2016-2017 International College Student Accident and Sickness Insurance

Medical Expense Benefits

Rates per month:

Under age 24 $96
Age 24-30 $171
Age 31-40 $219
Age 41-50 $380
Age 50-64 $484

Student pays any credit card administration fee in addition to the premium listed above
Students above age 64 are not eligible for coverage
Dependents are not eligible for coverage
US Citizens are not eligible for coverage

Schedule of Benefits

Total Maximum for all Accident or Sickness Expense Benefits $100,000
Maximum for Preexisting Conditions $1,000
Maximum for Dental Treatment (Injury Only) $250 per tooth
Maximum for Mental and Nervous Inpatient $5,000 per lifetime
Outpatient $500 per lifetime
Maximum for Room & Board Charges Average semi-private room rate up to $1,000 per day
Maximum for ICU Room & Board Charges Average semi-private room rate up to $1,500 per day
Ancillary Hospital Exspenses
Up to $1,000 per day
Newborn Nursery Care Up to $350
Therapeutic Termination of pregnancy Up to $350
Deductible $75 per covered accident or sickness
Emergency Room Deductible $300 per covered accident or sickness, waived if admitted to hospital
Chiropractic Care $50 per visit maximum up to 10 visits per year
Prescription Drugs Inpatient—80% usual and customary charges
Outpatient 50% up to $1,000 per plan year


Coinsurance 80% of U&C
Incurral Period 60 days after the date of covered accident or sickness
Maximum Benefit Period The earlier of the date the covered person's trip ends, or 26 weeks from the date of a covered accident or sickness
Maximum Period of Coverage 364 Days
Emergency Medical Benefits Up to $10,000
Emergency Medical Evacuation Benefit 100% of the covered expenses
Repatriation of Remains Benefit 100% of the covered expenses

Learn More

Contact ISM's International Student Accident and Sickness Administrator, Tascha Gourley by email, or call 302-656-4944.

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