Participants of EXPLO are recommended to purchase an insurance policy with either $50,000 or $100,000 policy maximums.
Enrollment for insurance plans opens March 01, 2021.
The Atlas plan provides a range of high quality travel insurance benefits that are designed to offer coverage in the event of an unexpected accident or injury when you are abroad.
Highlights of the Atlas Travel Medical plan include:
- Up to $2 Million in Coverage
- Hospitalization/ Doctors Visits
- Prescription Medication
- Evacuation/ Repatriation
- Skiing / Snowboarding Included
- Lost Luggage
- Trip Interruption
- Online Instant Application
- Plan Management Online
- and much more…
Need your documents now? If you need your insurance documents quickly, you can Buy your coverage and receive all your insurance documents online and to your email address in PDF format immediately. Simply download and print these documents for instant proof of coverage.
Atlas Travel | Benefits
The table below outlines the policy benefits available, per individual, on the Atlas Travel International Travel Medical Insurance plan. Coverage is available for both US and Non-US Citizens who are planning to travel, study or live abroad with coverage starting at just 5 days and up to 364 days inside the USA and 1 year outside the USA with renewal possibilities of up to 3 years.
Please review the table for full details and if you have any questions, please contact our customer support team for assistance.
|Policy Maximum||$50,000, $100,000, $250,000, $500,000, $1,000,000, or $2,000,000 (Ages 65 to 79: $50,000 or $100,000 limit; Ages 80+: $10,000 limit)|
|Deductible||$0, $100, $250, $500, $1,000, $2,500, or $5,000 The deductible is due once per certificate period|
|ER Co-Pay Only applies to Claims incurred in U.S.||$200 for each use of the emergency room if not admitted to the hospital as an in-patient. Waived for Emergency treatment of injury.|
|Urgent Care Co-Pay Only applies to Claims incurred in U.S.||$15 per visit, then the coinsurance will apply. Not subject to deductible. Co-payment waived if $0 deductible elected.|
|Provider Network||Doctor/Hospital Search|
|Coinsurance||100% coverage on eligible expenses, after the deductible, up to the policy maximum.|
|The following benefits are ALL subject to deductible, coinsurance, overall maximum limit, and are per certificate period unless specifically indicated otherwise.|
|Hospital Room & Board||Average semi-private room rate, including nursing services.|
|Intensive Care Unit||Up to the Overall Maximum.|
|Local Ambulance||Usual, reasonable, and customary charges (URC) when covered illness or injury results in hospitalization as inpatient.|
|Outpatient Physical Therapy and Chiropractic Care||Up to $50 maximum per day. Must be ordered in advance by a physician.|
|Emergency Dental||Acute Onset of Pain — Up to $300 Not subject to deductible. Accident — Up to the overall maximum|
|Emergency Eye Exam for a Covered Loss||Up to $150. $50 deductible per occurrence. Plan deductible is waived.|
|Prescription Medication||Up to the Overall Maximum. For those members with a US destination, you will be automatically enrolled into the VantageAmerica Drug Discount program — see further details.|
Acute Onset of a Pre-existing Condition
Only available for members under age 80.Excluded chronic and congenital disorders.
