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University of Michigan
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U-M Health Insurance Standards
1.The following kinds of insurance plans are not considered to be comparable to the U-M International Student/Scholar Insurance (IHI) and therefore are NOT acceptable: a.Travel insurance is not acceptable. Travel insurance is in effect for a short period of time (60-90 days, for example) and is designed for short trips. Insurance that you plan to substitute for the IHI Plan should be in effect at least through August 31 of the current academic year unless you plan to leave the University permanently before then.
b.Insurance that covers emergencies only is not acceptable.
c.Insurance that pays for a patient's condition to be ¡°stabilized¡± but then requires the patient to be returned to the home country for treatment is not acceptable.
d.Coverage under MediShare (or other forms of cost-sharing arrangements that are not true medical insurance) is not acceptable.
e.Insurance that does not cover or limits coverage for pre-existing conditions is not acceptable.
2.Preventive care must be covered at 100% of usual and customary charges in the Ann Arbor, Michigan area. The IHI plan will include this coverage effective September 1, 2012, in order to comply with the Affordable Care Act. Insurance plans will not be considered comparable to the IHI plan unless they are also in compliance with the Affordable Care Act.
3.Pregnancy must be treated as any other medical condition. Coverage for maternity/pregnancy must be provided regardless of your age or gender, or the age or gender of your dependents (this is to be in compliance with federal antidiscrimination laws, specifically Title IX of Education Amendments of 1972, as amended by the Civil Rights Restoration Act of 1987). Insurance plans that exclude pregnancy coverage or severely limit it will not be accepted.
4.Oral contraceptives must be covered at 100% of usual and customary charges in the Ann Arbor, Michigan area. The IHI plan will include this coverage effective September 1, 2012, in order to comply with the Affordable Care Act. Insurance plans will not be considered comparable to the IHI plan unless they are also in compliance with the Affordable Care Act.
5.The insurance plan must provide medical benefits of $500,000 or more PER accident or illness. This amount must be available for each accident or illness. For example, a plan paying up to $250,000 for accident and $250,000 for illness would not be acceptable, or a plan that has a maximum benefit of $500,000 per policy year as opposed to per issue would not be acceptable either.
6.The insurance plan must cover at least 80% of usual and customary charges in the Ann Arbor, Michigan area for hospital room, board, miscellaneous hospital expenses, physician expenses in and out of the hospital, ambulance service, outpatient labs, x-rays, and diagnostic tests. The plan may not contain specific limitations for the treatment of medical conditions relative to standard hospital or outpatient care. For example, an insurance plan that has limited coverage of hospital room and board to $500 or limited coverage of ambulance costs to $350 would not be acceptable.
7.The insurance plan must cover at least 90% of usual and customary charges for prescription drugs.
8.The insurance plan must have a deductible of no more than $100 per accident or illness, or $150 per policy year.
9.The insurance plan must cover both inpatient and outpatient mental health treatment and must cover treatment for substance abuse (both alcohol and drug abuse.) This coverage must be comparable to the coverage provided by the IHI Plan. The IHI plan covers 100% of in-network charges for inpatient mental health treatment after a $150 co-pay per admission, and covers outpatient mental health treatment with a co-pay of $20 per visit (in network) or 80% of the recognized charge (not in network).
10.The insurance plan must not contain major differences in coverage between the primary insured and dependents.
11.The insurance plan must cover treatment related to suicide or attempted suicide.
12.There must be a U.S. phone number for the insurance claims agent.
13.The plan must have a
¡°medical evacuation to home country¡± benefit of at least $50,000 and a
¡°repatriation of remains¡± benefit of at least $25,000.
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