|
Benefits
|
In Network (PPO)
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Out of Network
|
|
Medical expense per accident/sickness
|
$75,000
|
$75,000
|
 Lifetime medical maximum
|
No Limit
|
No Limit
|
|
Deductible per event at Student Health Center
|
$0
|
$0
|
|
Deductible per event
|
$0 if first visited the Student Health Center, $100 otherwise
|
$0 if first visited the Student Health Center, $200 otherwise
|
|
Co-insurance
|
80% of the first $50,000, 100% up to $75,000 of PPO Allowance and eligible medical
expense
|
60% of Reasonable and Customary charges and eligible medical expense
|
|
Pre-existing condition
|
Covered after 6 months
|
Covered after 6 months
|
|
Prescription*
|
$1,500 annually
|
$1,500 annually
|
|
Medical evacuation
|
$100,000
|
$100,000
|
|
Repatriation of remains
|
$100,000
|
$100,000
|
|
Accidental death & dismemberment
|
$10,000
|
$10,000
|
|
View policy brochure
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*Prescription co-pays are: $30 generic / $40 all other
in-network, $60 out-of-network. For pharmacy locations and questions call Medco
(800) 400-0136 or visit www.medcohealth.com.
Eligibility: You are eligible if you have a current passport or
visa and are temporarily residing outside your home country/country of permanent
residence while actively engaged in education or research activities and attend
Texas A&M University. You are “actively engaged“ in education or research activities
if you are one of the following:
- F1/J1 valid visa holder
- Undergraduate - registered for and attending classes for twelve (12) or more credit
hours
- Graduate student
- Scholar or researcher who is invited by an educational organization
- Student involved in education, educational activities, or research- related activities
Your spouse and dependent children under the age of 19 are also eligible for coverage
if accompanying you. For purposes of this insurance, if the Eligible Person’s home
country or country of permanent residence (passport country) is different from the
Eligible Person’s country of permanent residence (location in which the Eligible
Person permanently resides), the Eligible Person will not be covered in either location