共同保险额度
In-Network: 80% of the next $45,000 of eligible expenses after applicable co-pays, then 100% to the overall maximum.
Out-Network: Usual, Reasonable, and Customary (URC)
已存在状况/疾病 (急性发作)
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
已存在状况/疾病
12-month waiting period
怀孕生育保障
最高上限$5,000
心理健康保障
Outpatient: Max. 30 days of coverage. Inpatient: Max. 30 visits. Coverage includes drug and alcohol abuse.
学校团队运动保障
不理赔
休闲、娱乐、健身等活动/运动
按保障条款覆盖
极限运动
Some exclusions apply
紧急医疗运送/遗体运送回国
25万美元 / $25,000美元
Elite
最高医疗保额
$5,000,000
每宗伤害或疾病的最高保额
50万美元
免赔额
$0 (co-pays apply)
共同保险额度
In-Network: 80% of the next $10,000 of eligible expenses after applicable co-pays, then 100% to the overall maximum.
Out-Network: Usual, Reasonable, and Customary (URC)
已存在状况/疾病 (急性发作)
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
已存在状况/疾病
6-month waiting period
怀孕生育保障
Up to $15,000
心理健康保障
Outpatient: Max. 40 days of coverage. Inpatient: Max. 40 visits. Coverage includes drug and alcohol abuse.
学校团队运动保障
Coverage up to $5,000 coverage per injury / illness — medical expenses only for intercollegiate, interscholastic, intramural, or club sports
休闲、娱乐、健身等活动/运动
按保障条款覆盖
极限运动
Some exclusions apply
紧急医疗运送/遗体运送回国
$50万美元 / $5万美元
Standard
最高医疗保额
50万美元
每宗伤害或疾病的最高保额
30万美元
免赔额
$100
共同保险额度
In-Network: The plan pays 100% of eligible expenses up to Maximum Limit Out-Network:The plan pays 80% of eligible expenses up to $5,000, then 100% up to Maximum Limit