Up to the overall maximum
$25,000 lifetime maximum for emergency medical evacuation
|Terrorism||$50,000 limit for eligible medical expenses only|
|All Other Eligible Medical Expenses||Up to the Overall Maximum.|
|The following benefits are NOT subject to the deductible or coinsurance unless otherwise stated:|
|Emergency Medical Evacuation||$1,000,000 limit Except as provided under the Acute Onset of a Pre-Existing Condition. Not subject to overall maximum limit.|
|Repatriation of Remains||Equal to the elected overall maximum limit. This limit is for this benefit only and is not included in or subject to the overall maximum limit.|
|Local Burial or Cremation||$5,000 lifetime maximum|
|Crisis Response Ransom, Personal Belongings, and Crisis Response Fees and Expenses||$10,000 maximum Not subject to overall maximum limit.|
|Emergency Reunion||$100,000 limit, Maximum of 15 days|
|Bedside Visit||$1,500 limit|
|Return of Minor Children||$50,000 limit|
|Pet Return||$1,000 to return a pet home if member is hospitalized|
|Political Evacuation||Up to $100,000 lifetime maximum|
|Trip Interruption||$10,000 limit|
|Common Carrier Accidental Death||
Under 18: $10,000 limit
|Accidental Death and Dismemberment (excludes loss due to Common Carrier Accident)||
Under 18: $5,000 lifetime maximum
|Lost Checked Luggage||$1,000 limit|
|Travel Delay||Maximum $100 a day after a 12-hour delay period requiring an unplanned overnight stay. Subject to a maximum of 2 days.|
|Lost or Stolen Passport/Travel Visa||$100 limit|
|Border Entry Protection||Up to $500 if traveling on a valid B-2 visa and denied entrance at the U.S. border.|
|Natural Disaster Benefit — Replacement Accommodations||Maximum $250 for 5 days|
|Emergency Quarantine Indemnity — COVID-19||$50 a day for up to 10 days Proof of quarantine mandated by physician or governmental authority required. Quarantine must be due to you testing positive for COVID-19/SARSCoV2, or you are symptomatic and waiting on diagnostic test results. Minimum of 30 days of coverage required. Coverage available only outside of your home country.|
|Hospital Indemnity||$100 per day of inpatient hospitalization|
|Personal Liability||$25,000 Lifetime Maximum Not subject to overall maximum limit.|
|Sports||Non-contact, leisure, recreational and fitness sports included, along with select hazardous sports See policy wording for full details.|
Atlas Travel | Exclusions
Charges for the following conditions, treatments (including diagnoses, tests, and examinations), services, supplies, acts, omissions, and/or events are excluded from coverage hereunder:
- Pre-existing Conditions, except charges resulting directly from an Acute Onset of Pre-existing Condition, as herein defined, subject to the limits set forth in the Schedule of Benefits and Limits.
- Birth defects and congenital illnesses. Birth defects are deemed to include hereditary conditions.
- Mental health disorders.
- Pregnancy except as covered under Complications of Pregnancy, as herein defined, termination of pregnancy except in connection with covered Complications of Pregnancy, all charges related to pregnancy after the 26th week of pregnancy, routine prenatal care, childbirth, postnatal care, and charges incurred by a child under the age of 14 days.
- Impotency or sexual dysfunction.
- All sexually transmitted diseases and conditions.
- HIV, AIDS, or ARC, and all diseases caused by and/or related to HIV.
- All forms of cancer / neoplasm.
- Substance abuse or addiction or conditions that may be attributed to substance abuse or addictions and direct consequences thereof.
- Acne, moles, skin tags, diseases of sebaceous glands, seborrhea, sebaceous cyst, hypertrophic and atrophic conditions of skin, nevus.
- Sleep apnea or other sleep disorders.
- Obesity or weight modification, including but not limited to wiring of the teeth and all forms of intestinal bypass surgery.
- Self-inflicted injury or illness and/or suicide or attempted suicide whether sane or insane.
- Injury sustained that is due wholly or partially to the effects of intoxication or drugs other than drugs taken in accordance with treatment prescribed by a physician and except drugs prescribed for the treatment of substance abuse.
- Injury sustained while operating any motorized vehicle, aircraft or watercraft whether registered or not while under the influence of alcohol as defined under the law of the jurisdiction where the injury occurs or with a .08 Blood Alcohol Content (BAC), whichever is lower.
- Routine medical examinations, including but not limited to vaccinations, immunizations, annual check-ups, the issue of medical certificates and attestations, and examinations as to the suitability of employment or travel.
- Dental treatment and treatment of the temporomandibular joint, except for emergency dental treatment necessary to replace sound natural teeth lost or damaged in an accident covered hereunder or for the emergency relief of acute onset of pain
- Promotion or prevention of conception including but not limited to: artificial insemination, treatment for infertility, sterilization or reversal of sterilization.
- Organ or tissue transplants or related services.
- Eye surgery, such as corrective refractory surgery, when the primary purpose is to correct nearsightedness, farsightedness or astigmatism.
- Corrective devices and medical appliances, including eyeglasses, contact lenses, hearing aids, hearing implants, eye refraction, visual therapy, and any examination or fitting related to these devices, dentures or dental appliances, and all vision and hearing tests and examinations, except as provided for under Emergency Eye Exam.
- Orthoptics and visual eye training.
- Orthopedic shoes, orthopedic prescription devices to be attached to or placed in shoes, treatment of weak, strained, flat, unstable or unbalanced feet, metatarsalgia or bunions, and treatment of corns, calluses or toenails.
