The Collegiate Care Premier is an International Travel Medical and Evacuation & Repatriation Insurance Plan is only for International Students, Scholars studying or teaching in California USA. Student must have a valid F, M, or Q visa. Not Eligible are: F1 visa holder on OPT, Dependents of the eligible person, Green Card Holders. and Students who are US citizens.

Eligible individuals may enroll onto the Plan no earlier than 30 days prior to the start of their classes

A 3-month minimum purchase required.

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Plan Highlights

  • United Healthcare PPO Network
  • Unlimited - Primary / $250,000 per Period of Insurance for Dependents
  • In-Network Provider $100 Primary Insured/$500 Dependents per Insured Person
  • Primary - In-Network 80% Out-of-Network 70% Dependents In-Network 80% Out-of-Network 70%
  • Out-of-Network Provider $500 Primary Insured /$750 Dependents per Insured Person
  • $0 Student Health Center Deductible
  • Copayments- Physician/Specialist $30; Urgent Care Center $50
  • Plan covers 80% of the Preferred Allowance
  • Maternity coverage-restrictions apply
  • Pre-existing Conditions Waiting Period: No Waiting Period
  • COVID-19 EXPENSES are covered and treated as any other sickness
  • See plan documents for full details

Benefits of Coverage

Medical Benefits
Medical Maximum
Unlimited - Primary / $250,000 per Period of Insurance for Dependents
  • Coverage Area: USA Only
  • Home Country Coverage per Period of insurance: N/A
  • Covered Benefits and Limits: See Certificate for a list of Covered Benefits and Limits (including per visit limits)
Deductible
In-Network Provider $100 Primary Insured/$500 Dependents per Insured Person/Out-of-Network Provider $500 Primary Insured /$750 Dependents per Insured Person/Student Health Center $0/Deductible and always In-Network/The Deductible for In-Network does not accrue towards the Out-of-Network Deductible
Co-insurance
Primary - In-Network 80% Out-of-Network 70% Dependents In-Network 80% Out-of-Network 70%
Copayments
Copayments do not apply to the Deductible or the Out-of-Pocket Maximum
  • Student Health Center: $0
  • Physician/Specialist Office Visit: $30 per Visit
  • Urgent Care Center: $50 per Visit
  • Hospital Copayment: $0 Primary /$500 Dependent In-Network
  • Emergency Room Visit (waived if admitted): $250 per Visit
  • Advanced Medical Imaging Copayment: $200 Per Visit
Out-of-Pocket-Maximum per Period of Insurance
The deductible does not apply to the Out-of-Pocket Maximum
  • In-Network: $6,850 (Per Insured Person per Policy Year)
  • Out-of-Network: $10,000 (Per Insured Person per Policy Year)
Maternity and Prenatal
Primary - In-Network 80% Out-of-Network 70% Dependents In-Network 80% Out-of-Network 70%
  • Conception must occur while covered on the Plan
Durable Medical Equipment
Primary - In-Network 80% Out-of-Network 70% Dependents In-Network 80% Out-of-Network 70% $1,000 maximum per Period of Insurance
  • a. When purchased by a physician.
  • b. When a written prescription accompanies the claim when submitted.
Prescription Medications
$15 Copayment per prescription for Tier 1 ~ 30% Coinsurance per prescription for Tier 2~ 45% Coinsurance per prescription for Tier 3
Titers
Benefits are limited to titers relating to immunizations for the following: Polio Virus Immune Status, Varicella-Zoster AB, IgG, Hepatitis B surf AB, MMR, Hep B, Hep A, Tdap, and Rubella.
Medical Evacuation and Repatriation of Remains Benefit
100%
Telemedicine
Covered - must use teladoc provider listed in plan documents
Provider Network
United Healthcare (UHC)
Emergency Evacuation/Repatriation Benefits
Return of Minor Children or Grandchildren
100%
Accidental Death Benefits
Accidental Death & Dismemberment
$5,000 Principal Sum
24/7 Assistance Benefits
Maximum Length of Coverage
Up to 364 days
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.