Trail Blazer Elite

 

  • $600,000 Medical Maximum Per Accident or Sickness
    Unlimited Lifetime Maximum
    $100 Deductible per Policy Period

Rates (per month)

$104
BenefitsCoverage
Annual/Lifetime Maximum Unlimited
Maximum per Covered Accident or Sickness $600,000
Deductible $100 per Policy Period
Coinsurance Single:  80% of Covered Expenses for the first $10,000; 100% of Covered Expenses thereafter                                                           Family:  80% of Covered Expenses for the first $25,000; 100% of Covered Expenses thereafter
Maximum Out of Pocket $2,000 Single/ $5,000 Family
Pre-Existing Condition Limitation 6 months
Copays:  
Dr's Office Visit $25 Waived at Student Health Center
Emergency Room $100
Hospital room and Board $100
Prescription Drugs $20 Generic $50 All Other $15 Oral Contraceptives
Maximum for Dental Treatment $2,500 (Injury Only)
AD&D $15,000
Emergency Evacuation/Repatriation of Remains 100% of Actual Cost
Emergency Reunion $3,500
Family Reunion $3,500