- Hair loss including wigs, hair transplants or any drug that promises hair growth, whether or not prescribed.
- Speech, vocational, occupational, biofeedback, acupuncture, recreational, sleep or music therapy, holistic care of any nature, massage and kinesiotherapy.
- Psychometric, intelligence, competency, behavioral and educational testing.
- Cosmetic or aesthetic reasons, except for reconstructive surgery when such surgery is directly related to and follows a surgery which was covered hereunder.
- Modifications of the physical body intended to improve the psychological, mental or emotional wellbeing, including but not limited to sex-change surgery.
- Exercise programs, whether or not prescribed or recommended by a physician.
- Incurred as a result of exposure to non-medical nuclear radiation and/or radioactive material(s).
- Cryo preservation and implantation or re-implantation of living cells.
- Genetic or predictive testing.
- Investigational, experimental or for research purposes.
- While confined primarily to receive custodial care, educational or rehabilitative care, or any medical treatment in any establishment for the care of the aged, except rehabilitative care received upon direct transfer from an acute care hospital.
- Not medically necessary.
- Not administered by or under the supervision of a physician, and products that can be purchased without a doctor's prescription.
- Provided by a relative, family member or any person who ordinarily resides with you.
- Provided at no cost to you.
- Failure to keep a scheduled appointment.
- Payable under any government system, including the Australian Medicare system.
- Payable under Worker’s Compensation or Employer’s Liability Laws, or by any coverage provided or required by law.
- Charges exceeding usual, reasonable and customary.
- Charges resulting from or occurring during the commission of a violation of law, including without limitation, the engaging in an illegal occupation or act, but excluding minor traffic violations.
Any illness or injury incurred as a result of epidemics, pandemics, public health emergencies, natural disasters, or other disease outbreak conditions that may affect a person’s health when, prior to your effective date, any of the following were issued:
- The United States Centers for Disease Control & Prevention had issued a Warning/Alert Level 3 or higher for a location or destination, including common carriers; or
- The United States Centers for Disease Control & Prevention had issued a Global or Worldwide Warning/Alert Level 3 or higher.
- War, military action or while on duty as a member of a police or military force unit.
- Travel or accommodations, except as provided for in the Local Ambulance, Emergency Medical Evacuation, Repatriation of Remains, Emergency Reunion, Natural Disaster, Return of Minor Children, Political Evacuation, Trip Interruption, Trip Delay, Emergency Quarantine Indemnity and Border Entry Protection sections of this insurance.
- Incurred outside your certificate period.
- Submitted to us for payment more than 60 days after the last day of the certificate period.
- When departure from the home country is to obtain treatment in the destination country/countries.
- Complications or consequences of a treatment or condition not covered hereunder.
- Not included as Eligible Expenses as described herein.
Pre-existing Condition: Any (1) condition for which medical advice, diagnosis, care, or treatment (includes receiving services and supplies, consultations, diagnostic tests or prescription medicines) was recommended or received during the 2 years immediately preceding the Certificate Effective Date; (2) condition that had manifested itself in such a manner that would have caused a reasonably prudent person to seek medical advice, diagnosis, care, or treatment (includes receiving services and supplies, consultations, diagnostic tests or prescription medicines) within the 2 years immediately preceding the Certificate Effective Date; (3) injury, illness, sickness, disease, or other physical, medical, mental, or nervous conditions, disorder or ailment (whether known or unknown) that, with reasonable medical certainty, existed at the time of application or within the 2 years immediately preceding the Certificate Effective Date. For the purposes of the Complications of Pregnancy coverage offered hereunder, Pregnancy will not be included within the definition of a Pre-existing Condition.
Atlas Travel | FAQ
- When can I purchase my plan online?
- When does my coverage become effective?
- When does my coverage end?
- Will I get my documents immediately?
- Will I get my ID card and documents in the mail?
- How do I get a visa letter?
- What forms of payment do you accept?
- What is a beneficiary?
- Does this plan have dental or vision coverage?
- What does Usual, Reasonable and Customary (URC) mean?
- What is a deductible?
- What is coinsurance?
- Does the Atlas Travel plan provide any home country coverage?
- What is the VantageAmerica Discount Card?
- Does my plan cover telemedicine?
Who underwrites the Atlas Travel plan?
