- Lifetime maximum:
Unlimited
- Annual maximum:
$100,000
- Co-insurance in network:
80%
- Co-insurance out-of-network:
60%
- Deductible per sickness or injury:
$500
- Co-pay in ER (waived if admitted):
$350
- Co-pay in SHC:
$5
- Co-pay hospitalization:
$200
- Pre-existing condition waiting period:
12 months
- Medical evacuation:
$50,000
- Repatriation:
$25,000
- Rating base:
Monthly
- Premium:
$37.0/Month
- Annual maximum:
$500,000
- Co-insurance in network:
90%
- Co-insurance out-of-network:
70%
- Deductible per sickness or injury:
$100
- Co-pay in ER (waived if admitted):
$350
- Co-pay in SHC:
$5
- Co-pay hospitalization:
$200
- Pre-existing condition waiting period:
6 months
- Medical evacuation:
$50,000
- Repatriation:
$50,000
- Rating base:
Monthly
- Premium:
$95.0/Month