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2019 J-1 Visa Plan

Plan Type
Medical

The J-1 Visa Plan is a point-of-service plan where costs are less if covered individuals use providers in the plan’s network whereas accessing doctors, hospitals, and providers outside the network can be accessed without a referral for an additional cost. The J-1 Visa Plan includes the Prescription Drug Plan.

Features
  • No contribution for employee-only coverage.
  • Aetna Open Choice PPO Network.
  • After meeting the annual deductibles, coverage begins for all other medical services.
  • After reaching the out-of-pocket maximums (OPMs), services are covered at 100%.
  • In-network providers deliver coverage at the lowest cost. All out-of-network costs are subject to reasonable and customary limits.
  • A claim form must be submitted to be reimbursed for out-of-network expenses.

To minimize costs, consider using the following providers and resources:

Coverage Options
In-Network
Out-of-Network
Plan Design
Employee
$0.00
Employee & Children
$260.00
Employee & Spouse
$345.00
Family
$526.00
In- or Out-of-Network
Individual
$500.00
Family
$1,000.00
In- or Out-of-Network
Individual
$2,500.00
Family
$5,000.00
Physician Visits

Telemedicine (Offered through Teladoc)

In- or Out-of-Network
$40 until deductible is met, then 20% after deductible

Telemental Health (Offered through Teladoc)

In- or Out-of-Network
20% after deductible

Primary Care Physician (PCP)

In- or Out-of-Network
20% after deductible

Preventive Care & Immunizations

In- or Out-of-Network
20% after deductible

Specialists

In- or Out-of-Network
20% after deductible
Emergency & Urgent Care Services

Urgent Care Center

In- or Out-of-Network
20% after deductible

Emergency Room (No coverage for non-emergencies)

In- or Out-of-Network
20% after deductible
Maternity

Prenatal Care Visits

In- or Out-of-Network
20% after deductible

Delivery

In- or Out-of-Network
20% after deductible

Post-Partum Visits

In- or Out-of-Network
20% after deductible
Inpatient Services

Medical & Surgical Procedures

In- or Out-of-Network
20% after deductible

Mental Health

In- or Out-of-Network
20% after deductible
Outpatient Services

Surgical Procedures

In- or Out-of-Network
20% after deductible

Laboratory

In- or Out-of-Network
20% after deductible

Radiology (X-Ray)

In- or Out-of-Network
20% after deductible

Hi-Tech Radiology (MRI, CAT, etc.)

In- or Out-of-Network
20% after deductible

Mental Health

In- or Out-of-Network
20% after deductible

Annual Eye Exam

In- or Out-of-Network
Not covered

Prescription Eyeglasses and/or Contact Lenses

In- or Out-of-Network
Not covered

Physical Therapy (100 visits per calendar year)

In- or Out-of-Network
20% after deductible

Speech Therapy / Occupational Therapy / Pulmonary & Cardiac Rehabilitation (100 visits per calendar year)

In- or Out-of-Network
20% after deductible

Chiropractic Care (20 visits per calendar year)

In- or Out-of-Network
20% after deductible

Acupuncture (20 visits per calendar year)

In- or Out-of-Network
20% after deductible
Additional Information

All employees with a J-1 Visa can elect coverage under the J-1 Visa Plan or HMO Plan. The J-1 Visa Plan is the default option for J-1 visa holders who do not elect or waive a medical plan.

The U.S. government requires that J-1 visa holders and their dependents have health insurance coverage while at Princeton University as an exchange scholar. If medical coverage is waived at Princeton, J-1 visa holders must be covered for health insurance through their home country, institution, or own private policy. The health insurance must provide J-1 visa holders and their dependents with the following coverage:

Medical benefits of at least $100,000 per accident or illness with a deductible not to exceed $500 per accident or illness;

At least $50,000 for expenses associated with a medical evacuation to the home country; and

At least $25,000 for the repatriation of remains.

Princeton will provide up to $50,000 toward expenses associated with a medical evacuation to an individual’s home country, and up to $25,000 for the repatriation of remains.

ID cards will be mailed to home addresses within three to four weeks following enrollment in or changes to medical coverage. Individuals can view ID cards on the provider’s website or app or within the CastLight app. A separate ID card is issued for the Prescription Drug Plan, and individuals can print or view them on the OptumRx website or app.

Disclaimer

If there are any discrepancies between the information in this publication, verbal representations, and the plan documents, the plan documents always govern. Although Princeton intends to continue these benefits, the University reserves the right to amend or terminate these plans at any time.