Lloyd’s is the underwriter of the Atlas Travel plan. They are rated A (Excellent) by AM Best Company and A+ (Strong) by Standard and Poor’s, meeting visa requirements for the USA and countries around the world.
Am I eligible for the Atlas Travel plan?
The plan is available to anyone who is traveling outside of their home country and are at least 14 days old. This includes international students, study abroad students, ESL students, foreign scholars, dependents living internationally, travelers, chaperones, international business groups, etc.
Where will this plan cover me?
The Atlas Travel plan will cover you anywhere in the world, outside of your home country. If you are a US citizen, your home country is automatically the USA, regardless of your principal residence. For non-US Citizens, home country is the country where you principally reside and receive regular mail.
When can I purchase my plan online?
You can purchase your plan up to six months in advance of your selected policy start date, however, please note that the full premium will be charged immediately at the time of the application. You are also able to purchase coverage even if you have departed for your travels and are in another country other than your home country.
When does my coverage become effective?
Your coverage becomes effective on the latest of:
- We receive your application and payment (if application and payment is made online or by fax)
- 12:01am US Eastern Standard Time on the date we receive your application and payment (if application and payment is made by mail)
- The moment you depart for your home country, or
- 12:01am US Eastern Standard Time on the date you request on your application
When does my coverage end?
Your coverage will end on the earliest of:
- 12:01am US Eastern Standard Time on the last day of the period for which you have paid a premium,
- 12:01am US Eastern Standard Time on the date requested on your Application, or
- The moment of your arrival upon return to your home country (unless you have started a benefit period or are eligible for home country coverage).
Will I get my documents immediately?
Yes, when you apply online we will send all your documents to you immediately via email. You can download these documents, print them off and show them as proof of coverage. If you have applied for a plan and haven’t received your policy documents, be sure to check your spam or bulk folder.
Once you have applied online, within an hour you will be able to log into the “Student Zone” to download your ID card, visa letter, or get claims information. If you are still not able to locate your policy documents after purchase, you can contact us for further assistance.
Will I get my ID card and documents in the mail?
No, all documents are automatically emailed to you — however you can opt to have hard copies mailed to you when you apply so please make sure to indicate this on the application form when you apply if this is your prefered option.
How do I get a visa letter?
You will receive a copy of your visa letter right after purchase, in your fulfillment documents. You can also access your visa letter by logging into the “Student Zone” and selecting the “Visa Letter” option after you have applied.
What forms of payment do you accept?
We accept Visa, MasterCard, Discover and American Express credit and debit cards online. You are also welcome to use a friend or family member’s credit or debit card with their permission. If you would prefer to pay using a check and wire transfer, please contact us for more information.
What is a beneficiary?
A beneficiary refers to someone who is eligible to receive distributions from your insurance plan in case of your death while covered under the policy. Under the Atlas Travel plan, there are death benefits that will pay out a financial sum if this were to happen, and so on the application, you will need to indicate who would receive these benefits. Typically, you would put down your mother, father, brother, sister, husband, or wife as a beneficiary — but you have the option to put anyone you would like, even if they are located outside of your host country.
Can I extend or renew my coverage?
- If your Atlas plan includes the US or if you are a US citizen — you can purchase coverage and extend up to a total of 364 days.
- If your Atlas plan excludes the US and you are not a US citizen – you can purchase and extend coverage up to 365 days. Once you have a full 365 days of coverage, you can renew your coverage for up to two additional years.
Please note — Extensions and renewals may be completed through the Student Zone before the plan expires and there is a $5 fee per extension or renewal.
My plan has expired, how can I reinstate it?
Once a plan has expired or lapsed, it cannot be reinstated or restarted. You can instead purchase a new plan and begin coverage as soon as the same day. Apply now for the Atlas Travel if you’d like to purchase a new plan.
Can I cancel my Atlas Travel plan?
Yes, to be eligible for a full refund the cancellation request must be received prior to the effective date of your insurance plan. Cancellation requests received after the effective date will be subject to the following conditions:
- a $25 cancellation fee; and
- only the unused portion of the plan cost will be refunded; and
- only members who have no claims are eligible for premium refund.
All cancellation requests must be submitted in writing, we cannot accept cancellation requests over the phone. You can send this request by email through our contact page.
Does this plan have vision or dental coverage?
