury
  • Coverage Area: USA Only
  • Home Country Coverage per Period of insurance: N/A
Deductible
In-Network or Out -of -Network Provider $100 per Insured Person, 2 x Individual per family/Student Health Center $0/Deductibles are waived when services are rendered at Student Health Center/The Deductible for In-Network does not accrue towards the Out-of-Network Deductible
Copayments
Copayments do not apply to the Deductible or the Out-of-Pocket Maximum
  • Student Health Center Copayment: $0 per Visit
  • Physician/Specialist Office Visit Copayment: $0 per Visit
  • Hospital Copayment per Admission: $250 per Admission
  • Urgent Care Center visit Copayment: $0 per Visit
  • Emergency Room Visit Copayment (waived if admitted): $250 per Visit
  • Copayments are waived when services are rendered at the Student Health Center and are reimbursed at 100%
Co-insurance
100% of Preferred Allowance/ Out of Network Provider 75% Usual & Customary
Out-of-Pocket-Maximum per Period of Insurance
The deductible does not apply to the Out-of-Pocket Maximum
  • In-Network: Unlimited per Insured Person
  • Out-of-Network: Unlimited per Insured Person
Emergency Dental
100% Preferred Allowance
  • Limited to accidental Injury of sound natural teeth sustained while covered
  • Maximum Benefit per Period of Insurance: $500
Palliative Dental Care
100% Preferred Allowance
  • Sudden onset of pain
  • Maximum Benefit per Period of Insurance: $350
Maternity and Prenatal
Not Covered
Cancer Care and Oncology
100% Preferred Allowance
Kidney Dialysis
100% Preferred Allowance
Durable Medical Equipment
100% UCR
  • a. When purchased by a physician.
  • b. When a written prescription accompanies the claim when submitted.
Prescription Medications
80% of charges
  • Up to 31-day supply per prescription
  • Includes oral contraceptives
  • Network pharmacy is required
Medical Evacuation and Repatriation of Remains Benefit
Included Medical Evacuation and Repatriation Maximum Benefit per Period of Insurance: $50,000/Return of Remains Maximum Benefit per Period of Insurance: $25,000
Telemedicine
Covered - must use teladoc provider listed in plan documents
Pre-Existing Conditions Benefits
Pre-Existing Conditions Look Back Period
12 Months Lookback Period
  • Student and Dependents: Pre-existing Conditions are covered after a 12 month Waiting Period
Additional Benefits
Accidental Death & Dismemberment
$25,000 (covers Passive War and Terrorism)
24/7 Non-Insurance Benefits
Maximum Length of Coverage
Up to 364 days
Network Provider
United Healthcare (UHC)
Non Insurance Assistance Services
Included

In the event that you are dissatisfied and wish to make a complaint, you can do so at: complaints@trawickinternational.com

Sanctions Limitations Clause

The Insurer will not provide any cover, pay any claim or provide any benefit under this Plan to the extent that the provision of such cover, the payment of such claim or the provision of such benefit would expose them to any sanction, prohibition or restriction under United Nations resolutions or the trade or economic sanctions, laws or regulations of the European Union, United Kingdom or United States of America.

Disclosure Details

This plan summary contains a description of the insurance benefits provided by the insurance plan you have purchased. The coverage is provided by a group insurance policy issued to the AMD Global Trust by Zurich Insurance Europe AG, Belgian branch. By purchasing this coverage, you have become a participant in the AMD Global Trust and a copy of the subscription agreement is contained herein. Please keep this summary as an explanation of the benefits available. This summary is not intended to be a contract of insurance. Complete provisions pertaining to the insurance coverage are contained in the policy. In the event of any conflict between this plan summary and the policy, the policy will govern. The policy is not designed to cover US citizens or residents, and it is not subject to guaranteed issue or renewal. This insurance is not subject to and does not provide certain insurance benefits required by the United States’ Patient Protection and Affordable Care Act (“PPACA”).

Insurance coverage is not subject to and does not provide certain insurance benefits required by the United States’ Patient Protection and Affordable Care Act (“PPACA”). PPACA requires certain US citizens or US residents to obtain PPACA compliant health insurance, or “minimum essential coverage.” In some cases, certain individuals may be deemed to have minimum essential coverage under PPACA even if their insurance coverage does not provide all of the benefits required by PPACA. You should consult your attorney or tax professional to determine whether the policy meets any obligations you may have under PPACA.

Privacy Statement. We know that privacy is important to you and we strive to protect the confidentiality of non-public personal information. We do not disclose any non-public personal information about our insureds or former insureds to anyone, except as permitted or required by law. We maintain appropriate physical, electronic and procedural safeguards to ensure the security of non-public personal information. You can find a copy of our Privacy Policy here: https://www.trawickinternational.com/privacy-policy/ and Privacy Policy | SureGo Administrative Services (mysurego.com)

Data Protection. Please note that sensitive health and other information that is provided to us may be used by us, our representatives, the insurers and industry governing bodies and regulators to process the insurance, handle claims and prevent fraud. This may involve transferring information to other countries (some of which may have limited, or no data protection laws). We have taken steps to ensure the information is held securely. Where sensitive personal information relates to anyone other than you, you must obtain the explicit consent of the person to whom the information relates, both to the disclosure of such information to us and its use as set out above. Information we hold will not be shared with third parties for marketing purposes. Insureds have the right to access their personal records.

By purchasing this insurance provided by Zurich Insurance Europe AG, Belgian branch, you agree to subscribe and become a participant in the AMD Trust and understand that participation in the Trust is a prerequisite to procuring the insurance coverage.