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Liaison Student Basic Insurance

Quotes for Liaison Student Basic Insurance

Liaison Student Basic provides medical insurance benefits to students and other educational professionals with valid J-1, H-3, F, M or Q Visas. It can be renewed as long as the student satisfy the eligibility requirements and also offers coverage for maternity.

  • Non US Citizens and U.S Citizens
  • International Students, visiting faculty, scholars between 12 and 64 years of age and the student must be engaged in full-time educational, research activities residing outside their home country.
  • Non US citizens must have a valid J-1, H-3, F-1, M-1 or Q-1 Visa and are covered if destination is the United States.
  • U.S. citizen must have a current passport and visa issued by their host country and are covered for destinations outside of the United States.
COVERAGE : 5 days to 364 days

  • State Restrictions: The plan will not accept a mailing address in Maryland, Washington, New York, South Dakota, and Colorado.
  • Country Restrictions: The plan will not accept an address in Islamic Republic of Iran, Syrian Arab Republic, U.S. Virgin Islands, Gambia, Ghana, Nigeria, and Sierra Leone.
  • Destination Restrictions: The plan will not cover trips to Islamic Republic of Iran and Syrian Arab Republic.
RATING : A (excellent) by AM Best
UNDERWRITERS : Certain Underwriters at Lloyd's of London (rated "A" (Excellent) by AM Best) and Tramont Insurance Company Limited.

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Plan Highlights

Policy Maximum Ages 14 days to 59 years: $50,000; $100,000; $250,000; $500,000
Ages 60 to 64 years: $50,000; $100,000; $250,000


Ages 14 days to 59 years: $50; $100; $250
Ages 60 to 64 years: $100; $250
Inside the United States
  • In ppo network : We pay 80% of the first $5,000, then 100% to the medical maximum..
  • Out of ppo network : We pay 70% of the first $5,000, then 100% to the medical maximum.
Inside the United States
  • The plan pays 100% to the medical maximum.

Benefits Details

Benefits Coverage
Medical Maximum Options
Ages 14 days to 59 years: $50,000; $100,000; $250,000; $500,000
Ages 60 to 64 years: $50,000; $100,000; $250,000
Deductible Options Ages 14 days to 59 years: $50; $100; $250
Ages 60 to 64 years: $100; $250
Hospital Room & Board URC to medical maximum
Emergency Room Services $100 copay
Doctor’s Office Visits $15 copay
Urgent Care Visits $30 copay
Prescription Drugs $15 copay
Physiotherapy $25 per visit, 60 visits maximum
Vaccinations Not Available
Spinal Manipulation $25 per visit, 60 visits maximum
Local Ambulance Benefit $350
Coma benefit $10,000
separate from the medical maximum
Felonious assault $10,000
separate from the medical maximum
Extension of Benefits to Home Country $1,000
Incidental Trips to Home Country $1,000
Acute Onset of Pre-existing Conditions $5,000
Mental Illness including Alcohol and Substance Abuse Inpatient: $5,000, 45-day limit
Outpatient:80% up to $500
Motor Vehicle Accident Inside the United States: 50% up to $100,000
Outside the United States: Up to medical maximum
Non-contact Amateur Sports $2,500
Maternity Care Inside the United States : Not Available
Outside the United States :Not Available
Routine Newborn Care Not Available
Dental — Sudden Relief of Pain $150
Dental Emergency — Accident $500
Emergency Medical Evacuation & Repatriation $100,000
Emergency Medical Reunion $200 per day, 10-day limit $15,000 maximum
Return of Children $25,000
Return of Mortal Remains $50,000
Local Cremation or Burial $5,000
Natural Disaster Evacuation $5,000
Natural Disaster Daily Benefit $25 per day, 5-day limit
Political Evacuation & Repatriation $10,000
Terrorist Activity $25,000
Pre-certification — 25% penalty Required inside the United States for specific types of treatment. Penalty does not apply to emergencies.
Accidental Death and Dismemberment (AD&D) Primary Insured or Travel Companion $25,000 Principal Sum
Eligible Spouse $10,000 Principal Sum
Eligible Dependent Children $5,000 Principal Sum
Aggregate limit of $250,000 for total number of insureds on the plan
Personal Liability $25,000
Hazardous Sports Up to medical maximum

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