The Atlas Travel plan does not cover routine vision or dental services, however, it does offer a limited emergency eye exam benefit, as well as limited coverage for dental accidents and emergency dental treatment for unexpected pain. Please see the plan benefits page for full details.
Please note — routine dental check-ups such as cleanings are not covered — if you are looking for a more comprehensive dental insurance plan, please see our dental discount plans.
What does Usual, Reasonable and Customary (URC) mean?
URC — which stands for Usual Reasonable and Customary — is either the lesser of 150% of the charges payable under the United States Medicare program for claims incurred outside the PPO network within the U.S., or the average cost charged by a provider for a specific procedure in a specific geographic area. For example, if a particular procedure costs $5,000 on average in the New York City, the insurance company will not pay your provider in New York City $10,000 for the same exact procedure. Instead, they will limit their payment to "Usual Reasonable and Customary" — in this example, $5,000.
What is a deductible?
The deductible is the amount you are required to pay to your provider before the insurance company pays toward your eligible expenses. On this plan, you can choose your deductible (options are: $0, $100, $250, $500, $1,000, $2,500, or $5,000) which is paid once per certificate period.
What is coinsurance?
Coinsurance is the percentage that the insurance will pay toward your medical bill after you have already paid your deductible.
- Outside the USA
- After your deductible, the insurance plan will cover 100% of your eligible expenses up to the policy maximum.
- Inside the USA
- After your deductible, the insurance plan will cover 100% of your eligible expenses up to the policy maximum. In the United States, the Atlas plan uses an optional (Preferred Provider Organization) Network. By going in-network, the provider will typically be able to direct bill the insurance company, so you don’t have to pay for the services up front the time of treatment.
Does the Atlas Travel Plan provide any home country coverage?
Yes, the plan provides the following home country coverage options:
- Incidental home country Coverage
- For every three months of coverage, the Atlas Travel will provide you with 15 days (for US citizens) or 30 days (for non-US citizens) of medical expense coverage for incidental trips back to your home country. Return to your home country must not be taken for the purpose of obtaining treatment of an illness or injury that began while traveling, and you must return to your host country to be eligible for this benefit.
- Benefit Period Medical Coverage
- A benefit period begins on the first day you receive a diagnosis or treatment of a covered illness or injury while outside your home country and lasts for 90 days. If you started a benefit period while this insurance was in effect, you are covered only for medical expenses for the duration of the benefit period, regardless of whether you are at home or abroad.
What is the VantageAmerica Discount Card?
For policies purchased with a United States destination, you will be provided with a VantageAmerica Discount Pharmacy Card. This card will provide discounts on most FDA approved prescription drugs at over 54,000 participating pharmacies across the United States, and will save you an average 5%-15% off the cash price for brand drugs and an average 15%-40% of the price of generic drugs.
Once you have received your instant discount, the remaining prescription expenses can still be submitted for reimbursement as usual.Please note:
- Card NOT Valid in AK, MA, MN, MT, VT, and Canada.
- Pharmacy discounts are NOT insurance and are NOT intended as a substitute for insurance.
- The discount is only available at participating pharmacies.
Does my plan cover telemedicine?
Yes, the Atlas Travel plan covers virtual visits to your doctor for any new, eligible conditions. To find providers in your area, please visit our online provider search tool.
What doctors or hospitals (providers) can I go to?
You are free to visit any provider you wish with the Atlas Travel plan; however, the plan does have an optional Preferred Provider Organization in the USA. In network providers will typically be able to direct bill the insurance company so you won’t have to pay for the services up front at the time of treatment. Direct billing is always up to the provider, so we suggest calling the provider before seeking treatment to be sure.
- If your plan was purchased prior to July 1st, 2019, or, if your home country or citizenship is in the European Union, your plan uses the First Health Network as the Preferred Provider Organization in the United States.
- If your plan was purchased as of July 1st, 2019, and, if your home country or citizenship is not in the European Union, your plan uses the UnitedHealthcare Network as the Preferred Provider Organization in the United States.
- To find providers in your area that accept these networks, please visit our online provider search tool.
How do I know which network my plan uses?
Depending on when you purchased your plan, and where you are from, your Atlas plan will either use the First Health Network or the UnitedHealthcare Network when seeking treatment in the United States. The network logo will be included on your insurance ID card, but please also keep in mind the following:
If your plan was purchased prior to July 1st, 2019, or, if your home country or citizenship is in the European Union, your plan uses the First Health Network as the Preferred Provider Organization.
