Student Health Plans Summary

DIANins · International Student Health Plans
Plan Comparison
White · Green · Blue 80/90/100 · Blue 80/90/100 CA — all use the U.S. network Aetna. Figures follow each plan's Schedule of Benefits; coinsurance (%) is In-Network unless noted.
The Blue plan names reflect the coinsurance level: Blue 80 pays 80%, Blue 90 pays 90%, Blue 100 pays 100%.

* White plan: This plan has many benefits with fixed daily limits. Plans of this type were widely introduced in the early 2000s and remain popular with students studying in cities with lower medical costs.

* Green plan: No daily limits, covering up to $500,000 per claim. Used ~20 years ago to meet many schools' waiver requirements, it is still popular as a waiver plan at schools in small and mid-sized cities. Relative to its premium, it covers preventive vaccinations at 100% up to $250/year.
* Blue plan: Launched in the late 2010s as a waiver plan for international students, the Blue plan is required as a waiver condition by most universities in larger, higher-cost cities. It offers very comprehensive benefits at a highly competitive price.

* Blue CA plan: Derived from the Blue plan, this version adds ACA-required benefits such as rehabilitation therapy, HIV screening, and pediatric dental.
Covered    Not covered    orange text = has a cap    best in this row
  WhiteBasic · Non-ACA GreenStandard Blue 80/90/100Comprehensive Blue 80/90/100 CAACA Comparable
Core Benefits
DeductibleIn-Network $100 $500

$500

$100

$0

$500

$100

$0

DeductibleOut-of-Network $100 $750

$750

$500

$200

$750

$500

$200

Maximum per policy year $100,000per illness/injury · $250,000/yr $500,000Lifetime unlimited Unlimited Unlimited Unlimited Unlimited
Out-of-pocket maximumIn-Network UnlimitedNo cap ⚠ $7,000

$7,000

$6,000

$5,000

$8,000

$7,000

$6,000

CoinsuranceIn-Network 100%* most items · OON 80% 80%OON 60%

80%

90%

100%

OON 70%

80%

90%

100%

OON 70%
Pre-existing condition 6-month waitStudent / Dependents 24mo 6-month waitStudent / Dependents 24mo No waitStudent / Dependents 24mo No wait Student & Dependents
Vaccine & Physical Exam No separate benefit $250/yr cap In-Net 100% In-Net 100%
Copay — Office visitPhysician / Specialist $0 $30 $25 $25
Copay — ERwaived if admitted $250 $250 $150 $150
Copay — SHC / Urgent CareSHC / Urgent Care $0 / $0 $15 / $30 $0 / $50 $0 / $50
Prescription Drugs Reimbursement only · $100max per illness, no tiers $20 / $40 / $70Tier 1 / 2 / 3 $10 / $30 / $50 Tier 1 / 2 / 3 $10 / $30 / $50 Tier 1 / 2 / 3
Other Key Benefits
Hospitalization $1,250/day · 30 days 80% · no daily cap 80%/90%/100% 80%/90%/100%
ICU / Cardiac $1,750/day · 30 days
Surgical Benefits included within limits within limits specified · 80%/90%/90% specified · 80%/90%/90%
Reconstructive Surgery
Inpatient Rehabilitation 45 days
Maternity Vaginal $5,000 / C-section $7,500 80% 80%/90%/100% 80%/90%/100%
Elective Abortion life-threatening only life-threatening only $1,500 80%/90%/100%
Mental Health $3,000 · 30 visits · 80% 80% 80%/90%/100% 80%/90%/100%
Physical / Therapeutic 12 visits · $35/visit 80% 12 visits 80%
Cancer & Oncology Inpatient $1,000 + Outpatient $1,000 80% 80%/90%/100% 80%/90%/100%
AIDS · HIV · STD Excluded 80% (schedule) 80%/90%/100% 80%/90%/100%
Alcohol / Substance $50/visit · 30 days 80% UCR 80%/90%/100% UCR 80%/90%/100% UCR
Chiro / Acupuncture $500 $500
Home Health / Hospice Hospice 45 days / $5,000
Organ / Transplant 1 per lifetime
Congenital / Habilitative 80%
Allergy / HIV Screening HIV screening 100%
Pediatric Dental / Vision Children only
Emergency Dental $500/tooth 80% $250/tooth · $1,000 $250/tooth · $1,000
Palliative Dental $600 $600
Recreational Sports 80%/90%/100% 80%/90%/100%
Evacuation / Repatriation 100% 100% 100% 100%
Exclusions carved back in higher plans
AIDS · HIV · STD
Elective Abortion
Chiro / Acupuncture
Recreational sports (non-competitive)
Organ / Transplant
Excluded in all four
Gender identity/dysphoria · cosmetic/elective surgery · infertility (IVF)/sterilization · vision correction·glasses·LASIK (except pediatric vision) · dental (except accidental/pediatric) · hearing aids · obesity/weight-loss treatment · smoking cessation · sleep studies (sleep apnea) · sexual dysfunction · genetic screening · breast reduction · travel immunizations · competitive/hazardous sports (varsity·club competition, skydiving, scuba beyond 30m, etc.)·motorcycles · war·terrorism · home-country care (beyond schedule) · care by a family member · costs reimbursable by other insurance/government
How the out-of-pocket maximum (OOPM) accrues —: For White · Green · Blue, the deductible and copays do not accrue toward the OOPM. In contrast, Blue CA is an ACA-style structure where deductible, copays, and coinsurance all count toward the OOPM. White's OOPM is itself "Unlimited (no cap)", so out-of-pocket costs can grow large on major claims.
* White coinsurance: most items pay 100% In-Network Preferred Allowance, except mental health, ER, and cancer at 80%. Out-of-network 80% overall.
Common: all four plans use the U.S. Aetna network, are issued by Spectrum Life, and use Global Reach Rx network pharmacies for prescriptions.
This table summarizes the Schedule of Benefits; final contract terms follow the official policy document.