Bronze Explorer Silver Diamond Elite
Price/30 days
Deductible
PPO Network UnitedHealthcare Aetna UnitedHealthcare UnitedHealthcare
Maximum Benefit $250,000 Unlimited OR $1,000,000 $500,000 Unlimited
Deductible at SHC $40 $0 $0 $0
Covid-19 Testing ✓ ✓ ✓ ✓ (1 Free without referral)
Co-Insurance 100% 100% 80% 90%
Physician Visits $0 copay (max $50) $50 copay $0 copay $20 copay
Urgent Care $0 copay $50 copay $50 copay $50 copay
Emergency Room Visits $100 copay $350 copay $200 copay $150 copay
Prescription Drugs 100% (max $200) 100% 70% $15/$30/$50 copays
Preventive Care Not Covered Not Covered Not Covered 100% In-Network
Pre-existing Condition $1,000 benefit; No exclusion after 12-mos ✘ ✓ (after 6 months) No waiting period
Out-of-Pocket Maximum ✘ ✘ ✘ $5,000
Maternity 100% ✘ 80% 90%
Mental Health 100% 100% 80% 90%
Intramural, Club & Recreational Sports ✘ ✘ ✓ ✓
Pediatric Dental/Vision ✘ ✘ ✘ ✓
Medical Evacuation & Repatriation ✓ ✓ ($100,000 Max) ✓ ✓
Return of Mortal Remains ✓ ✓ ($50,000 Max) ✓ ✓
Worldwide Coverage ✓ (except Home Country) ✓ (except Home Country) ✓ (except Home Country) ✓ (except Home Country)