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Health
and Welfare Benefits for International Visiting Scholars(These guidelines
meet the U.S. Department of State regulations for J-1 visa holders effective 10/7/99.)
Contents: Please
note: Informational meetings regarding health insurance for international
visiting scholars are offered by University Health Services every Tuesday morning
at 10 am in the Tang Center, 2222 Bancroft Way. For more information about these
meetings, call (510) 642-5742. HealthCare
Plus is no longer accepting new enrollments,
effective immediately. The HealthCare Plus plan is being discontinued as
of August 1, 2008. Existing enrollments will be honored through their expiration
dates. Please contact the International Scholar Advisor at scholars@uhs.berkeley.edu
or (510) 642-5742 for information about alternative health insurance plans for
international visiting scholars.
| Definition
of Visiting Scholar | See the Visiting
Scholar Definition. | | Overview
of Insurance Requirement | All international visiting scholars
at UC Berkeley are required to have health insurance for themselves and all accompanying
dependents. Insurance must be purchased within 31 days of arrival in the US. Several
plans are available for purchase through University Health Services. NOTE:
When the scholar does not purchase health insurance prior to traveling to the
United States, purchase of a travel insurance policy to cover the trip and the
first 30 days in the US is strongly recommended. |
| Proof of Coverage Through
Another Plan | Scholars who choose to purchase health
insurance in their home country (prior to arrival in the United States) must purchase
insurance that meets US State Department requirements (see below). Written proof
of policy benefits must be translated into English. The scholar must also obtain
a Certificate of Health Insurance Coverage verified and signed by the insurance
company. Upon arrival at UC Berkeley, the scholar must present the health
insurance documents to his or her host department. The scholar may also attend
the weekly informational meeting at the Tang Center or schedule an appointment
with the International Health Insurance Advisor to provide insurance documents
for verification. For additional information, please review the Health
Insurance for Visiting Scholars Brochure. The plan must meet the
following requirements established by the US Department of State and required
by UC Berkeley: - Medical benefits of at least $50,000 per accident
or illness.
- Deductible no greater than $500 per accident or illness.
- Coverage
of expenses associated with the medical evacuation of the exchange visitor to
his or her home country in the amount of $10,000 (minimum).
- Coverage
of expenses associated with repatriation of remains in the amount of $7,500 (minimum).
- Pre-existing conditions must be covered after a 12-month waiting period.
- Coverage may include a provision for co-insurance with a maximum 25%
coinsurance or co-payment by the exchange visitor. Coinsurance must allow for
customary & reasonable charges in US dollars, not equivalent cost for services
in home country.
- Coverage cannot exclude benefits for perils inherent
to the activities of the program in which the visitor participates.
- Policy
must be underwritten by an insurance corporation meeting the rating requirements
of the US Department of State or backed by the full faith and credit of the government
of the visitor's home country.
If the foreign insurance policy
does not meet all of the above requirements, the scholar is required to attend
the weekly informational meeting at the Tang Center within 31 days arrival at
UC Berkeley to purchase an insurance plan meeting these guidelines. Cost
of US Health Care: Health care in the US is very expensive, and most US healthcare
providers will not bill international insurance companies. We recommend that you
have a source of income readily available (such as a credit card with a high spending
limit) to pay for treatment of accidents, illnesses or preexisting conditions.
