International Student Health Insurance, OPT Health Insurance, AT Health Insurance, Visiting Faculty Health Insurance, Scholar Health Insurance

VISIT^® International Health Insurance Program
for International Students, Scholars, Spouses, Families and Visitors

Call Us Today 1-800-247-5575 or 1-703-660-9062 or

The Trusted Name in International Health and Travel Medical Insurance for over 30 Years!

VISIT^® International Student Plans Are Ideal For

International Students & Scholars (F1, J1, H, M or Q)
OPT/AT Students

ESL or High School Students
Visiting Faculty

Any Study/Research in USA & Canada
Includes Maternity

Choose from 9 different International Student Insurance Plans


Choose $100K or $250K Medical Maternity included up to $10,000 $100 deductible per illness/injury (reduced to $50 if Student Health) 80/20 co-insurance to $10,000 Medical Lifetime Maximum - $1 million As low as $54 per month	Choose $100K or $250K Medical Maternity included up to $10,000 $100 deductible per illness/injury (reduced to $50 if Student Health) 80/20 co-insurance to $5000 Medical Lifetime Maximum - $1 million As low as $57 per month	Choose $100K or $250K Medical Maternity covered to policy max $100 deductible per illness/injury (reduced to $50 if Student Health) 80/20 co-insurance to $5000 Medical Lifetime Maximum - $1 million As low as $70 per month	Choose $100K or $250K Medical Maternity covered as any other illness $100 deductible per illness/injury (reduced to $50 if Student Health) 80/20 co-insurance to $5000 Pre-existing conditions covered after 6 months Medical Lifetime Maximum - $1 million As low as $79 per month	$100K, $250K, $1 Million Medical No maternity coverage Choose $100, $250 or $500 deductible per policy period 80/20 co-insurance to $5000 Now as low as $29.40 per month

Economy, Standard, Super & Platinum Plan Benefits
Underwritten by certain Underwriters at Lloyd's, London - Lloyd's currently enjoys an A rating from A.M. Best and A+ ratings from Fitch Ratings and Standard & Poor's.

Economy, Standard, Super, Platinum and E^PLUS plans meet or exceed U.S. State Department DS2019 requirements
Choose your own doctor or hospital; you are not required to use doctors within a specific network
Deductible reduced to $50 per occurrence if the university student health center is used first
Maternity coverage included - limits vary by plan
Pre-existing conditions covered after 12 months of continuous coverage (6 months for Platinum)
Sports & hazardous sports coverage included

VISIT STUDENT Plans (Economy, Standard, Super & Platinum) are open to International Students, visiting Faculty, Scholars, or other persons over the age of twelve (12) up to and including age sixty-four (64), who are temporarily residing outside their Home Country. The Insured must remain engaged in educational or research activities outside their Home Country during the Period of Coverage. Education or research activities shall mean the Insured: 1) is enrolled and participating in an educational, vocational, cultural exchange, or training program; and 2) has a valid J-1, H-3, F, M, or Q Visa.

ECONOMY International Student Insurance Plans
Choose $100K or $250K (maternity included)

ECONOMY Plan Monthly Rates

Rates effective July 1, 2013

Age	Economy $100K	Economy $250K
12-18	$54	$61
19-23	$68	$76
24-30	$143	$161
31-40	$223	$249
41-49	$284	$317
50-64	$399	n/a
VISIT STUDENT Plans (Economy, Standard, Super & Platinum) are open to International Students, visiting Faculty, Scholars, or other persons over the age of twelve (12) up to and including age sixty-four (64), who are temporarily residing outside their Home Country. The Insured must remain engaged in educational or research activities outside their Home Country during the Period of Coverage. Education or research activities shall mean the Insured: 1) is enrolled and participating in an educational, vocational, cultural exchange, or training program; and 2) has a valid J-1, H-3, F, M, or Q Visa.

