All foreign nationals 14 days or older and 69 years or younger who are visiting within the boundaries of the United States with valid visa are eligible to enroll.
How much does the plan cost ?
The premium rates are based on age, deductible selection, and the period of coverage.
International Visitor Emergency Medical Insurance Plan GLB9499910
All charges shown include administrative fees and premiums.
What does the plan cover ?
This Plan covers Emergency, and Emergency ONLY. Based on the age of the Insured, the maximum coverage is :
Insured Age
Maximum
14 Days - 29
$250,000
30 - 39
$150,000
40 - 49
$50,000
50 - 59
$25,000
60 - 69
$25,000
What does the plan not cover ?
This Plan does not cover cancer, child birth, mental disease and pre-existing conditions, except heart-related emergencies, which covers up to $10,000.00
How to enroll ?
Fill out the Enrollment Form and pay the premium online through PSI's secured website. You may then retrieve your Insurance ID Card, Claim Form, Policy Brochure and other insurance documents from the PSI website.
How to use the insurance ?
In the event of sickness or injury, the student should:
1. Report at once to the Student Health Center, if available.
2. For referral to a participating doctor. call 1-800-878-7896 PIN# 3722
3. Submit Medical Claims by MAIL or ONLINE.
BY MAIL - Send this Claim Form & All Itemized Bills to:
Benefit Concepts, Inc.
PO Box 60608, King of Prussia, PA 19406
ONLINE - Doctors/Hospitals can also send claims billing via Electronic Data interchange (EDI) Payor ID:51037