Be prepared to pay for any and all medical services and to be responsible for
submitting claims to the insurance company for reimbursement. US Government
Programs: As a non-immigrant J-1 Exchange Visitor, you and your dependents
are not eligible for any state or federally-sponsored healthcare programs (such
as Medi-Cal or Healthy Families). | | Additional
Insurance Plan Information | The Bureau of Educational
and Cultural Affairs of the US Department of State publishes a list
of US commercial insurance companies that offer health insurance to international
students and scholars studying in the United States. |
| Coverage Options |
UC Berkeley offers international visiting scholars the opportunity to purchase
one of several health insurance plans. See plan brochures and applications (links
are provided under each plan description below). StudentSecure offers
coverage for accidents and illnesses for scholars and family members traveling
with them (dependents) through two plans, Select or Budget. Lloyd's
is the insurer of StudentsSecrure's Preferred Provider Organization (PPO)
plans. In a Preferred Provider Organization (PPO) plan, the insurance
company contracts with specific groups of health care providers (doctors, hospitals
and other medical facilities) to offer services at a reduced cost. Using PPO "network"
providers saves patients money. Services received from providers that are not
part of the PPO network are more expensive to the patient because the services
are reimbursed at a lower rate. Gateway Plan offers coverage for
accidents and illnesses for scholars and family members traveling with them (dependents)
through two plans, Gateway USA and Gateway Premier Plan 1. Medical
services covered by these plans may be obtained from any provider. The Gateway
Plans are underwritten by the Insurance Company of the State of Pennsylvania,
a member of the American International Group of Companies (AIG). |
| Eligibility
for Enrollment | Nonimmigrant international visiting
students and scholars on F or J visas are eligible to enroll in the StudentSecure
plans or the Gateway plans. (These plans are not available to US passport
holders, regardless of country of residence.) Dependents of international
students and scholars on F or J visas (spouses and children under the age of 19)
are eligible to enroll in the StudentSecure plans; however, the scholar must also
enroll in order to purchase the plan for dependents. Dependents of international
students and scholars on F and J visas (spouses and children under 18) can enroll
in the Gateway plans even when the scholar is covered by another insurance plan. You
can only enroll in the StudentSecure plan within 31 days of first arrival at UC
Berkeley. | | StudentSecure
Select Benefits & Exclusions | Benefits:
Please refer to the Plan Brochure for a complete list of covered services.
- StudentSecure Select will reimburse 100% of fees for most services provided
by University Health Services (UHS) at the Tang Center, after a $50 deductible
per injury or illness.
- Services provided by PPO providers are covered
100%, after a $100 deductible per injury or illness.
- Services provided
by non-PPO providers are covered at 80%, after a $100 deductible per injury or
illness.
- Maternity benefits are available when conception occurs after
the effective date of coverage.
- Prescription drugs are covered at 50%.
- The
maximum benefit per policy year is $300,000 for scholars and $50,000 for each
dependent.
- Preexisting conditions are covered after twelve months of continuous
coverage under a StudentSecure plan.
- Medical evacuation expenses are covered
up to $300,000 for the scholar and $50,000 for each dependent.
- Repatriation
of remains expenses are covered up to $25,000 per insured.
- An Accidental
Death & Dismemberment Coverage (AD&D) benefit of up to $25,000 for the
scholar is included. A lower benefit is offered to dependents.
Exclusions
- Preventive care, vision care and dental care are not covered.
- Charges
for use of an Emergency Room are not covered unless the patient is admitted as
an inpatient for further treatment.
- Conditions that existed in the 12
months prior to coverage (including pregnancy) are not covered.
The
above is a summary of benefits and exclusions. For
a complete list, print the plan brochure. StudentSecure also offers
a lower cost plan, called StudentSecure Budget. See the Plan Brochure
for additional information. | | Gateway
USA Benefits & Exclusions | Benefits: Please
refer to the Plan Brochure for a complete list of covered services.
- Minimum term of insurance is 15 days. Maximum initial or renewal term is 12
months, up to a total of 36 consecutive months.
- There is a $150 deductible
per policy period, applied once during each new term of insurance. For eligible
renewals, the deductible is applied once during every 12-month period from the
original effective date of insurance.
- After the deductible, Gateway USA
pays eligible expenses up to $5,000 and thereafter at 100% (up to the maximum
benefit amount or coverage period, whichever occurs first).
- Coverage
includes most services provided by University Health Services (UHS) at the Tang
Center, including prescription drugs but excluding mental health.
- Maternity
benefits are not offered.
- A maximum benefit of either $50,000 or $100,000
is available, depending on the plan premium chosen.
- Medical evacuation
expenses are covered up to $50,000.
- Repatriation of remains expenses
are covered up to $20,000.
- An Accidental Death & Dismemberment Coverage
(AD&D) benefit of up to $25,000 is included, and an optional additional benefit
of $100,000 may be purchased.
Exclusions - Gateway
USA does not cover preventive care, vision care, or dental care. Gateway USA also
excludes maternity care, mental health care, and substance abuse care.
- Conditions
that existed in the 12 months prior to coverage are not covered.
The
above is a summary of benefits and exclusions. For
a complete list, print the plan brochure. |
| Gateway
Premier Plan 1 Benefits & Exclusions | Benefits:
Please refer to the Plan Brochure for a list of covered services.