ECONOMY Plan Coverages
Coverage	Economy $100K	Economy $250K
Accident & Sickness Medical Routine physical exams and vaccinations are not covered	$100,000 per injury or illness maximum Student - $50,000 (Age 50-64)	$250,000 per injury or illness maximum Student - $100,000 (Age 50-64)
Deductible	$50 Student Health / $100 non-Student Health per injury or illness	$50 Student Health / $100 non-Student Health per injury or illness
Co-insurance	80% to $10,000, 100% thereafter to policy maximum	80% to $10,000, 100% thereafter to policy maximum
Medical Lifetime Maximum	$1,000,000	$1,000,000
Emergency Medical Evacuation	$100,000	$100,000
Repatriation of mortal remains	$25,000	$25,000
Pre-existing condition coverage	Pre-existing Conditions 12 months prior to Effective Date, waived after 12 consecutive months of coverage	Pre-existing Conditions 12 months prior to Effective Date, waived after 12 consecutive months of coverage
AD&D - Accidental Death & Dismemberment	$10,000	$10,000
Maternity Coverage	up to $10,000 (must be insured for a minimum of 30 days prior to conception to receive maternity benefits)	up to $10,000 (must be insured for a minimum of 30 days prior to conception to receive maternity benefits)
Home Country Coverage	30 days of coverage up to a max. of $25,000 per policy period	30 days of coverage up to a max. of $25,000 per policy period
Sports Coverage (non-interscholastic sports)	$10,000 per policy period	$10,000 per policy period
Hazardous sports coverage	$10,000 per policy period	$10,000 per policy period
View Policy Details

STANDARD International Student Insurance Plans
Choose $100K or $250K (maternity included)

STANDARD Plan Monthly Rates

Rates effective July 1, 2013

Age	Standard $100K	Standard $250K
12-18	$65	$72
19-23	$83	$93
24-30	$174	$195
31-40	$271	$303
41-49	$345	$386
50-64	$486	$544
VISIT STUDENT Plans (Economy, Standard, Super & Platinum) are open to International Students, visiting Faculty, Scholars, or other persons over the age of twelve (12) up to and including age sixty-four (64), who are temporarily residing outside their Home Country. The Insured must remain engaged in educational or research activities outside their Home Country during the Period of Coverage. Education or research activities shall mean the Insured: 1) is enrolled and participating in an educational, vocational, cultural exchange, or training program; and 2) has a valid J-1, H-3, F, M, or Q Visa.

STANDARD Plan Coverages

Coverage	Standard $100K	Standard $250K
Accident & Sickness Medical Routine physical exams and vaccinations are not covered	$100,000 per injury or illness maximum Student - $50,000 (Age 50-64)	$250,000 per injury or illness maximum Student - $100,000 (Age 50-64)
Deductible	$50 Student Health / $100 non-Student Health per injury or illness	$50 Student Health / $100 non-Student Health per injury or illness
Co-insurance	80% to $5000, 100% thereafter to policy maximum	80% to $5000, 100% thereafter to policy maximum
Medical Lifetime Maximum	$1,000,000	$1,000,000
Emergency Medical Evacuation	$100,000	$100,000
Repatriation of mortal remains	$25,000	$25,000
Pre-existing condition coverage	Pre-existing Conditions 12 months prior to Effective Date, waived after 12 consecutive months of coverage	Pre-existing Conditions 12 months prior to Effective Date, waived after 12 consecutive months of coverage
AD&D - Accidental Death & Dismemberment	$10,000	$10,000
Maternity Coverage	up to $10,000 (must be insured for a minimum of 30 days prior to conception to receive maternity benefits)	up to $10,000 (must be insured for a minimum of 30 days prior to conception to receive maternity benefits)
Home Country coverage	30 days of coverage up to a max. of $25,000 per policy period	30 days of coverage up to a max. of $25,000 per policy period
Sports Coverage (non-interscholastic sports)	$10,000 per policy period	$10,000 per policy period
Hazardous sports coverage	$10,000 per policy period	$10,000 per policy period
View Policy Details

SUPER International Student Insurance Plans
Choose $100K or $250K (maternity included)

SUPER Plan Monthly Rates

Rates effective July 1, 2013

Age	Super $100K	Super $250K
12-18	$74	$77
19-23	$95	$100
24-30	$197	$209
31-40	$306	$324
41-49	$390	$413
50-64	$548	$n/a
VISIT STUDENT Plans (Economy, Standard, Super & Platinum) are open to International Students, visiting Faculty, Scholars, or other persons over the age of twelve (12) up to and including age sixty-four (64), who are temporarily residing outside their Home Country. The Insured must remain engaged in educational or research activities outside their Home Country during the Period of Coverage. Education or research activities shall mean the Insured: 1) is enrolled and participating in an educational, vocational, cultural exchange, or training program; and 2) has a valid J-1, H-3, F, M, or Q Visa.

