FAQs about Health Insurance

• How do international students enroll in Shorelight’s health insurance solution?

  If you are enrolled in one of the universities listed above and interested in purchasing Shorelight’s Health Insurance Solution, contact us at marketplace@shorelight.com.

• My school requires that the health insurance plan I purchase be ACA compliant; does Shorelight’s solution meet this requirement?

  Yes! Shorelight’s health insurance solution is ACA compliant and filed / approved to meet your school’s requirements.

• What does ACA mean?

  The Affordable Care Act (ACA) is a comprehensive reform law, enacted in the United States in 2010, that increases health insurance coverage for the uninsured and implements reforms to the health insurance market. Many universities require that their students have an ACA compliant health insurance plan when they enroll.

• Is health insurance required for a US visa for international students?

  The U.S. Department of State does not require F-1 or F-2 visa holders to have health insurance. However, most universities require you to have health insurance before taking classes.

• What is the average cost of health care in the US without health insurance?

  Health care costs in the United States can be costly if the patient doesn’t have health insurance coverage.

  • The average cost of an emergency room (ER) visit without insurance can cost anywhere from $2,700 to over $20,000.

  • Routine doctor visits can range from $100 to $300 per visit with specialist visits ranging from $200-$2,000 depending on care and tests required.

  • Prescriptions can range from $10-$50 per prescription for generic medications and $100-$500 or more for brand name medications.

  Source: 2023 Risk Strategies Report

• How much does student health insurance cost in the US?

  The average cost of Health Insurance through the ACA Marketplace for a 21 year old averages $3,924 annually for bronze level, $5,136 for silver level and $6,696 for gold level.*

  Shorelight’s Wellfleet International Student Health insurance is ACA compliant and has an annual cost that is $500-$1,000 cheaper than comparable plans and a variety of features designed for international students, including:

  • Comprehensive dental and vision coverage

  • Preventative coverage at no additional cost

  • Low annual deductibles ($100) and co-pays ($10/per vist) for office visits

  • 10% coinsurance for emergency services (waived if admitted)

  • A prescription formulary with 40+ common prescriptions at no additional cost

  • 24/7 access through call or text to confidential and discreet behavioral health support

  *Source: Forbes Advisor, 6/18/25

• Are there any exclusions to the Shorelight Health Insurance Solution?

  Exclusions and Limitations

  Exclusion Disclaimer: Any exclusion in conflict with the Patient Protection and Affordable Care Act or any state-imposed requirements will be administered to comply with the requirements of the federal or state guideline, whichever is more favorable to You.

  The Certificate does not cover Loss nor provide benefits for any of the following, except as otherwise provided by the benefits of the Certificate and as shown in the Schedule of Benefits.

  General Exclusions

  • International Students Only - Eligible expenses within Your Home Country or country of origin that would be payable or medical Treatment that is available under any governmental or national health plan for which You could be eligible.

  • Treatment, service or supply which is not Medically Necessary for the diagnosis, care or Treatment of the Sickness or Injury involved. This applies even if they are prescribed, recommended or approved by the Student Health Center or by Your attending Physician or dentist.

  • Medical services rendered by a provider employed for or contracted with the Policyholder, including team Physicians or trainers, except as specifically provided in the Schedule of Benefits or as part of the Student Health Center benefits provided by this plan.

  • Professional services rendered by an Immediate Family Member or anyone who lives with You.

  • Charges of an institution, health service or infirmary for whose services payment is not required in the absence of insurance or services covered by Student Health Fees.

  • Any expenses in excess of Usual and Customary Charges except as provided in the Certificate.

  • Treatment, services, supplies or facilities in a Hospital owned or operated by the Veterans Administration or a national government or any of its agencies, except when a charge is made which You are required to pay.

  • Services that are duplicated when provided by both a certified Nurse midwife and a Physician.

  • Expenses payable under any prior policy which was in force for the person making the claim.

  • Loss resulting from war or any act of war, whether declared or not, or Loss sustained while in the armed forces of any country or international authority.

  • Injury sustained as the result of Your operation of a motor vehicle while not properly licensed to do so in the jurisdiction in which the motor vehicle Accident takes place.

  • Expenses covered under any Workers’ Compensation, occupational benefits plan, mandatory automobile no-fault plan, public assistance program or government plan, except Medicaid.

  • Expenses incurred after:

    • The date insurance terminates as to an Insured Person, except as specified in the extension of benefits provision; and

    • The end of the Policy Year specified in the Policy.

    • Elective Surgery or Elective Treatment unless such coverage is otherwise specifically covered under the Certificate.

  • You are:

    • committing or attempting to commit a felony,

    • engaged in an illegal occupation, or

    • participating in a riot.

  • Custodial Care service and supplies.

  • Charges for hot or cold packs for personal use.

  • Services of private duty Nurse except as provided in the Certificate.

  • Expenses that are not recommended and approved by a Physician.

  • Experimental or Investigative drugs, devices, Treatments or procedures unless otherwise covered under Covered Clinical Trials. See the Other Benefits section for more information.

  • Routine harvesting and storage of stem cells from newborn cord blood, the purchase price of any organ or tissue, donor services if the recipient is not an Insured Person under this plan, or services for or related to the transplantation of animal or artificial organs or tissues.

