Page 6 - StudentSecure_Specimen
P. 6
In the event you begin a benefit period while the certificate is in effect, and the certificate terminates
because you return to your home country, we will pay eligible medical expenses which are incurred
in your home country during the benefit period. Home country coverage applies only to eligible
medical expenses for which you are hospitalized as an inpatient on the termination date of the
certificate.
INCIDENTAL HOME COUNTRY COVERAGE
For every three month period during which you are covered, eligible medical expenses are covered
up to a maximum of 15 days for any three month period. Any benefit accrued under a single three
month period does not accumulate to another period. Failure to continue your international trip or
your return to your home country for the sole purpose of obtaining treatment for an illness or injury
that began while traveling shall void any home country coverage provided under the terms of this
agreement.
For all non-U.S. citizens electing coverage “Excluding the U.S.” and for all U.S. citizens or residents,
no coverage is provided within the U.S., except for U.S. citizens or residents during an eligible
incidental home country visit or an eligible benefit period.
Except for a benefit period, coverage provided under this Master Policy is for a maximum duration of
364 days. Any extension is based upon the eligibility rules in force and is solely at our discretion.
Notwithstanding the foregoing, coverage under all plans shall terminate on the date we, at our sole
option, elect to cancel all members of the same sex, age, class or geographic location, provided we
give no less than 30 days advance written notice by mail to your last known address.
SPECIMEN
SCHEDULE OF BENEFITS AND LIMITS
Plan Details
Overall Maximum Limit Elite $1,000,000
Select $600,000
Maximum per Injury / Budget $500,000
Illness Smart $200,000
Elite $500,000
Select $300,000
Budget $250,000
Smart $100,000
Deductibles (Except Elite $25 per injury or illness within the Preferred Provider
Emergency Room) Select Organization (PPO) network or student health center;
Budget otherwise $50 per injury or Illness.
If treatment received outside of U.S., $25 per illness or injury.
$35 per injury or illness within the Preferred Provider
Organization (PPO) network or student health center;
otherwise $70 per injury or Illness.
If treatment received outside of U.S., $35 per illness or injury.
$45 per injury or illness within the Preferred Provider
Organization (PPO) network or student health center;
otherwise $90 per injury or Illness.
If treatment received outside of U.S., $45 per illness or injury.
6 StudentSecure Description of Coverage | Tokio Marine HCC – MIS Group
because you return to your home country, we will pay eligible medical expenses which are incurred
in your home country during the benefit period. Home country coverage applies only to eligible
medical expenses for which you are hospitalized as an inpatient on the termination date of the
certificate.
INCIDENTAL HOME COUNTRY COVERAGE
For every three month period during which you are covered, eligible medical expenses are covered
up to a maximum of 15 days for any three month period. Any benefit accrued under a single three
month period does not accumulate to another period. Failure to continue your international trip or
your return to your home country for the sole purpose of obtaining treatment for an illness or injury
that began while traveling shall void any home country coverage provided under the terms of this
agreement.
For all non-U.S. citizens electing coverage “Excluding the U.S.” and for all U.S. citizens or residents,
no coverage is provided within the U.S., except for U.S. citizens or residents during an eligible
incidental home country visit or an eligible benefit period.
Except for a benefit period, coverage provided under this Master Policy is for a maximum duration of
364 days. Any extension is based upon the eligibility rules in force and is solely at our discretion.
Notwithstanding the foregoing, coverage under all plans shall terminate on the date we, at our sole
option, elect to cancel all members of the same sex, age, class or geographic location, provided we
give no less than 30 days advance written notice by mail to your last known address.
SPECIMEN
SCHEDULE OF BENEFITS AND LIMITS
Plan Details
Overall Maximum Limit Elite $1,000,000
Select $600,000
Maximum per Injury / Budget $500,000
Illness Smart $200,000
Elite $500,000
Select $300,000
Budget $250,000
Smart $100,000
Deductibles (Except Elite $25 per injury or illness within the Preferred Provider
Emergency Room) Select Organization (PPO) network or student health center;
Budget otherwise $50 per injury or Illness.
If treatment received outside of U.S., $25 per illness or injury.
$35 per injury or illness within the Preferred Provider
Organization (PPO) network or student health center;
otherwise $70 per injury or Illness.
If treatment received outside of U.S., $35 per illness or injury.
$45 per injury or illness within the Preferred Provider
Organization (PPO) network or student health center;
otherwise $90 per injury or Illness.
If treatment received outside of U.S., $45 per illness or injury.
6 StudentSecure Description of Coverage | Tokio Marine HCC – MIS Group