SUPER Plan Coverages

Coverages	Super $100K	Super $250K
Accident & Sickness Medical Routine physical exams and vaccinations are not covered	$100,000 per injury or illness medical maximum Student - $50,000 (Age 50-64)	$250,000 per injury or illness maximum Student - $100,000 (Age 50-64)
Deductible	$50 Student Health / $100 non-Student Health per injury or illness	$50 Student Health / $100 non-Student Health per injury or illness
Co-insurance	80% to $5000, 100% thereafter to policy maximum	80% to $5000, 100% thereafter to policy maximum
Medical Lifetime Maximum	$1,000,000	$1,000,000
Emergency Medical Evacuation	$100,000	$100,000
Repatriation of mortal remains	$25,000	$25,000
Pre-existing condition coverage	Pre-existing Conditions 12 months prior to Effective Date, waived after 12 consecutive months of coverage	Pre-existing Conditions 12 months prior to Effective Date, waived after 12 consecutive months of coverage
AD&D - Accidental Death & Dismemberment	$10,000	$10,000
Maternity coverage	up to policy maximum (must be insured for a minimum of 30 days prior to conception to receive maternity benefits)	up to policy maximum (must be insured for a minimum of 30 days prior to conception to receive maternity benefits)
Home Country coverage	30 days of coverage up to a max. of $25,000 per policy period	30 days of coverage up to a max. of $25,000 per policy period
Sports Coverage (non-interscholastic sports)	$10,000 per policy period	$10,000 per policy period
Hazardous sports coverage	$10,000 per policy period	$10,000 per policy period
View Policy Details

PLATINUM International Student Insurance Plans
Choose $100K or $250K (maternity included)

PLATINUM Plan Monthly Rates

Rates effective July 1, 2013

Age	Platinum $100K	Platinum $250K
12-18	$79	$88
19-23	$102	$113
24-30	$211	$236
31-40	$327	$366
41-49	$417	$468
50-64	$586	$n/a
VISIT STUDENT Plans (Economy, Standard, Super & Platinum) are open to International Students, visiting Faculty, Scholars, or other persons over the age of twelve (12) up to and including age sixty-four (64), who are temporarily residing outside their Home Country. The Insured must remain engaged in educational or research activities outside their Home Country during the Period of Coverage. Education or research activities shall mean the Insured: 1) is enrolled and participating in an educational, vocational, cultural exchange, or training program; and 2) has a valid J-1, H-3, F, M, or Q Visa.

PLATINUM Plan Coverages

Coverages	Platinum $100K	Platinum $250K
Accident & Sickness Medical Routine physical exams and vaccinations are not covered	$100,000 per injury or illness medical maximum Student - $50,000 (Age 50-64)	$250,000 per injury or illness maximum Student - $100,000 (Age 50-64)
Deductible	$50 Student Health / $100 non-Student Health per injury or illness	$50 Student Health / $100 non-Student Health per injury or illness
Co-insurance	80% to $5000, 100% thereafter to policy maximum	80% to $5000, 100% thereafter to policy maximum
Medical Lifetime Maximum	$1,000,000	$1,000,000
Emergency Medical Evacuation	Unlimited	Unlimited
Repatriation of mortal remains	unlimited	unlimited
Pre-existing condition coverage	6 months prior to Effective Date, waived after 6 consecutive months of coverage	6 months prior to Effective Date, waived after 6 consecutive months of coverage
AD&D - Accidental Death & Dismemberment	$10,000	$10,000
Maternity coverage	Covered as any other Illness (must be insured for a minimum of 30 days prior to conception to receive maternity benefits)	Covered as any other Illness (must be insured for a minimum of 30 days prior to conception to receive maternity benefits)
Home Country coverage	30 days of coverage up to a max. of $25,000 per policy period	30 days of coverage up to a max. of $25,000 per policy period
Sports Coverage (non-interscholastic sports)	$10,000 per policy period	$10,000 per policy period
Hazardous sports coverage	$10,000 per policy period	$10,000 per policy period
View Policy Details

Plan E^PLUS
Underwritten by certain Underwriters at Lloyd's, London - Lloyd's currently enjoys an A rating from A.M. Best and A+ ratings from Fitch Ratings and Standard & Poor's.

Plan E^PLUS Monthly Rates (standard 30-day month)

Plan E PLUS Rates Remain Competitive for 2013-2014!

