Máximo de cobertura |
$600,000 |
$5,000,000 |
$500.000 |
$1.000.000 |
$5,000,000 |
$1.000.000 |
Beneficio máximo por lesión o enfermedad |
$300.000 |
$500.000 |
$250.000 |
$300.000 |
$500.000 |
$500.000 |
Deducible |
$35 |
$25 |
$0 (co-pays apply) |
$0 (co-pays apply) |
$0 (co-pays apply) |
$25 |
Coaseguro |
In-Network: 80% of the next $5,000 of eligible expenses after the deductible, then 100% to the overall maximum
Out-Network: Usual, Reasonable, and Customary (URC) |
In-Network: 100% of eligible expenses after the deductible to the overall maximum
Out-Network: Usual, Reasonable, and Customary (URC) |
In-Network: 80% of Eligible Expenses up to $5,000, then 100% up to the Maximum Benefit
Out-Network: 70% of Eligible Expenses up to Maximum Benefit |
In-Network: 80% of Eligible Expenses up to $5,000, then 100% up to the Maximum Benefit
Out-Network: 80% of Eligible Expenses up to Maximum Benefit |
In-Network: 100% of Eligible Expenses up to the Maximum Benefit
Out-Network: 90% of Eligible Expenses up to Maximum Benefit |
In-Network: 100% of eligible expenses up to Maximum Limit Out-Network: 80% up to $5,000, then 100% up to Maximum Limit |
Condiciones preexistentes (inicio agudo) |
Additional $25,000 lifetime maximum for eligible medical expenses for the acute onset of pre-existing condition during waiting period
See policy wording for full benefit description |
Additional $25,000 lifetime maximum for eligible medical expenses for the acute onset of pre-existing condition during waiting period
See policy wording for full benefit description |
$5,000 lifetime maximum for eligible medical expenses for the acute onset of pre-existing condition during waiting period |
$15,000 lifetime maximum for eligible medical expenses for the acute onset of pre-existing condition during waiting period |
$25,000 lifetime maximum for eligible medical expenses for the acute onset of pre-existing condition during waiting period |
Sin cobertura |
Condiciones preexistentes |
Periodo de espera de 6 meses |
Periodo de espera de 6 meses |
Periodo de espera de 12 meses |
Periodo de espera de 12 meses |
Periodo de espera de 6 meses |
Después de 6 meses de cobertura continua |
Maternidad |
Up to $10,000 |
Up to $25,000 |
In Network: Plan pays 80% to $5,000 for a covered pregnancy. Out-of-Network: Plan pays 60% to $5,000 for a covered pregnancy. |
In Network: Plan pays 80% to $10,000 for a covered pregnancy. Out-of-Network: Plan pays 60% to $10,000 for a covered pregnancy. |
In Network: Plan pays 80% to Maximum Benefit for a covered pregnancy. Out-of-Network: Plan pays 60% to Maximum Benefit for a covered pregnancy. |
Up to $5,000 |
Salud mental |
Outpatient: Max. 30 days of coverage. Inpatient: Max. 30 visits. Coverage includes drug and alcohol abuse. |
Outpatient: Max. 30 days of coverage. Inpatient: Max. 30 visits. Coverage includes drug and alcohol abuse. |
Outpatient: Max. 30 days of URC coverage. Inpatient: Max. 30 visits of URC coverage. Coverage includes substance abuse. |
Outpatient: Max. 30 days of URC coverage. Inpatient: Max. 30 visits of URC coverage. Coverage includes substance abuse. |
Outpatient: Max. 30 days of URC coverage. Inpatient: Max. 30 visits of URC coverage. Coverage includes substance abuse. |
Tratamiento de paciente hospitalizado: $10.000 máximo de por vida Tratamiento de paciente ambulatorio: $50 por día; $500 máximo de por vida. *No elegible para cobertura en un Centro de Salud Estudiantil |
Deportes escolares |
No Coverage
Optional Team Sports rider available, please select that option to view pricing |
No Coverage
Optional Team Sports rider available, please select that option to view pricing |
Coverage up to $5,000 coverage per injury / illness — medical expenses only for intercollegiate, interscholastic, intramural, or club sports |
Coverage up to $5,000 coverage per injury / illness — medical expenses only for intercollegiate, interscholastic, intramural, or club sports |
Coverage up to $5,000 coverage per injury / illness — medical expenses only for intercollegiate, interscholastic, intramural, or club sports |
Coverage up to $5,000 coverage per injury / illness — medical expenses only for intercollegiate, interscholastic, intramural, or club sports |
Actividades recreativas, de ocio y de acondicionamiento |
Cubierto por condiciones de póliza |
Cubierto por condiciones de póliza |
Cubierto por condiciones de póliza |
Cubierto por condiciones de póliza |
Cubierto por condiciones de póliza |
Cubierto por condiciones de póliza |
Deportes de aventura |
Se aplican algunas exclusiones |
Se aplican algunas exclusiones |
No Coverage
Optional Adventure Sports rider available, please select that option to view pricing. |
No Coverage
Optional Adventure Sports rider available, please select that option to view pricing. |
No Coverage
Optional Adventure Sports rider available, please select that option to view pricing. |
No Coverage
Optional Adventure Sports rider available, please select that option to view pricing. |
Evacuación/Repatriacón Médica de Emergencia |
$300,000 / $50,000 |
$500.000 / $50.000 |
$250,000/ $50,000 |
$300,000/ $50,000 |
$500,000/ $50,000 |
$500.000 / $50.000 |