Bronze Silver
Price/30 days
$30.60
$250 ded.
$50.70
$1500 ded.
$56.10
$500 ded.
$66.30
$100 ded.
PPO Network UnitedHealthcare UnitedHealthcare
Maximum Benefit $500,000 $500,000
Deductible at SHC $0 $0
Co-Insurance 80% 80%
Physician Visits $0 copay (max $50) $0 copay
Urgent Care $0 copay $0 copay
Emergency Room Visits $350 copay $500 copay
Prescription Drugs 100% (Max $100 PIS) 70%
Preventive Care Not Covered Not Covered
Pre-existing Condition ✓ (after 6 months) ✓ (after 6 months)
Out-of-Pocket Maximum ✘ ✘
Maternity 80% 80%
Mental Health 80% 80%
Intramural, Club & Recreational Sports ✘ ✘
Pediatric Dental/Vision ✘ ✘
Medical Evacuation & Repatriation ✓ ($60,000 Max) ✓
Return of Mortal Remains ✓ ($50,000 Max) ✓
Worldwide Coverage ✓ ($1,000 for HomeCountry) ✓ (except Home Country)
The plan comparison and benefit information provided on this webpage is for general reference only and does NOT guarantee coverage or payment. For complete and detailed information regarding your coverage, plan benefits, exclusions, and claims procedures please download the official Policy Brochure and/or Terms & Conditions. The provisions outlined in the Policy Brochure and/or Terms & Conditions will prevail.