Patriot Exchange Program| International Student Protection

Patriot Exchange Program ^SM
Short-term accident and sickness coverage available from one month up to four years for educational and cultural exchange programs, including J1 scholars and exchange program participants, as well as J2 dependents of J1 visa holders.

Patriot Exchange Program is designed to meet the U.S. visa travel insurance requirements for individuals studying abroad or participating in a cultural exchange program, including J1 and J2 visa holders. Coverage may be purchased for spouses and unmarried dependent children traveling with the student/participant on individual coverage. Individuals and groups have the option to select from different plan options - $50,000, $100,000, $250,000, and $500,000 maximum per illness/Injury.

The $50,000 maximum per Illness/Injury option does not comply with J1 and J2 visa requirements.

Please note the rates displayed below reflect a $100 deductible per occurrence. Enrollees can choose from deductible options of $0, $100, $250, or $500 after clicking Enroll Now and proceeding to obtain a quote.

Rates (per month) --$100,000 Benefit Maximum

Rates (per month)-- $250,000 Benefit Maximum

Rates (per month)-- $500,000 Benefit Maximum

DETAILED BROCHURE

Patriot Exchange Program^SM

SUMMARY OF BENEFITS - ELIGIBLE MEDICAL EXPENSES ARE LIMITED TO USUAL, REASONABLE AND CUSTOMARY LIMITS PER PERIOD OF COVERAGE UNLESS STATED AS MAXIMUM LIMIT
Maximum Limit	$5,000,000
Deductible Options	$0, $100, $250 or $500 per illness or injury available
Maximum Limit Per Illness or Injury	Choice of $50,000, $100,000, $250,000 or $500,000
Coinsurance	Company pays 100%

INPATIENT/OUTPATIENT BENEFITS
Hospital Room and Board	Up to average semi-private room rate
Intensive Care Unit	Company pays 100% after deductible is met
Physical Therapy	Company pays 100% after deductible is met; one visit per day (Medical order or treatment plan required)
Bedside Visit	$1,500 maximum limit. Must be hospitalized in an intensive care unit. Not subject to deductible
Physician Visit	Company pays 100% after deductible is met; one visit per day
Student Health Center	$5 copay per visit. Not subject to deductible
Prescription Drugs	Company pays 100% after deductible is met 90 day dispensing maximum
Urgent Care	$50 copay. Not subject to deductible. Copay is not applicable if you choose a $0 Deductible
Walk-in Clinic	$20 copay. Not subject to deductible. Copay is not applicable if you choose a $0 Deductible
Eligible Medical Expenses	Company pays 100% after deductible is met
Emergency Room visit with In-patient Admission	Company pays 100% after deductible is met
Emergency Room visit without In-patient Admission	Additional $250 deductible
Interfacility Ambulance Transfer (For Services Rendered in the U.S. )	Company pays 100%. Transfer must be a result of an inpatient hospital admission Not subject to deductible
Dental	Non-emergency treatment at a dental provider due to an accident: $500 period of coverage limit per injury; Treatment due to unexpected pain to sound, natural teeth: $350 period of coverage limit
Mental or Nervous / Substance Abuse	Not covered if incurred in student health center Inpatient: $10,000 maximum limit Outpatient: $50 maximum limit per day. $500 maximum limit

EVACUATION BENEFITS (NOT SUBJECT TO DEDUCTIBLE)
Emergency Medical Evacuation	$50,000 maximum limit
Emergency Reunion	$15,000 maximum limit
Return of Mortal Remains or Cremation/Burial	$25,000 maximum limit for return of mortal remains or $5,000 maximum limit for cremation/burial
Political Evacuation	$10,000 maximum limit

ADDITIONAL BENEFITS
Accidental Death & Dismemberment	$25,000 principal sum; Not subject to deductible
Terrorism	$50,000 maximum limit; Not subject to deductible
Sudden & Unexpected Recurrence of a Pre-existing Condition	Eligible medical expenses: $5,000 maximum limit Emergency medical evacuation: $25,000 maximum limit
Pre-Existing Conditions	For conditions existing within 36 months before effective date, charges excluded until after 12 months of coverage and then $500 per period of coverage and $1,500 maximum limit
Incidental Trip Coverage (Available for non-U.S. residents only)	Up to a cumulative 14 days

OPTIONAL ADD-ON RIDERS
Lost Personal Property	$250 per period of coverage limit
Legal Assistance	$500 per period of coverage limit
Personal Liability - Injury to third party Personal Liability - Damage to third party’s property	$2,000 per period of coverage limit after $100 deductible $500 per period of coverage limit after $100 deductible