| 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) |