FL Trail Blazer Elite

 

  • Rates Starting at $70 per month
    $600,000 Medical Maximum per Accident or Sickness
    No Deductible and Lowered Out of Pocket Expenses
    $20 Office Copay (Waived at Student Health Center)

Rates (per month)

$70
Benefits Coverage
Annual/Lifetime Maximum Unlimited
Maximum per Covered Accident or Sickness $600,000
Deductible $0
In Network Coinsurance Single:  80% of Preferred Provider Charges up to $10,000; 100% of Preferred Provider Charges thereafter
Family:  80% of Preferred Provider Charges up to $25,000; 100% of Preferred Provider Charges thereafter
Out of Network Coinsurance 70% of Usual & Customary
Maximum Out of Pocket- In Network Only $2,000 Single/ $5,000 Family
Pre-Existing Condition Limitation 6 months
Copays:  
Dr's Office Visit $20 Waived at Student Health Center
Emergency Room $75
Hospital room and Board $75
MRI/CAT Scans $100
Prescription Drugs $20 Generic $50 All Other $15 Oral Contraceptives
Maximum for Dental Treatment $2,500 (Injury Only)
AD&D $10,000
Emergency Evacuation/Repatriation of Remains 100% of Actual Cost
Emergency Reunion $3,500
Family Reunion $3,500

 

Florida Trail Blazer Brochure