| Gold | Platinum | |
|---|---|---|
| Price/30 days |
$78.90
$500 ded.
$96.30
$250 ded.
|
$120.60
$500 ded.
$142.80
$250 ded.
|
| PPO Network | UnitedHealthcare | UnitedHealthcare |
| Maximum Benefit | $2,000,000 | Unlimited |
| Deductible at SHC | $0 | $0 |
| Co-Insurance | 80% | 80% |
| Physician Visits | $25 copay | $25 copay |
| Urgent Care | $50 copay | $50 copay |
| Emergency Room Visits | $500 copay | $500 copay |
| Prescription Drugs | 70%; Max. Benefit of $2,000 | $20 copays/$40 copays / 60% co-insurance |
| Preventive Care | 100% In-Network; Max. Benefit of $500 | 100% In-Network |
| Pre-existing Condition | $2500 benefit; No exclusion after 6-mos | No Waiting Period |
| Out-of-Pocket Maximum | ✘ | $6,350 |
| Maternity | 80% | 80% |
| Mental Health | 80% | 80% |
| Intramural, Club & Recreational Sports | ✘ | ✓ |
| Pediatric Dental/Vision | ✘ | ✓ |
| Medical Evacuation & Repatriation | ✓ | ✓ |
| Return of Mortal Remains | ✓ | ✓ |
| Worldwide Coverage | ✓ (except Home Country) | ✓ (except Home Country) |