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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:

  1. Medical benefits of at least $50,000 per accident or illness.
  2. Deductible no greater than $500 per accident or illness.
  3. 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).
  4. Coverage of expenses associated with repatriation of remains in the amount of $7,500 (minimum).
  5. Pre-existing conditions must be covered after a 12-month waiting period.
  6. 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.
  7. Coverage cannot exclude benefits for perils inherent to the activities of the program in which the visitor participates.
  8. 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 AgeScholarScholar + SpouseScholar + ChildrenScholar + 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 AgeScholarScholar + SpouseScholar + ChildrenScholar + 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 AgeMonthly* Premium with $50,000 maximum benefitMonthly* 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$185N/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 AgeMonthly 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
Spouse
$3200
$2400
$1600
$801
$267
Each Child
$1384
$1038
$692
$347
$116
Age 30 and over
Student or Scholar Only
$577
$432
$289
$145
$49
Spouse
$3200
$2400
$1600
$801
$267
Each Child
$1384
$1038
$692
$347
$116

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

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 InsuranceEmergency 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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