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StudentSecure Budget Insurance

Please use this high level information as a guide only and do not make any decisions solely based on this information. If you have any concerns, doubts or questions, please refer to the individual policy details for complete information, as it is not possible to accurately represent all the details in concise information such as follows, or call us for further details. If there is any discrepancy between this information and the actual policy details, the policy details will override.

All the amounts are in U.S. dollars.

Vision (eyeglasses, etc.) is not covered in any of the plans.

General

StudentSecure® Budget
Comprehensive
Within PPO network: After copayments, plan pays 80% up to $45,000, then 100% up to the policy maximum. Outside PPO network: Pays Usual, Reasonable and Customary to policy maximum. Outside US: After copayments, plan pays 100% to policy maximum.
$25 copay per visit

Medical - Outpatient

Within the PPO network or outside the U.S.: $50 copay per visit. Otherwise, $100 copay per visit.
Urgent Care: $75 copay per visit within the PPO network or outside the U.S. Otherwise, $150 copay per visit.
To policy maximum In US: $350 copay
50% of actual charges
To policy maximum
To policy maximum
To policy maximum
20% of primary surgeon charge. No standby availability coverage.
To policy maximum
To policy maximum

Medical - Inpatient

To policy maximum, average semi-private room including nursing services.
To policy maximum
To policy maximum
To policy maximum
20% of primary surgeon charge. No standby availability coverage.
To policy maximum
To policy maximum

Medical - Other Treatment And Services

60 days
Standard basic hospital bed and/or standard wheelchair rental up to purchase prices
Recreational: Included
$500 per injury/illness, if covered injury/illness results in hospital admission.
$5,000. Pregnancy must begin after effective date.
Maximum of 30 days. Cannot be provided at a Student Health Center.
Maximum of 30 visits. Cannot be provided at a Student Health Center.
Included in the Mental & Nervous Disorder benefit
Physical Therapy and Chiropractic Care: $50 per day

Must be ordered in advance by a physician.
United Healthcare PPO
Network of physicians, hospitals, urgent cares, labs and other healthcare providers.
No network for pharmacies, dentists, ambulance.
On effective date, $25,000 for Acute Onset only. After 12 month waiting period, same as any other eligible expense.
$250
$500
-
-
Included

Other

-
Incidental: 15 days per 3 month period
Within the PPO network or outside the U.S.: $150 copay per visit. Otherwise, $300 copay per visit.
-
-
-
$50,000 Eligible medical expenses only
Outside Home Country

Plan Features

Before effective date, full refund. After effective date, must be within first 60 days, pro-rated refund for whole months minus $25 cancellation fee, as long as no claims have been filed since the effective date; form required.
1 month up to 4 years
$0
-
Email
Postal Mail
Courier
Per Incident
$0 0-64
Per Incident
$250,000 0-64
WorldTrips
Lloyd's

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  • For medical benefits, to policy maximum, refer to the Usual, Reasonable and Customary Charges. Deductible and coinsurance apply, unless otherwise noted.
  • Whenever there is a difference in benefits levels within PPO network and outside PPO network, the benefits shown above are applicable when availing treatment within PPO network.
  • Coverages shown are per person unless noted otherwise.
  • The dash (-) in the fields above means Not Applicable (N/A).

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