|
iStudentCity Student Health Insurance Plan Summary & Complete Pricing
|
| Three Options for You: |
Plan A |
Plan B |
Plan C |
Maximum Benefit
(You can choose based on your school requirement) |
$100,000
|
$250,000
|
$500,000
|
Insurance Price
- Student/Scholar |
$55/mo
|
$65/mo
|
$112/mo
|
Insurance Price
- Spouse |
$145/mo
|
$155/mo
|
$261/mo
|
Insurance Price
- 1 Child Only |
$89/mo
|
$95/mo
|
$170/mo
|
Insurance Price
- 2 or More Children |
$125/mo
|
$145/mo
|
$414/mo
|
| Deductible |
$100
per policy year per insured person |
| Coverage |
100% of Preferred Allowance for PPO;
80% of Reasonable and Customary Expenses (R&C) when treated by non-network providers
|
| Prescription Medication |
100% of R&C, up to $3,000
After a $20 copay per prescription
|
| In-patient Benefit |
Yes |
| Lab, Diagnostic, X-ray |
Yes |
| Pre-admission Testing |
Yes |
| Physiotherapy |
Yes |
| Accidental Death and Dismemberment Benefits |
Yes |
| Medical Evacuation |
100% of policy maximum coverage |
| Repatriation of Remains |
100% of policy maximum coverage |
