Insurance Provider
|
Çб³º¸ÇèÁ¦ÈÞ |
LIG¼ÕÇØº¸Çè |
Lifetime Maximum
|
$500,000 |
Unlimited |
Benefit
|
Student: $100,000
|
$50,000 per Sickness or Injury |
Dependent:$50,000
|
copay or Deductible
°í°´ºÎ´ã±Ý |
Health Cente : none
|
$0 |
IN NETWORK:$350
|
OUT OF NETWORK:$500
|
Health Center
(´ëÇк¸°Ç¼¾ÅÍ ÀÌ¿ë½Ã) |
100% |
100% |
Çù·Âº´¿øÀÌ¿ë½Ã/º¸Çèȸ»çºÎ´ãºñÀ²
|
IN NETWORK:
80% Allowable Charge after
deductible with $200 copay per admission
|
ºñÇù·Âº´¿ø/º¸Çèȸ»çºÎ´ãºñÀ²
|
OUT OF NETWORK:
60% R&C after deductible with $300 copay per admission
|
100% |
Prescription Drug
(¾à°ª°í°´ºÎ´ã±Ý)
|
Health Center
80% º¸»óÀÌ µÇ°í $10 °í°´ºÎ´ãÀÌ ÀÖÀ½ ³â°£ $1,000 º¸»óÀÌ µÇ¸ç º¸»ó±â°£Àº
30ÀϱîÁöÀÓ
|
º¸»óÇѵµ¿¡ Æ÷ÇÔ
°í°´ºÎ´ã ¾øÀ½ |
IN - OUT OF NETWORK
80% after a $100 Policy Year deductible and $10 Generic copay/$25
³â°£ $1,000¸¸ º¸»óµÇ°í º¸»ó±â°£Àº 30ÀϱîÁöÀÓ
|
Premium
(Annual) |
Student: $1,227
Spouse:$1,752
Child: $1,461
|
Student: $492
Spouse:$492
Child:$492
|