COMPARE BENEFITS

Four benefit levels are available to meet your needs.

Download the full brochure.



Smart Plan

Standard

Preferred 300

Preferred 500

Maximum Medical Limit

$200,000

$200,000

$300,000

$500,000

Maximum Injury or Illness

$100,000

$100,000

$300,000

$500,000

Pre‑Existing Condition Waiting Period

N/A - No coverage

N/A - No coverage

12 Months

6 Months

Deductible
(except Emergency Room)

$50 per Injury or Illness with the Preferred Provider Organization or Student Health Center; otherwise $100 per Injury or Illness

$50 in network/$150 out of network

$45 in network/$90 out of network

$25 in network/$50 out of network

Emergency Room Deductible

$350 per incident

$350 per incident

$250 per incident

$100 per incident

Prescription Drugs

For outpatient prescriptions: 50% of actual charges

$10 generic / $20 brand name

$10 generic / $20 brand name

$10 generic / $20 brand name

Wellness

N/A

100% of one routine physical exam per member

100% of one routine physical exam per member

100% of one routine physical exam per member

Physical Therapy & Chiropractic Care

$25 per visit per day. Must be ordered in advance by a physician and not obtained at a student health center.

$50 per visit

$50 per visit

$50 per visit

Dental Treatment
(Due to Accident)

N/A

N/A

$1,000 maximum per certificate period

$1,000 maximum per certificate period

Dental Treatment
(to alleviate pain)

N/A

N/A

$100

$100

Mental Health Disorders

Outpatient: $50 maximum per day, $500 maximum. Inpatient: Usual, reasonable and customary charges up to $5,000

$5,000

$10,000

80% in network; 60% out of network

Emergency Medical Evacuation

$50,000 lifetime maximum

$500,000 lifetime maximum

$500,000 lifetime maximum

$500,000 lifetime maximum

Accidental Death & Dismemberment

N/A

$25,000 lifetime maximum

$25,000 lifetime maximum

$25,000 lifetime maximum

Repatriation of Remains

$25,000 lifetime maximum

$25,000 lifetime maximum

$25,000 lifetime maximum

$25,000 lifetime maximum

Maternity Care for Covered Pregnancy

N/A

80% in network; 70% out of network

80% in network; 70% out of network

80% in network; 70% out of network

Intramural, Intercollegiate, Interscholastic or Club Sports

N/A

$5,000 maximum per injury or illness, medical expenses only

$5,000 maximum per injury or illness, medical expenses only

$5,000 maximum per injury or illness, medical expenses only

Terrorism

N/A

$50,000 lifetime maximum

$50,000 lifetime maximum

$50,000 lifetime maximum

Emergency Reunion

$1,000, subject to a maximum of 15 days

$2,500

$2,500

$5,000