- Gateway Premier Plan 1 is for international scholars who travel to the United
Sates. [Plans 2 and 3 exclude travel to the US.]
- Minimum term of insurance
is six months. Coverage is available for a period of 6 months to one year, and
can be renewed for up to 12 months at a time for a maximum total of 60 consecutive
months (5 years).
- There is a $100 deductible applied once every 12 months.
You may also select a deductible of $500 and pay a lower monthly premium.
- After
the deductible, Gateway Premier pays 80% of eligible expenses up to $5,000 and
thereafter at 100% (up to the maximum benefit amount or coverage period, whichever
comes first).
- Coverage includes most services provided by University
Health Services (UHS) at the Tang Center, including prescription drugs but excluding
mental health.
- Maternity benefits are not offered.
- There is a
maximum benefit of $500,000.
- Medical evacuation expenses are covered up
to $100,000. Repatriation of remains expenses are covered up to $20,000.
- An
Accidental Death & Dismemberment Coverage (AD&D) benefit of up to $25,000
is included, and an optional additional benefit of $100,000 or $250,000 may be
purchased.
- Gateway Premier covers medical expenses on return trips home
up to $50,000.
- Gateway Premier covers expenses to return minor children
to their home country up to $5,000, subject to limitations.
Exclusions
- Gateway Premier does not cover preventive care, vision care,
or dental care. Gateway Premier also excludes maternity care, mental health care,
and substance abuse care.
- Conditions that existed in the 12 months prior
to coverage are not covered.
The above is a summary of benefits and
exclusions. For a complete list, print the plan
brochure. | | United
Chinese Plan -Health Insurance for students and scholars from certain Asian
countries | UnitedHealthcare Student Resources offers
an association health plan to students and scholars through the New York Service
Center for Chinese Study Fellows. The United Chinese Plan is an accident
and sickness policy. Students and scholars who reside in the following countries
are eligible foe enrollment: China, South Korea, Japan, Malaysia, Singapore, Indonesia,
Philippines, Burma, Vietnam, Cambodia, Laos, Brunei, North Korea, Mongolia, and
regions of Hong Kong, Macao, and Taiwan. Medical evacuation and repatriation benefits
are included. Two options are available.
The Standard plan (2008-1716-3) has the following benefits:
- Maximum lifetime benefit of $300,000.
- Claims
up to $1,500 paid at 100% (after deductible) and then 80% of the next $50,000.
- $45
per event deductible (maximum $180 per plan year), which is waived when services
are received at a student health center.
- Maternity benefits provided.
- Access
to a prescription drug discount program.
- An Accidental Death & Dismemberment
Coverage (AD&D) benefit of up to $15,000 is included.
The Premier plan (2008-1716-5) has the same coverage except it
covers claims up to $5,000 at 100% (after deductible) and thereafter
at 80% of the next $50,000, and it has a prescription drug benefit.
Certain benefit limits apply to both plans.
The above is a summary of benefits and exclusions. For a complete
list, print
the plan policy. Scholars can enroll
online for 3, 6, 9, or 12 months (note purchase date limitations
below). The plan may also be purchased for one month only, but
the application must be mailed or faxed in. Download the application
here.
