| Plan name |
Liaison Student Economy PURCHASE NOW |
Liaison Student Choice PURCHASE NOW |
Liaison Student Elite PURCHASE NOW |
|---|---|---|---|
| Benefits | |||
| Medical Maximum Options (per person per disablement) |
Ages 14 days to 64 $50,000; $100,000; $250,000; $500,000; $1,000,000 |
Ages 14 days to 64 $50,000; $100,000; $250,000; $500,000; $1,000,000 |
Ages 14 days to 64 $50,000; $100,000; $250,000; $500,000; $1,000,000 |
| Hospital room and board | Usual, Reasonable and Customary to the medical maximum. | Usual, Reasonable and Customary to the medical maximum. | Usual, Reasonable and Customary to the medical maximum. |
| Prescription Drugs | Inside the U.S - $10 copay for generic/$20 copay for brand name (not subject to the deductible) Outside the U.S - $0 copay (deductible applies) |
Inside the U.S - $5 copay for generic/$10 copay for brand name (not subject to the deductible) Outside the U.S - $0 copay (deductible applies) |
Inside the U.S - $10 copay for generic/$20 copay for brand name (not subject to the deductible) Outside the U.S - $0 copay (deductible applies) |
| Vaccinations (in the U.S. only as required by school, university or visa program) |
$100 per 364 days of continuous coverage | $150 per 364 days of continuous coverage | $200 per 364 days of continuous coverage |
| Physical Therapy | $25 per day to a max of 60 days | $50 per day to a max of 60 days | $75 per day to a max of 60 days |
| Spinal Manipulation | $25 per day to a max of 60 days (if prescribed by a physician for pain relief) | $50 per day to a max of 60 days (if prescribed by a physician for pain relief) | $75 per day to a max of 60 days (if prescribed by a physician for pain relief) |
| Local Ambulance Benefit | Inside the U.S - $350 per disablement (injury/illness) Outside the U.S - Up to medical maximum |
Inside the U.S - $500 per disablement (injury/illness) Outside the U.S - Up to medical maximum |
Inside the U.S - $750 per disablement (injury/illness) Outside the U.S - Up to medical maximum |
| Coma Benefit | $10,000 (separate from the medical maximum) | $25,000 (separate from the medical maximum) | $50,000 (separate from the medical maximum) |
| Extension of Benefits to Home Country | $1,000 | $5,000 | $10,000 |
| Incidental Trips to Home Country (for minimum purchases of 30 days) |
$1,000 | $5,000 | $10,000 |
| Waiver of Pre-existing Conditions | After a waiting period of 364 days of continuous coverage, pre-existing conditions are covered as any other disablement. | After a waiting period of 364 days of continuous coverage, pre-existing conditions are covered as any other disablement. | After a waiting period of 364 days of continuous coverage, pre-existing conditions are covered as any other disablement. |
| Acute Onset of a Pre-existing Condition (during the initial 364 days of coverage) |
Medical covered expenses up to $5,000 | Medical covered expenses up to $10,000 | Medical covered expenses up to $25,000 |
| Mental Illness including Alcohol & Substance Abuse | Inpatient: $5,000 (45 days max), Outpatient: 80% of URC to $500 | Inpatient: $10,000 (45 days max), Outpatient: 80% of URC to $1,000 | Inpatient: $20,000 (45 days max), Outpatient: $2,000 |
| Motor Vehicle Accident | Inside the U.S - 50% up to $100,000 Outside the U.S - Up to medical maximum |
Inside the U.S - 75% up to $100,000 Outside the U.S - Up to medical maximum |
Inside the U.S - 100% up to $100,000 Outside the U.S - Up to medical maximum |
| Non-contact Amateur Sports | $2,500 | $5,000 | $10,000 |
| Maternity Care For a pregnancy to be covered, conception must occur 180 days after coverage begins. |
$500 Benefits reduced 25% for failure to notify us within the first 90 days of pregnancy |
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| Routine Newborn Care | $250 per newborn child | $500 per newborn child | $750 per newborn child |
| Dental - Sudden Relief of Pain (for minimum purchases of 30 days) |
$150 | $250 | $350 |
| Dental - Accident | $500 | $1,000 | $2,500 |
| Emergency Medical Evacuation & Repatriation | $100,000 (separate from the medical maximum) | $500,000 (separate from the medical maximum) | $750,000 (separate from the medical maximum) |
| Emergency Medical Reunion | Up to $200 per day/$15,000 maximum | Up to $200 per day/$25,000 maximum | Up to $200 per day/$50,000 maximum |
| Return of Child(ren) | $25,000 | $40,000 | $25,000 |
| Return of Mortal Remains | $50,000 | $50,000 | $50,000 |
| Local Burial or Cremation | $5,000 | $5,000 | $5,000 |
| Natural Disaster Evacuation | $5,000 | $10,000 | $10,000 |
| Natural Disaster Daily Benefit | $25 per day, 5-day limit | $50 per day, 5-day limit | $75 per day, 5-day limit |
| Political Evacuation & Repatriation | $10,000 | $10,000 | $10,000 |
| Felonious Assault | $10,000 (separate from the medical maximum) | $15,000 (separate from the medical maximum) | $20,000 (separate from the medical maximum) |
| Terrorism | $25,000 | $50,000 | $100,000 |
| Accidental Death and Dismemberment (AD&D) |
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| Personal liability | $25,000 | $50,000 | $100,000 |
| Hazardous Activities | Up to medical maximum | Up to medical maximum | Up to medical maximum |