TaiAn Select ExtendSM
TaiAn Select ExtendSM

 
PLAN INFORMATION & HIGHLIGHTS
Maximum Limit Unlimited Unlimited Unlimited
Coinsurance for Eligible Medical Expenses Plan pays 80%; Insured pays 20% Plan pays 70%; Insured pays 30% Plan pays 80%; Insured pays 20%
Deductible Options $0, $250, or $500
MyIMGSM 24-hour secure access from anywhere in the world to manage your account at anytime
International Emergency Care A wide range of international emergency benefits available, including emergency evacuation, emergency reunion, and return of mortal remains
Dependent Coverage Coverage provided for dependents of faculty, scholars, students, and exchange participants
Optional Add-on Plan Additional coverage is available for high school sports, personal liability, and legal assistance
Student Health Center $5 copay per visit
Pre-existing Conditions Period of coverage limit (after 12 months of continuous coverage): $100,000
Maximum limit: $125,000
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
MEDICAL BENEFITS
Eligible Medical Expenses 80% 70% 80%
Physician Visits/Services
  • Maximum visits per day: 1
 80% 70% 80%
Urgent Care Clinic
  • Copayment: $40
  • Copayment is not applicable if declaration states a $0 deductible
80% 70% 80%
Teladoc Consultation* - U.S. services only 100% N/A N/A
Hospital Emergency Room
  • Injury: Not subject to Emergency Room Deductible
  • Illness: Subject to a $250 deductible for each emergency room visit for treatment that does not result in a direct hospital admission
80% 70% 80%
Hospitalization/Room & Board 80% 70% 80%
Intensive Care 80% 70% 80%
Bedside Visit
  • Not subject to Deductible
  • Maximum Limit: $1,500
  • Hospitalized in an Intensive Care Unit
  • Refer to the BEDSIDE VISIT provision for further details
 100% 100% 100%
Physical Therapy: Inpatient
Medical order or treatment plan required		 80% 70% 80%
Physical Therapy: Outpatient
  • Maximum visits per day: 1
  • Medical order or treatment plan required
 80% 70% 80%
Prescription Drugs and Medication
  • Maximum limit per period of coverage: $250,000
  • Obtained through retail pharmacy, inpatient and outpatient surgery, emergency room and outpatient office visits
  • 90 day dispensing maximum
  • Prescription drugs and medication maximum limit accumulates toward the plan maximum limit
 80% 70% 80%
EMERGENCY SERVICES (When coordinated through the Plan Administrator)
Emergency Local Ambulance
  • Injury / Illness resulting in an inpatient hospital admission
 N/A 80% 80%
Emergency Medical Evacuation
  • $50,000 maximum limit
 100% 100% 100%
Emergency Reunion
  • $15,000 maximum limit
  • 15 day maximum
  • $25 meal maximum per day
100% 100% 100%
Interfacility Ambulance Transfer
  • Services rendered in the U.S.
  • Transfer must be a result of an Inpatient Hospital admission
100% 100% N/A
Political Evacuation & Repatriation
  • $10,000 maximum limit
 100% 100% 100%
Return of Mortal Remains
  • $25,000 maximum limit for return of mortal remains or $5,000 for cremation/burial
100% 100% 100%
OTHER SERVICES
Accidental Death & Dismemberment Principal sum maximum limit: $25,000
Accidental Death: 100% of Principal Sum
Death must occur within 90 days of the accident
Dental Treatment
  • Subject to deductible and coinsurance
  • Period of Coverage Limit: $350 (treatment due to unexpected pain to sound, natural teeth)
  • Period of Coverage Limit per Injury: $500 (Non-emergency treatment by a dental provider due to an accident)
N/A 80% 80%
Traumatic Dental Injury
  • Subject to deductible and coinsurance
 80% 70% 80%
Incidental Trip
  • Subject to deductible and coinsurance
  • Insured person’s country of residence is not the United States
  • 14 days maximum
N/A N/A 80%
Terrorism
  • Maximum limit: $50,000
 100% 100% 100%
OPTIONAL ADD-ON PLAN
High School Interscholastic, Intramural, or Club Sports Coverage Up to Maximum Limit per Illness or Injury shown in the Declaration for Eligible Medical Expenses
Lost Personal Property $250 Maximum Limit per Period of Insurance for loss or theft of (a) Baggage; (b) Valuables; or (c) Personal papers.
Legal Assistance $500 Maximum Limit per Period of Coverage for legal expenses incurred in the event the Insured Person is served a summons, complaint, or other legal notice of a valid claim for personal injury or property damage against the Insured Person
Personal Liability

$2,000 Maximum Limit per Period of Coverage after $100 deductible is met for Injury caused by the Insured Person to a third party.

$500 Maximum Limit per Period of Coverage after $100 deductible is met for damage caused by the Insured Person to a third party’s property.

*Coverage for a Teladoc Consultation is not a determination that any specific condition discussed, raised, or identified during such consultation is covered under this insurance. The company reserves the right to decline future claims relating to or arising from any condition discussed, raised or identified during a Teladoc Consultation where the Illness or Injury is directly or indirectly related to any Pre-Existing Condition or is otherwise excluded under this Certificate of Insurance All coverage and benefits in the plan are in United States (U.S.) dollars. Benefits are subject to the exclusions and limitations and are payable only at Usual, Reasonable and Customary charges. This is a summary of a selection of plan benefits offered only as an illustration and does not supersede in anyway the Certificate of Insurance and governing policy documents (together the “Insurance Contract”). The Insurance Contract is the only source of the actual benefits provided.

All coverage and benefits in the plan are in United States (U.S.) dollars. Benefits are subject to the exclusions and limitations and are payable only at Usual, Reasonable and Customary charges. This is a summary of a selection of plan benefits offered only as an illustration and does not supersede in anyway the Certificate of Insurance and governing policy documents (together the “Insurance Contract”). The Insurance Contract is the only source of the actual benefits provided.

 
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