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Comparison Charts for International Students & Scholars in the US

Compare ISP Tourer, Explorer and Pioneer Plans
 


Coverage
TOURER
(Maximum Amount Payable)
EXPLORER
(Maximum Amount Payable)
PIONEER Basic
(Maximum
Amount Payable)
PIONEER Enriched
(Maximum
Amount Payable)
In-
Network
Out-of-
Network
In-
Network
Out-of-
Network

Lifetime Maximum

$300,000

$500,000

$250,000

$500,000

Maximum for Interscholastic Sports

N/A

N/A

$5,000

 

Maximum Benefit Limit per Sickness or Injury

$150,000

$250,000

$125,000

$300,000

Deductible per Person per Sickness or Injury

$100/$50*

$90/$45*

$70*

$200*

$50*

$200*

*Reduced to $50 per event if first rendered at School Student Health Facility

*Reduced to $45 per event if first rendered at School Student Health Facility

*Reduced to $20 per event if first rendered at School Student Health Facility. Combined maximum $600

*Reduced to $20 per event if first rendered at School Student Health Facility. Combined maximum $400

Copayments ER Visit (waived if admitted)

$0

$300

Coinsurance

The plan pays 100%
of covered medical expenses

The Plan pays 80% of the 1st $6,000;
100% thereafter to a maximum of $125,000

The Plan pays 70% of the 1st $6,000; 100% thereafter to a maximum of $125,000

The Plan pays 80% of the 1st $4,000; 100% thereafter to a maximum of $300,000

The Plan pays 70% of the 1st $4,000; 100% thereafter to a maximum of $300,000

Pre-Existing Condition Exclusion

6 months (credit is applied
for prior continuous coverage)

Covered with no waiting period

Prescription Drugs

$1000 Maximum

$750

$1,000

Prescription Copay

$25
*Not subject to deductible or co-insurance

N/A

Diagnostic X-rays and Lab Services

$1000

Additional $250 one CAT scan,
PET scan or MRI

Covered as any other medical benefit

Maternity (conception must occur while coverage is in force)

$5,000 for
natural delivery

$7,500 for
C-section delivery

$7,500 for
natural delivery

$10,000 for
C-section delivery

Covered as any other sickness

Mental and Nervous Disorder and Substance Abuse

Covered as any other sickness

Covered as any other sickness

Emergency Evacuation

$50,000

$100,000

100% of covered expenses

Repatriation of Remains

$25,000

$50,000

100% of covered expenses

Accidental Death and Dismemberment Coverage

$15,000

$15,000

$25,000

Paralysis

Included

Included

Coma

Included

Not included

Assistance Provider

Travel Guard

Europe Assistance

Home Country Coverage

$500

Not included

Emergency Medical Reunion

$1,000
lifetime maximum

$1,500
lifetime maximum

$2,500

 

Surgical Treatment

$25,000

$50,000

$25,000

$50,000

Physician’s Non-Surgical Visit

$50/visit, 1 visit/day,
30 visits maximum

$60/visit, 1 visit/day,
30 visits maximum

$50/initial visit,
$40 each follow up visit

$70/initial visit,
$50 each follow up visit

Hospital Room and Board

$1,000/day,
to 30 days maximum

$700/day,
to 30 days maximum

$1,000/day,
to 30 days maximum

Hospital Miscellaneous

$500/day, to 30 days maximum

$3,000

Covered as any other medical expense

Hospital Intensive Care Unit

Additional $525/day,
to 8 days maximum

Daily room rates

Anesthetist

25% of surgical benefit

Covered as any other medical expense

Assistant Surgeon

25% of surgical benefit

Covered as any other medical expense

Consultant Physician, when Requested by Attending Physician

$400

$200

$250

Pre-Admission Tests within 7 Days before Hospital Admission

$900

Covered as any other medical expense

Inpatient Private Duty Nurse

$500

Not included

Day Surgery Miscellaneous
Related to outpatient scheduled surgery performed at a Hospital or licensed outpatient surgery center; including the cost of operating room, anesthesia, drugs and medicines and medical supplies.

$2,000

$2,500

$5,000

$7,500

Hospital Emergency Room

75% of usual and customary
to $10,000 maximum

Covered as any other medical expense

Ambulance Services

$400

Covered as any other medical expense

Initial Orthopedic Prosthesis or Brace

$1,000

Covered as any other medical expense

Dental Treatment for Injury to Sound, Natural Teeth

$500

$250 per tooth

$300 per tooth

Chemotherapy and/or Radiation Therapy

$5,000

Covered as any other medical expense

Physiotherapy (Inpatient and Outpatient)

$35/visit, 1 visit/day,
12 visits maximum

$40 per visit

$60 per visit

Lost Baggage

Not covered

$250/bag, 2 bag maximum

Trip Interruption

Not covered

$2,000

$5,000

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Rates (Per Month): Tourer, Explorer and Pioneer Plans
 

Age Tourer Explorer   Age Pioneer
  Basic Enriched

Age 29 and under

$32

$41

 

Age 25 and Under

$30

$37

30 – 40

$102

$115

 

26 – 29

$59

$69

41 – 50

$118

$163

 

30 – 65

$99

$120

51 – 65

$137

$181

 

Spouse

$235

$290

Dependent

$186

$276

 

Each Child

$90

$130

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Learn More About ISP’s Premier Plan: Mountaineer
 


Coverage
Mountaineer
In-Network Out-of-Network

Participants Lifetime Medical Maximum

$2,000,000

$1,000,000

Participants Maximum Benefit Limit per Sickness or Injury

$300,000

$300,000

Deductible per Person per Sickness or Injury

N/A

N/A

Copays

   
  • At Student Health Center

$0

$0

  • Elsewhere

$40

$60

  • Prescription Drugs

$20 Generic/
$30 All Other

$40

  • Emergency Room (waived if admitted)

$100

$150

  • Hospitalization

$250

$250

Coinsurance

80% of the first $4,000—100% thereafter to a maximum of $300,000

75% of usual and customary charges up to a maximum of $300,000

Maximum Out-of-Pocket Expense

$2,000
(not Including copayment)

No maximum

Pre-Existing Condition Exclusion

6 months
(credit is provided for prior continuous coverage)

Prescription Drugs

$2,000 maximum

Diagnostic X-rays and Lab Services

$2,000 maximum

Maternity (conception must occur while coverage is in force)

Covered as any other sickness

Mental and Nervous Disorder and Substance Abuse

Limited to 1 visit per day to maximum of 35 visits per year

Emergency Medical Evacuation

$500,000

Repatriation of Remains

$100,000

Accidental Death & Dismemberment Coverage

$20,000

Paralysis

Included

Coma

Included

Chartis Solutions (Personal Security Assistance, Live Travel/Medical Assistance, Worldwide Travel Assist, Concierge Services)

Included

Home Country Coverage

$1,000 Maximum

Emergency Medical Reunion

$2,000 Lifetime Maximum

Dependents Medical maximum

$250,000 Lifetime/ $100,000 per sickness or injury

Rates (Per Month)
 

Age Mountaineer

Participant (age 25 and under)

$60

Participant (over age 25)

$74

Participant and Spouse

$208

Participant and Dependent Child(ren)

$208

Participant, Spouse and Dependent Child(ren)

$326

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