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INTERNATIONAL STUDENT PLANS

Rates, Benefits, and Applications Included

Mountaineer is a high-end health plan for international students and scholars studying in the United States. Rates start at $70 per month for students age 25 and under. Mountaineer is an affordable alternative to MSU’s school insurance program.

If you have continuous coverage under a prior US insurance policy without interruption, you will receive credit toward Mountaineer’s six-month pre-existing condition limitation.

Enroll in the Mountaineer Plan Now!

Plan Highlights

  • High lifetime medical maximum
  • No copayment for treatment received at Student Health Center
  • $500,000 medical evacuation benefit
  • Dependent coverage available

Waiver Instructions

  • All Fall Semester and Annual waiver requests must be completed by 2/15/14.
  • Make sure you have all necessary waiver information available BEFORE commencing the waiver process. Complete ALL necessary information before leaving the waiver site.

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Summary of Benefits (Policy #GLMN05007367)

Benefit Description
Mountaineer

Lifetime Medical Maximum

$2,000,000

Maximum per Injury/Sickness

$300,000

Maximum Out-of-pocket Expense

$2,000

Coinsurance

Plan pays 80% of first

$4,000 in expenses

and 100% thereafter

Copays**

  • Student Health Center

No copay

  • Elsewhere

$40

  • Emergency Room (waived if admitted)

$100

  • Hospital

$250

  • X-ray and Lab Tests

$40

  • Prescription Drugs

$20 (Generic)/
$30 (Other)

Home Country Coverage

$1,000

Emergency Medical Evacuation

$500,000

Emergency Medical Reunion

$2,000

Repatriation of Remains

$100,000

Accidental Death & Dismemberment Coverage

$20,000

*  You pay less for care received at the Student Health Center or from a doctor or hospital in the extensive Cofinity provider

network. If there are no Cofinity providers within 25 miles of where you are located, benefits will be paid at the In-Network level.

**Copays are waived if the participant is treated onsite at the Student Health Center and is not referred off campus:

  • In the case of a participant not being able to be treated at the Student Health Center and subsequently being referred to an off-campus private doctor by a licensed general health practitioner at the Student Health Center, the copay will be half of the scheduled copay amount.
  • In the case of treatment not being possible at the Student Health Center and the participant being referred to the ER by a licensed general health practitioner at the Student Health Center, the copay will be half of the scheduled copay amount.
  • In the case of treatment not being available at the Student Health Center, or if there is not one, and the participant is referred to or forced to go the ER and then subsequently hospitalized, then the ER, doctor’s visit and hospitalization copays will be integrated to a maximum of $250.

Rates (Per Month)

Participant Only: Age 25 and under

$70

Participant Only: Age 26 or Over

$84

Participant with Spouse

$280

Participant with Spouse and 1 Child

$315

Participant with Spouse and Children

$385

Participant with 1 Child

$245

Participant with Children

$280

Enroll in the Mountaineer Plan Now!