Insurance Terms

Coinsurance is the portion of the bill the plan pays after the student pays their deductible and/or copay. Coinsurance is typically shown as two percentages: one for in-network providers and one for out-of-network providers. For example, a plan might have 100% / 80% coinsurance. This means if an international student goes to an in-network provider, insurance will cover 100% of the bill for covered services, after the student pays any applicable deductible and/or copay. However, if the international student goes to an out-of-network provider, insurance will only cover 80% of the bill, after the student pays any applicable deductible and/or copay; the student would be responsible for the remaining 20% of the cost, up to their out-of-pocket maximum.

A copayment, or a copay, is a flat fee the student pays for healthcare services each time they use their insurance. Different copay amounts may apply depending on the healthcare service. For example, the copay amount may vary for office visits, specialist visits, urgent care visits, emergency room visits, and prescription medications.

A deductible is the amount the student must pay out-of-pocket before the insurance provider will pay any expense. After paying the deductible (or “meeting the deductible”), the student may or may not be responsible for paying an additional portion of their healthcare bills. Under some plans, healthcare expenses are covered at 100% after the student meets their deductible, meaning the student will not have to pay anything after meeting their deductible. Other plans may have in-network coinsurance of 90% or 80% and so the student will be responsible for paying their portion of the coinsurance after the deductible on those plans.

A student is inpatient when they have been admitted into a hospital to stay for treatment of an illness or accident.

Medical evacuation means transporting a patient experiencing a medical emergency to the nearest capable facility as safely and quickly as possible. Medical evacuation only occurs when the local facility cannot provide proper diagnosis, qualified medical personnel, or necessary equipment to treat the patient. After an attending physician determines an evacuation is necessary, specially trained medical personnel transport the patient.

A student is outpatient when they receive healthcare services and leave the facility the same day.

Out-of-Pocket Maximum is the maximum amount of money a student will have to pay for covered medical expenses during the policy period.

Plan Maximum is the largest amount an insurance company will pay for covered injuries or illnesses during the policy period. Plan Maximums are often shown as both annual and per injury or illness. This means that both types of Plan Maximums can apply to a student during the policy period. An annual Plan Maximum is the maximum amount the insurance company will pay for a given student for all injuries or illnesses during the policy period. A per injury or illness Plan Maximum means the maximum amount the insurance company will pay for treatment of any specific injury or illness during the policy period.

A Pre-Existing Condition is a health condition the student had prior to the date their health coverage began. For example, Preexisting Conditions could include, but are not limited to, asthma, diabetes, cancer, or pregnancy.

Premium is the cost the student pays to obtain insurance coverage. The premium is often shown as a daily, monthly, or annual rate. Some plans allow students to pay the Premium on a monthly basis, while others require the student to pay the full Premium for the policy period up front.

Preventative Care means care intended to prevent injury or illness. Preventative care can include, but is not limited to, routine screenings, annual check-ups, and immunizations.

Repatriation means the return of a student to their home country. For example, if student sustains an injury in a foreign country and needs to return to their home country for treatment, they would be repatriated. Additionally, in the unfortunate event that a student passes away while away from their home country, their remains can be repatriated home.