  • Loss incurred as the result of riding as a passenger or otherwise (including skydiving) in a vehicle or device for aerial navigation, except as a fare paying passenger in an aircraft operated by a scheduled airline maintaining regular published schedules on a regularly established route anywhere in the world.

  • Non-chemical addictions.

  • Outpatient non-physical, occupational, speech therapies (art, dance, etc.).

  • Modifications made to dwellings.

  • General fitness, exercise programs.

  • Hypnosis.

  • Rolfing.

  • Biofeedback.

  • Charges incurred for acupuncture, in any form, except to the extent provided in the Schedule of Benefits.

  • Sleep Disorders, except for a sleep study performed in the Insured Person’s home, the diagnosis, and Treatment of obstructive sleep apnea.

  • Routine foot care, including the paring or removing of corns and calluses, or trimming of nails, unless these services are determined to be Medically Necessary because of Injury, infection or disease.

  Activities Related

  • Braces and appliances used as protective devices during a student’s participation in sports. Replacement braces and appliances are not covered.

  • Loss resulting from playing, practicing, traveling to or from, or participating in, or conditioning for, any professional sport.

  • Loss resulting from playing, practicing, traveling to or from, or participating in, or conditioning for, any Intercollegiate sports for which benefits are paid under another Sports Accident policy issued to the Policyholder; or for which coverage is provided by the National Collegiate Athletic Association (NCAA), National Association of Intercollegiate Athletic (NAIA) or any other sports association.

  • Racing or speed contests, skin diving or sky diving, mountaineering (where ropes or guides are customarily used), ultra-light aircraft, parasailing, sail planing, hang gliding, bungee jumping, travel in or on ATV’s (all terrain or similar type vehicles).

  Weight Management/Reduction

  • Weight management. Weight reduction. Nutrition programs. This does not apply to nutritional counseling, or any screening or assessment specifically provided under the Preventive Services benefit, or otherwise specifically covered under the Certificate.

  • Treatment for obesity except surgery for morbid obesity (bariatric surgery). Surgery for removal of excess skin or fat.

  Family Planning

  • Infertility Treatment (male or female)-this includes but is not limited to:

    • Premarital examinations;

    • Genetic counseling and genetic testing;

    • Impotence, organic or otherwise;

    • Injectable infertility medication, including but not limited to menotropins, hCG and GnRH agonists;

    • In vitro fertilization, gamete intrafallopian tube transfers or zygote intrafallopian tube transfers;

    • Costs for an ovum donor or donor sperm;

    • Sperm storage costs;

    • Cryopreservation and storage of embryos;

    • Ovulation induction and monitoring;

    • Artificial insemination;

    • Hysteroscopy;

    • Laparoscopy;

    • Laparotomy;

    • Ovulation predictor kits;

    • Reversal of tubal ligations;

    • Reversal of vasectomies;

    • Costs for and relating to surrogate motherhood (maternity services are covered for Insured Persons acting as surrogate mothers);

    • Cloning; or

    • Medical and surgical procedures that are Experimental or Investigative, unless Our denial is overturned by an External Appeal Agent.

  • Elective abortions.

  Vision

  • Expenses for radial keratotomy.

  • Adult Vision unless specifically provided in the Certificate.

  • Charges for office visit exam for the fitting of prescription contact lenses,

  Dental

  • Treatment to the teeth, including orthodontic braces and orthodontic appliances, unless otherwise covered under the Pediatric and Adult Dental Care Benefit.

  Hearing

  • Charges for hearing exams, hearing screening, hearing aids and the fitting or repair or replacement of hearing aids or cochlear implants except as specifically provided in the Certificate.

  Cosmetic

  • Treatment of Acne unless Medically Necessary.

  • Charges for hair growth or removal unless otherwise specifically covered under the Certificate.

  • Surgery or related services for cosmetic purposes to improve appearance, except to restore bodily function or correct deformity resulting from disease, or trauma.

  Prescription Drugs

  • Any drug or medicine which does not, by federal or state law, require a prescription order, i.e., over-the-counter drugs, even if a prescription is written, except as specifically provided under Preventive Services or in the Prescription Drug Benefit section of this Certificate. Insulin and OTC preventive medications required under ACA are exempt from this exclusion;

  • Drugs with over-the-counter equivalents except as specifically provided under Preventive Services;

  • Allergy sera and extracts administered via injection;

  • Vitamins, and minerals, except as specifically provided under Preventive Services;

  • Food supplements, dietary supplements; except as specifically provided in the Certificate;

  • Cosmetic drugs or medicines including, but not limited to, products that improve the appearance of wrinkles or other skin blemishes;

  • Refills in excess of the number specified or dispensed after 1 year of date of the prescription;

  • Drugs labeled, “Caution – limited by federal law to Investigational use” or Experimental Drugs;

  • Any drug or medicine purchased after coverage under the Certificate terminates;

  • Any drug or medicine consumed or administered at the place where it is dispensed;

  • If the FDA determines that the drug is: contraindicated for the Treatment of the condition for which the drug was prescribed; or Experimental for any reason;

  • Prescription digital therapeutics;

  • Bulk chemicals;

  • Non-insulin syringes, surgical supplies, Durable Medical Equipment/medical devices, except as specifically provided in the Prescription Drug Benefit section of the Certificate;

  • Repackaged products;

  • Blood components except factors;

  • Any drug or medicine for the purpose of weight control;

  • Sexual enhancements drugs;

  • Vision correction products.