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Cleveland State University ̱бCleveland State University
Ȩ л, ȯ, ýĮ, Ʈ, ⱹϽô ݰ е ϽǼ ִ Դϴ.
Ͻø û ۼ ֽðų ̸ ֽø ˴ϴ.
ǽð Ͻø MSN ȭ ߰ ֽø ܱ ô Ǹ ϽǼ ֽϴ.

 

 

    

 

 

  Cleveland State University DBغ ǥԴϴ

 

 

 

 

 

Insurance  Provider

 

б

(Gold Plan)

DBغ

 

Lifetime Maximum

 

$150,000

Unlimited

 

Benefit

 

$150,000

 

$50,000 per Sickness or Injury

 

 

 

º̿/ȸδ

 

 

Preferred Care  : 100%

100%

 

 

 

º/ȸδ

 

 

Non-Preferred Care:70%

100%

 

 

Deductible

δ

 

  $350 per Policy Year

 

$0

 

 

Prescription Drug

 

(పδ)

 

 

$10 ~ $45

δ

$1,500 

ѵ

δ

Premium

(Annual)

 

Student: $1,762

Spouse: $5,725

Child: $3,085

 

 

Student: $480

 Spouse: $480

Child: $480

 

 

 

 

 

 

 

 

 

 

 

 




 

 

 

 

 

 

 

б޺

 

1. δ:  deductible δؾ ϴ ٴ

ǹմϴ.  deductible: $350

 

 

2. κп Preferred Care: 100% Non-Preferred Care:60%

 

  Non-Preferred Care   

忰 ġ  4 ߻Ͽٸ  

$40,000x60%( Non-Preferred Care) -Deductible $350= $23,650 ȸ翡 κ δ ϼž մϴ.

 

 3. δ ־ Ҹϴ.

 

4. ( copay )δ ִ  

 

 

 

 

 

 

 

Insurance waiver

 

All international students (F-1 & J-1visas)are required to carry health insurance while attending Cleveland State University. Your Treasury Service account will be billed for the GM-Southwest, Inc. Student Health Insurance Plan upon registration for classes

International students are required to buy the CSU health insurance policy. Students may not purchase insurance from an outside carrier

CSU Health Insurance Waivers

Waivers from the university health care policy are granted only in the following situations

 

You have insurance coverage because you are sponsored by the U.S. Government,your country's government, or the U.N.

You have insurance coverage because a parents works in th U.S.,your spouse works in the U.S. or you work in the U.S.

You are presently insured and receiving benefits for a pre-existing condition. Changing coverage would result in the loss of benefits

You are currently in the U.S. with a minor F-2 dependant and must be insured by another carrier in order to secure appropriate coverage for your dependant

In addition, your current policy must meet the following CSU minimum requirements:

 

Medical Benefits of at least 80% of first $50,000 of covered expense

Repatriation of Remains in the amount of atleast $10,000

Expenses for Medical Evacuation to home Country at least 15,000

Deductible of no greater than $350 per calendar year

Co-payment or coinsurance not to exceed 20% of covered expenses

Company who provides the coverage has required rating

 

 

 

 

 

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