Liaison Student Travel Medical Insurance International Student Rates

International Medical & Travel Insurance
Call 888.708.0812 or
+1.503.642.4646
FAX - +1.503.212.5599

Rates: International Students
foreign nationals studying in the US

Plan M – 80% Coinsurance / see schedule for deductible
Age Band	Participant	Participant’s Spouse	Participant’s Child
0-18	$37.00/$1.23	$84.00/$2.80	$83.00/$2.77
19-23	$40.00/$1.33	$134.00/$4.47	$83.00/$2.77
24-30	$74.00/$2.47	$195.00/$6.50	$83.00/$2.77
31-40	$110.00/$3.67	$228.00/$7.60	$83.00/$2.77
41-50	$182.00/$6.07	$282.00/$9.40	$83.00/$2.77
51-64	$248.00/$8.27	$282.00/$9.40	$83.00/$2.77
	monthly/daily	monthly/daily	monthly/daily

Plan N – 100% Coinsurance / see schedule for deductible
Age Band	Participant	Participant’s Spouse	Participant’s Child
0-18	$51.00/$1.70	$100.00/$3.33	$99.00/$3.30
19-23	$67.00/$2.23	$155.00/$5.17	$99.00/$3.30
24-30	$98.00/$3.27	$235.00/$7.83	$99.00/$3.30
31-40	$142.00/$4.73	$303.00/$10.10	$99.00/$3.30
41-50	$243.00/$8.10	$330.00/$11.00	$99.00/$3.30
51-64	$314.00/$10.47	$350.00/$11.67	$99.00/$3.30
	monthly/daily	monthly/daily	monthly/daily