Medical Maximum |
$200,000 |
$500,000 |
$600,000 |
$5,000,000 |
$5,000,000 |
$50,000, $100,000, $250,000, $500,000 $1,000,000, or $2,000,000 (Ages 70 to 79: $50,000 or $100,000 limit; Ages 80+: $10,000 limit) |
$50,000, $100,000, $500,000 or $1,000,000 (Ages 70 to 79: $50,000 limit; Ages 80+: $10,000 limit) |
Per Injury/Illness Maximum |
$100,000 |
$250,000 |
$300,000 |
$500,000 |
Choice of $50,000, $100,000, $250,000, or $500,000 |
Benefits up to policy max |
Benefits up to policy max |
Deductible |
$50 |
$45 |
$35 |
$25 |
Choice of $0, $100, $250, $500 per illness or injury |
$0, $100, $250, $500, $1,000, $2,500 or $5,000 |
$0, $100, $250, $500, $1,000 or $2,500 |
Coinsurance |
In-Network: 80% of eligible expenses after the deductible up to the overall maximum
Out-Network: Usual, Reasonable, and Customary (URC) |
In-Network: 80% of the next $25,000 of eligible expenses after the deductible, then 100% to the overall maximum
Out-Network: Usual, Reasonable, and Customary (URC) |
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) |
USA In-Network: Plan pays 90%; $1000 out-of-pocket maximum USA Out-of-Network: Plan pays 80%; up to maximum limit |
100% coverage on eligible expenses, after the deductible, up to the policy maximum. |
In Network: 100% Coverage Out of Network: 80% coverage up to $5,000, then 100% up to the policy maximum |
Pre-existing Conditions (Acute Onset) |
$25,000 lifetime maximum for eligible medical expenses for the acute onset of pre-existing condition only
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 |
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 |
Not Covered |
Only charges resulting from an Acute Onset of a Pre-existing Condition can be eligible for coverage. Coverage is for those under age 80 and is up to the policy maximum of the plan. For Emergency Medical Evacuation, an Acute Onset of a Pre-existing Condition is covered up to a $25,000 lifetime maximum.
See policy wording for full benefit description |
Only charges resulting directly from an Acute Onset of a Pre-existing Condition can be eligible for coverage prior to age 70 : Up to the maximum limit of the policy purchased |
Pre-existing Conditions |
Not Covered |
12-month waiting period |
6-month waiting period |
6-month waiting period |
$500 per period of coverage, $1,500 maximum limit
Available after 12 months of continuous coverage |
Not Covered |
Not Covered |
Maternity |
Not Covered |
Up to $5,000 |
Up to $10,000 |
Up to $25,000 |
Not Covered |
Only treatment for complications of pregnancy during the first 26 weeks of pregnancy can be covered. |
Not Covered |
Mental Health |
Outpatient: $50 per day, $500 Inpatient: Up to $5,000 |
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 coverage. Inpatient: Max. 30 visits. Coverage includes drug and alcohol abuse. |
Outpatient: $50 maximum per day; $500 maximum limit
Inpatient: $10,000 maximum limit
Not covered if incurred in student health center |
Not Covered |
Not Covered |
School Team Sports |
Not Covered |
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 |
No Coverage
Optional Team Sports rider available, please select that option to view pricing |
No Coverage
Optional Team Sports Add-on available, please select that option to view pricing. |
Not Covered |
Not Covered |
Recreational, Fitness and Leisure Activities |
Covered per policy conditions |
Covered per policy conditions |
Covered per policy conditions |
Covered per policy conditions |
Covered per policy conditions |
Covered per policy conditions |
Covered per policy conditions |
Adventure Sports |
Some exclusions apply |
Some exclusions apply |
Some exclusions apply |
Some exclusions apply |
No Coverage
Optional Adventure Sports rider available, please select that option to view pricing. |
Some exclusions apply |
No Coverage
Optional Adventure Sports rider available, please select that option to view pricing. |
Emergency Medical Evacuation/Repatriation |
$50,000 / $25,000 |
$250,000 / $25,000 |
$300,000 / $50,000 |
$500,000 / $50,000 |
$50,000/$25,000 |
$1,000,000 / Equal to the elected overall maximum limit |
$1,000,000 / Up to the maximum limit |