Student Health AdvantageSM
Student Health AdvantageSM

All amounts shown are in U.S. dollars.
Summary of Benefits
Maximum Limit Student- $500,000
Dependent- $100,000
Maximum Limit per Illness or Injury Student- $300,000
Dependent- $100,
Deductible $100 per illness or injury
Student Health Center: $5 copay per visit
Coinsurance Outside of the U.S.: Company pays 100%
In PPO Network or Student Health Center within the U.S.: Company pays 100%
Out of PPO Network if within the U.S.: Company pays 80% of eligible expenses up to $5,000; then 100% thereafter
Eligible Medical Expenses After deductible is met, company pays 80% of expenses out-of-network (U.S.) or 100% in-network (U.S.) and internationally
COVID-19/SARS-CoV-2 Coverage COVID-19/SARS-CoV-2 shall be considered by the Company the same as any other Illness or Injury, subject to all other Terms and conditions of this insurance
Hospitalization Room and Board Average semi-private room rate, including nursing service
Hospital Emergency Room Injury Company pays 80% of expenses out-of-network (U.S.) or 100% in-network (U.S.) and internationally. Not subject to emergency room deductible
Hospital Emergency Room Illness After deductible is met, company pays 80% of expenses out-of-network (U.S.) or 100% in-network (U.S.) and internationally. Subject to a $250 deductible for each visit that doesn’t result in a direct hospital admission
Intensive Care After deductible is met, company pays 80% of expenses out-of-network (U.S) or 100% in-network (U.S.) and internationally
Mental or Nervous / Substance Abuse Outpatient: $50 per day; $500 maximum limit;
Inpatient: After deductible is met, company pays 80% of expenses out-of-network (U.S.) or 100% in-network (U.S.) and internationally up to $10,000 maximum limit;
Prescription Drugs and Medication After deductible is met, company pays 80% of expenses out-of-network (U.S.) or 100% in-network (U.S.) and internationally; $250,000 period of coverage limit for insured student and $100,000 period of coverage limit for dependents. Retail pharmacy prescription drugs and medication are paid at 50% out-of-network and international with a 90 day dispensing maximum.
Physical Therapy
(Medical order or treatment plan required)
After deductible is met, company pays 80% of expenses out-of-network (U.S.) or 100% in-network (U.S.) and internationally; limit one visit per day
Emergency Local Ambulance $350 per illness resulting in an inpatient hospitalization or injury
Dental Non-emergency treatment at a dental provider due to an accident - $500 period of coverage limit per injury; Unexpected pain to sound, natural teeth - $350 period of coverage limit
Interfacility Ambulance Transfer
(For services rendered in the U.S.)
Company pays 100%. Transfer must be a result of an inpatient hospital admission
Emergency Medical Evacuation $500,000 maximum limit
Emergency Reunion $50,000 maximum limit
Return of Mortal Remains $50,000 maximum limit
Political Evacuation and Repatriation $10,000 maximum limit
Intercollegiate/Interscholastic/ Intramural or Club Sports $5,000 period of coverage limit per illness or injury
Incidental Trip Coverage Up to a cumulative 14 days (available for non-U.S. residents only)
Pre-existing Conditions Charges excluded until after 12 months of continuous coverage
Terrorism $50,000 maximum limit
Accidental Death & Dismemberment Student: $25,000 principal sum; Spouse: $10,000 principal sum; Dependent child: $5,000 principal sum Accidental dismemberment percentage of principal sum
Personal Liability
(Secondary to any other insurance)
$10,000 combined maximum limit
Injury to third person: subject to a $100 per injury deductible
Damage to third person's property: subject to a $100 per damage deductible

* This Web page contains only a consolidated and summary description of all current benefits, conditions, limitations and exclusions. A certificate containing the complete Certificate Wording with all terms, conditions and exclusions will be included in the fulfillment kit. IMG reserves the right to issue the most current Certificate Wording for this insurance plan in the event this Web page, application, and/or brochure has expired, is modified, or is replaced with a newer version. Current Certificate Wordings are available upon request.