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Medical Coverage

University Health Services: No Charge for University Health Services office visit.

Primary Care or Specialist Office Visit: $20 Copayment* due at the time of service, 80% of remaining balance is paid for by The Plan, 20% of remaining balance is the responsibility of the student.

* Copayments do not accumulate toward the out-of-pocket maximums.

Urgent Care Facility: $30 Copayment* due at the time of service, 80% of remaining balance is paid for by the Plan, 20% of remaining balance is the responsibility of the student.

* Copayments do not accumulate toward the out-of-pocket maximums.

Emergency Room: $50 Copayment* due at the time of service (waived if admitted), 80% of remaining balance is paid for by the Plan, 20% of remaining balance is the responsibility of the student.

* Copayments do not accumulate toward the out-of-pocket maximums.

Outpatient Services

In-Network: 80% of eligible charges are paid for by the Plan, the remaining 20% of charges are the responsibility of the student.

Out-of-Network:

60% of eligible charges are paid for by the Plan, the remaining 40% of charges are the responsibility of the student.

* This includes outpatient maternity services.

Mammography

The Plan will pay the cost, up to $85 per exam, for routine mammograms as follows:

Student Age (Years) # Exams
35 but less than 40 1 every 4 plan years
40 but less than 501 every 2 plan years
(1 per plan year if certified as high risk for breast cancer)
over 501 per plan year

Inpatient Services*

In-Network: 80% of eligible charges are paid for by the Plan; the remaining 20% of charges are the responsibility of the student.

Out-of-Network: 60% of eligible charges are paid for by the Plan; the remaining 40% of charges are the responsibility of the student.

*This includes inpatient maternity services

Medical Plan Out of Pocket Maximums:

In-Network: $5,000, per Plan Year

Out-of-Network: $7,500, per Plan Year

The Plan will pay 100% of the excess of eligible expenses incurred after the out-of-pocket maximum has been met, up to a maximum benefit of $250,000 per Plan Year.

Student Medical Plan Year and Lifetime Maximums:

Medical and Prescription Benefits Plan Year Maximum: $250,000

Medical and Prescription Benefits Lifetime Maximum: $2,000,000