University of California, Los Angeles
- The plans below are designed to meet the U.S. Department of State requirements for J visas.
- For Plans that we offer to Recent Grads, OPT Participants, and H1B visa holder, click HERE.
Age
Maple J1
- No Lifetime Limits On Benefits
- $100,000 per Injury/Illness
- Coinsurance: 80% In-Network, 60% Out-Network
- Physician Office Visit Copayment - $0
- Urgent Care Center Copayment - $0
- Diagnostic X-ray Services - 80% PA
- Laboratory Procedures - 80% PA
- Prescription Drug Benefits - 80% PA
- Repatriation of Remains - $25,000
- Medical Evacuation - $50,000
- A.M. Best rating: A
- COVID is treated like any other sickness
Cedar J1
- No Lifetime Limits On Benefits
- $100,000 per Injury/Illness
- Coinsurance: 100%
- Physician Office Visit Copayment - $0
- Urgent Care Center Copayment - $0
- Diagnostic X-ray Services - 100% PA
- Laboratory Procedures - 100% PA
- Prescription Drug Benefits - 100% PA
- Repatriation of Remains - $25,000
- Medical Evacuation - $50,000
- A.M. Best rating: A
- COVID is treated like any other sickness
J1 Scholar Premier
- Worldwide Coverage (excluding home country)
- $500,000 per Injury or Sickness
- Coinsurance: 80% In-Network
- In-Network Deductible: $100 per Illness or Injury
- Vaccines and Testing - 100% (EHIM In-Network)
- Urgent Care - $0 copay
- Out-of-pocket Maximum - $6,950
- Prescription Drugs $20/$40/$60 copay
- Pre-Ex Condition - 6 month waiting period
- ER $250 Copay (waived if admitted)
- Diagnostic Services and Laboratory Tests
- Mental Health Benefits
- Medical Evacuation & Repatriation
The plan comparison and benefit information provided on this webpage is for general reference only and does NOT guarantee coverage or payment. For complete and detailed information
regarding your coverage, plan benefits, exclusions, and claims procedures please download the official Policy Brochure and/or Terms & Conditions. The provisions outlined in the Policy Brochure
and/or Terms & Conditions will prevail.
PSI gathered this information as a resource for students, and this does not intend to imply a relationship between your school and our website, or company. Our plans simply offer an
alternative to the university's student health insurance plan.
See what your alumni said...
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