Silver Gold Diamond Elite Bronze
Price/30 days
Deductible
PPO Network UnitedHealthcare UnitedHealthcare UnitedHealthcare UnitedHealthcare
Maximum Benefit $500,000 $2,000,000 Unlimited $500,000
Deductible at SHC $0 $0 $0 $45
Covid-19 Testing ✓ ✓ (1 Free without referral) ✓ (1 Free without referral) ✓
Co-Insurance 80% 80% 90% 100%
Physician Visits $0 copay $25 copay $20 copay $0 copay (max $50)
Urgent Care $50 copay $50 copay $50 copay $0 copay (max $50)
Emergency Room Visits $200 copay $150 copay $150 copay $250 copay
Prescription Drugs 70% 70% $15/$30/$50 copays 100% (max $100)
Preventive Care Not Covered 100% In-Network 100% In-Network Not Covered
Pre-existing Condition ✓ (after 6 months) $2500 benefit; No exclusion after 6-mos No waiting period ✓ (after 6 months)
Out-of-Pocket Maximum ✘ ✘ $5,000 ✘
Maternity 80% 80% 90% 100%
Mental Health 80% 80% 90% 80%
Intramural, Club & Recreational Sports ✓ ✘ ✓ ✘
Pediatric Dental/Vision ✘ ✘ ✓ ✘
Medical Evacuation & Repatriation ✓ ✓ ✓ ✓ ($60,000 Max)
Return of Mortal Remains ✓ ✓ ✓ ✓ ($50,000 Max)
Worldwide Coverage ✓ (except Home Country) ✓ (except Home Country) ✓ (except Home Country) ✓ ($1,000 for HomeCountry)