If your home country or citizenship is in the following countries, your plan will use the First Health Network.
- EU Countries
- Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Poland, Portugal, Romania, Slovak Republic, Slovenia, Spain, Sweden and the United Kingdom.
- EU Territories
- Azores, Canary Islands, Guadeloupe, French Guiana, Madeira, Martinique, Mayotte, Reunion, and Saint Martin
- EU Economic Area Countries
- Iceland, Lichtenstein, and Norway
If your plan was purchased as of July 1st, 2019, or later, and if your home country is not in the European Union as listed above, your plan uses the UnitedHealthcare Network as the Preferred Provider Organization.
How are claims paid?
Claims are paid depending on where you are located and where you seek treatment:
- In-network while inside the USA
- When you visit a provider that is part of the Preferred Provider Organization, your insurance bill is typically paid directly. You will need to complete a claim form and email this to WorldTrips for processing.
- Out-of-network while inside the USA
- When you visit a provider that is outside the network, you will need to pay for all services up front and then submit your bills and receipts, along with a claim form for reimbursement to WorldTrips.
- Outside the USA
When visiting a provider around the world, please pay for the services up front and then submit your bills and receipts, along with a claim form, for reimbursement to WorldTrips.You can access the claims form through your online Student Zone, and email this to email@example.com for processing.
If you are hospitalized for an emergency or planned hospitalization, you will need to call the 24 hour emergency assistance number located on the back of your insurance ID card and WorldTrips will assist you further with settling the hospital bills.
Atlas Travel | Premiums
The Atlas Travel Medical Insurance plan can be purchased for as little as 5 days for both Non-US Citizens and US Citizens who are traveling outside of their home country. There are two main coverage options:
Premiums are all listed with a $250 deductible option — if you would like other deductible options, please run a free online quote.
Travel Outside the USA
|$50,000$50k||$100,000$100k||$250,000$250k||$500,000$500k||$1,000,000$1 mil.||$2,000,000$2 mil.|
|14d–29y||$0.81 / day||$0.97 / day||$1.22 / day||$1.34 / day||$1.46 / day||$1.52 / day|
|30–39||$1.02 / day||$1.27 / day||$1.52 / day||$1.64 / day||$1.85 / day||$1.91 / day|
|40–49||$1.68 / day||$1.87 / day||$2.20 / day||$2.36 / day||$2.60 / day||$2.69 / day|
|50–59||$2.94 / day||$3.03 / day||$3.51 / day||$3.74 / day||$4.13 / day||$4.25 / day|
|60–64||$3.64 / day||$3.60 / day||$4.24 / day||$4.54 / day||$4.96 / day||$5.11 / day|
|65–69*||$4.13 / day||$4.55 / day||N/A||N/A||N/A||N/A|
|70–79*||$6.72 / day||$7.40 / day||N/A||N/A||N/A||N/A|
|80+**||$12.31 / day||N/A||N/A||N/A||N/A||N/A|
|*$100,000 Maximum Limit for ages 65-79; **$10,000 Maximum Limit for age 80 and over.|
Travel to the USA
|$50,000$50k||$100,000$100k||$250,000$250k||$500,000$500k||$1,000,000$1 mil.||$2,000,000$2 mil.|
|14d–29y||$1.49 / day||$1.88 / day||$2.12 / day||$2.67 / day||$3.05 / day||$3.20 / day|
|30–39||$1.81 / day||$2.47 / day||$2.94 / day||$3.16 / day||$3.48 / day||$3.66 / day|
|40–49||$2.59 / day||$3.21 / day||$3.67 / day||$4.35 / day||$4.99 / day||$5.24 / day|
|50–59||$4.29 / day||$5.33 / day||$6.73 / day||$7.63 / day||$8.39 / day||$8.82 / day|
|60–64||$5.46 / day||$7.04 / day||$9.56 / day||$10.41 / day||$11.43 / day||$12.01 / day|
|65–69*||$6.36 / day||$8.03 / day||N/A||N/A||N/A||N/A|
|70–79*||$9.67 / day||$12.18 / day||N/A||N/A||N/A||N/A|
|80+**||$14.79 / day||N/A||N/A||N/A||N/A||N/A|
|*$100,000 Maximum Limit for ages 65-79; **$10,000 Maximum Limit for age 80 and over.|