	$50,000 Medical				$100,000 Medical				$250,000 Medical
AGE	$500 Deductible	$250 Deductible	$100 Deductible	$0 Deductible	$500 Deductible	$250 Deductible	$100 Deductible	$0 Deductible	$500 Deductible	$250 Deductible	$100 Deductible	$0 Deductible
0-29	$29.40	$33.00	$36.30	$42.60	$36.90	$41.10	$45.30	$53.00	$41.70	$46.50	$51.30	$60.60
30-39	$39.30	$43.80	$48.00	$56.70	$49.20	$54.60	$60.00	$70.80	$55.50	$61.50	$67.80	$80.10
40-49	$61.80	$68.70	$75.90	$89.40	$77.40	$86.10	$94.80	$111.90	$87.30	$96.90	$106.50	$126.00
50-59	$93.00	$103.50	$113.70	$134.40	$116.10	$129.30	$142.20	$168.30	$131.40	$145.80	$160.20	$189.60
60-64	$116.40	$129.30	$142.20	$168.30	$145.50	$161.70	$177.90	$210.30	$164.10	$182.40	$200.70	$237.00
65-69	$144.90	$160.80	$177.00	$209.10	$180.90	$201.00	$221.10	$261.30	n/a	n/a	n/a	n/a
70-79*	$182.70	$202.80	$223.20	$263.70	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a

	$500,000 Medical				$1,000,000 Medical
AGE	$500 Deductible	$250 Deductible	$100 Deductible	$0 Deductible	$500 Deductible	$250 Deductible	$100 Deductible	$0 Deductible
0-29	$45.90	$51.30	$56.40	$66.60	$50.10	$55.50	$60.90	$72.30
30-39	$61.20	$67.80	$74.40	$88.20	$66.30	$73.80	$81.30	$96.00
40-49	$96.00	$106.50	$117.30	$136.60	$105.00	$116.40	$128.10	$151.50
50-59	$144.30	$160.20	$176.10	$208.50	$157.20	$174.90	$192.60	$227.40
60-64	$180.30	$200.70	$220.80	$260.70	$196.80	$218.70	$240.30	$284.10
65-69	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a
70-79*	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a

*Maximum Medical coverage is $50,000 for Age 70-79. Optional Hazardous Sports coverage available for an additional fee.

Plan E^PLUS Coverages

Coverages	E^PLUS	E^PLUS with Hazardous Sport Coverage
Accident & Sickness Medical Routine physical exams and vaccinations are not covered	Choose $50,000, $100,000, $250,000, $500,000 OR $1,000,000 Medical Maximum per injury or illness Age 0-69 / $50,000 Age 70-79	Choose $50,000, $100,000, $250,000, $500,000 OR $1,000,000 Medical Maximum per injury or illness Age 0-69 / $50,000 Age 70-79
Deductible A Deductible is the amount you pay to the doctor before the insurance pays the rest	Choose $0, $100, $250 or $500 Deductible per policy period Students: please check if your school allows higher deductibles	Choose $0, $100, $250 or $500 Deductible per policy period Students: please check if your school allows higher deductibles
Co-insurance	After You pay the Deductible, the plan pays 80% of the next $5,000 of eligible expenses, then 100% to the selected Medical Maximum	After You pay the Deductible, the plan pays 80% of the next $5,000 of eligible expenses, then 100% to the selected Medical Maximum
Medical Lifetime Maximum	$50,000, $100,000, $250,000, $500,000 OR $1,000,000 Age 0-69/ $50,000 Age 70-79	$50,000, $100,000, $250,000, $500,000 OR $1,000,000 Age 0-69/ $50,000 Age 70-79
Emergency Medical Evacuation	up to $100,000	up to $100,000
Repatriation of mortal remains	up to $25,000	up to $25,000
Pre-existing condition coverage	no coverage	no coverage
AD&D - Accidental Death & Dismemberment	$25,000 per Insured/Spouse $5000 per Dependent Child	$25,000 per Insured/Spouse $5000 per Dependent Child
Maternity coverage	no coverage	no coverage
Home Country coverage	60 days per 12 months of coverage up to $50,000	60 days per 12 months of coverage up to $50,000
Sports Coverage (non-interscholastic sports)	up to policy maximum	up to policy maximum
Hazardous Sports coverage	no coverage	included
Trip Interruption	up to $5000	up to $5000
Return of minor child	up to $10,000	up to $10,000
Lost baggage	up to $250	up to $250
View Policy Details

CANCELLATION POLICY
All premiums are fully earned upon Application, and are Non-Refundable. Please apply only for the term of coverage you need, and re-apply as necessary as your plans may change.

VISIT International Health Insurance Program, an Insurance program of PENTECO, LLC
www.visitinsurance.com
Correspondence: P.O. Box 210, Mount Vernon, VA 22121 (703) 660-9062/ (800) 247-5575/ (703) 991-9164 fax
email: info@visitinsurance.com

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