|
| Plan Costs
| The figures below are monthly rates,
effective August 1, 2007 or as otherwise noted. Rates are subject to change. |
| StudentSecure Select -
Non-US Citizens | Scholar's
Age | Scholar | Scholar + Spouse | Scholar
+ Children | Scholar + Family | | Under
19 | $60 | -- | -- | -- |
| 19 - 23 | $80 | $374 | $225 | $524 |
| 24 - 30 | $95 | $468 | $245 | $618 |
| 31 - 40 | $172 | $650 | $283 | $819 |
| 41 - 50 | $295 | $728 | $369 | $878 |
| 51 - 64 | $380 | $813 | $445 | $963 |
| 65+ | Contact StudentSecure | StudentSecure
Budget - Non-US Citizen | Scholar's
Age | Scholar | Scholar + Spouse | Scholar
+ Children | Scholar + Family | | Under
19 | $40 | -- | -- | -- |
| 19 - 23 | $43 | $261 | $132 | $347 |
| 24 - 30 | $82 | $342 | $165 | $443 |
| 31 - 40 | $130 | $422 | $226 | $550 |
| 41 - 50 | $210 | $508 | $322 | $644 |
| 51 - 64 | $285 | $549 | $403 | $684 |
| 65+ | Contact StudentSecure | GatewayUSA
| Scholar's Age | Monthly* Premium with $50,000 maximum benefit | Monthly*
Premium with $100,000 maximum benefit | | 18-29 | $49 | $66 |
| 30-39 | $64 | $88 | | 40-49 | $92 | $128 |
| 50-59 | $126 | $168 | | 60-69 | $155 | $206 |
| 70-79 | $185 | N/A | | Each Child under 18
with parent | $26 | $34 | | $100,000 Additional
AD&D (Optional) | $14 per adult | $14 per adult | *Gateway
USA may also be purchased for 15 days only. See Plan Brochure for rate. Gateway
Premier Plan 1 | Scholar's Age | Monthly
Premium per Person | | Age 29 or Under | $80 |
| 30-54 | $125 | | 55-64 | $205 | | 65
or above | $432 | | Each Dependent Child (to age 18, or age
23 if a full-time student) | $40 | | $100,000 Additional
AD&D (Optional) | $12 per adult | | $250,000 Additional
AD&D (Optional) | $30 per adult | United Chinese
Plan - Standard |
| Annual |
Nine Months | Semi-Annual |
Quarterly | Monthly |
| Under Age 30 | |
Student or Scholar Only |
$485
|
$363
|
$243
|
$122
|
$41
|
| Spouse |
$2859
|
$2144
|
$1430
|
$716
|
$239
|
| Each Child |
$1238
|
$928
|
$619
|
$310
|
$104
|
| Age 30 and over |
| Student or Scholar Only |
$515
|
$386
|
$258
|
$130
|
$43
|
| Spouse |
$2859 |
$2144
|
$1430
|
$716
|
$239
| | Each Child |
$1238
|
$928
|
$619
|
$310
|
$104
| United Chinese Plan - Premier
| | Annual |
Nine Months | Semiannual |
Quarterly | Monthly |
| Under Age 30 | |
Student or Scholar Only |
$540
|
$404
|
$270
|
$136
|
$45
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| Spouse |
$3200
|
$2400
|
$1600
|
$801
|
$267
|
| Each Child |
$1384
|
$1038
|
$692
|
$347
|
$116
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| Age 30 and over |
| Student or Scholar Only |
$577
|
$432
|
$289
|
$145
|
$49
|
| Spouse |
$3200
|
$2400
|
$1600
|
$801
|
$267
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| Each Child |
$1384
|
$1038
|
$692
|
$347
|
$116
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Purchase Limitations:
Annual Can be purchased from 8/1/08 to 11/1/08
Nine Months Can be purchased from 8/1/08 to 2/1/09
Semiannual Can be purchased from 8/1/08 to 5/1/09
Quarterly Can be purchased from 8/1/08 to 8/1/09
Monthly Can be purchased from 8/1/08 to 10/1/09
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| How to
Enroll |
The StudentSecure, Gateway or United Chines Plan health insurance
plans may be purchased through the Student Health Insurance Office
at University Health Services, UC Berkeley's student health center.
In order to enroll in a plan, the scholar must attend an informational
meeting held every Tuesday morning at 10 a.m. in the Tang Center,
2222 Bancroft Way. Scholars must bring their passport, DS-2019
form and passports for all accompanying family members to the
meeting. Please be aware that insurance coverage may not be effective
immediately -- it can take from 3 to 10 days to complete the enrollment
process.
As noted
above, when the scholar does not purchase health insurance prior to traveling
to the United States, purchase of a travel insurance policy to cover the trip
and the first 30 days in the US is strongly recommended. |
| Emergency
Medical Evacuation and Repatriation Insurance | Emergency
medical evacuation and repatriation of remains insurance is required of all F
and J nonimmigrant visa holders. If your health insurance policy does not cover
these provisions, you may purchase a policy through the University. The policy
is available for download here.
| | Additional
Health and Welfare Services | See Additional
Health and Welfare Services for Visiting Scholars & Postdocs. |
| Questions
| For all questions, please call the UC Berkeley International
Health Insurance Advisor at (510) 642-5742, or email scholars@uhs.berkeley.edu. |
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