Plan E PLUS
Underwritten by Lloyd's, London -
Lloyd's has an
A rating from A.M. Best and A+ ratings from Fitch Ratings and Standard &
Poor's |
| Plan E PLUS Monthly Rates (30-day month) Rates are Based on the Age of each
Applicant
- Rates are the SAME for Dependents. Dependent(s) may enroll without
student. |
| |
$50,000 Medical |
$100,000 Medical |
$250,000 Medical |
| AGE |
$500
Deductible |
$250
Deductible |
$100
Deductible |
$0
Deductible |
$500
Deductible |
$250
Deductible |
$100
Deductible |
$0
Deductible |
$500
Deductible |
$250
Deductible |
$100
Deductible |
$0
Deductible |
| 0-29 |
$33.90 |
$38.10 |
$41.70 |
$48.90 |
$42.30 |
$47.40 |
$52.20 |
$61.50 |
$48.00 |
$53.40 |
$59.10 |
$69.60 |
| 30-39 |
$45.30 |
$50.40 |
$55.20 |
$65.10 |
$56.70 |
$62.70 |
$69.00 |
$81.30 |
$63.90 |
$70.80 |
$78.00 |
$92.10 |
| 40-49 |
$71.10 |
$78.90 |
$87.30 |
$102.90 |
$89.10 |
$99.00 |
$108.90 |
$128.70 |
$100.50 |
$111.30 |
$122.40 |
$144.90 |
| 50-59 |
$107.10 |
$119.10 |
$130.80 |
$154.50 |
$133.50 |
$148.80 |
$163.50 |
$193.50 |
$151.20 |
$167.70 |
$184.20 |
$218.10 |
| 60-64 |
$133.80 |
$148.80 |
$163.50 |
$193.50 |
$167.40 |
$186.00 |
$204.60 |
$241.80 |
$188.70 |
$209.70 |
$230.70 |
$272.70 |
| 65-69 |
$166.50 |
$184.80 |
$203.70 |
$240.60 |
n/a |
n/a |
n/a |
n/a |
n/a |
n/a |
n/a |
n/a |
| 70-79* |
$210.00 |
$233.10 |
$256.80 |
$303.30 |
n/a |
n/a |
n/a |
n/a |
n/a |
n/a |
n/a |
n/a |
|
*Maximum
Medical coverage is $50,000 for Age 65-79. |
|
|
$500,000 Medical |
$1,000,000 Medical |
ORDER ONLINE - Immediate ID Card
PRICES REMAIN THE SAME FOR
2018-2019!
Any Travel
Worldwide - Any Visa! |
| AGE |
$500
Deductible |
$250
Deductible |
$100
Deductible |
$0
Deductible |
$500
Deductible |
$250
Deductible |
$100
Deductible |
$0
Deductible |
| 0-29 |
$52.80 |
$59.10 |
$64.80 |
$76.50 |
$57.60 |
$63.90 |
$69.90 |
$83.10 |
| 30-39 |
$70.50 |
$78.00 |
$85.50 |
$101.40 |
$76.20 |
$84.90 |
$93.60 |
$110.40 |
Please Note:
J Exchange Visitor MINIMUM Medical requirement
is $100,000 |
| 40-49 |
$110.40 |
$122.40 |
$135.00 |
$159.30 |
$120.90 |
$133.80 |
$147.30 |
$174.30 |
| 50-59 |
$165.90 |
$184.20 |
$202.50 |
$239.70 |
$180.90 |
$201.00 |
$221.40 |
$261.60 |
| 60-64 |
$207.30 |
$230.70 |
$253.80 |
$299.70 |
$226.20 |
$251.40 |
$276.30 |
$326.70 |
 |
| 65-69 |
n/a |
n/a |
n/a |
n/a |
n/a |
n/a |
n/a |
n/a |
| 70-79* |
n/a |
n/a |
n/a |
n/a |
n/a |
n/a |
n/a |
n/a |
|
Plan E PLUS Coverages
|
| Coverages |
Plan E PLUS |
Plan E PLUS
with
Hazardous Sports Coverage (additional fee) |
Accident & Sickness
Medical
Routine physical exams and vaccinations are
not covered |
Choose
$50,000, $100,000, $250,000, $500,000
OR $1,000,000
Medical Maximum
per injury or illness
Age 0-64
$50,000 Age 65-79 |
Choose $50,000,
$100,000, $250,000, $500,000
OR $1,000,000
Medical Maximum
per injury or illness
Age 0-64
$50,000 Age 65-79 |
Annual Deductible
For a covered
medical expense, the Deductible is the portion of your medical
bill that is your responsibility. |
Choose
$0, $100,
$250 or $500 Deductible per
policy period
Students: please check if
your school allows higher
deductibles |
Choose $0, $100,
$250 or $500 Deductible per
policy period
Students: please check if
your school allows higher
deductibles |
Co-insurance
Co-insurance: Your share of the costs of
a covered health care service, calculated as a percent (20%) of
the allowed amount for the service. |
After You pay the Deductible, the plan pays 80%
of the next $5,000 of eligible expenses, then 100% to the
selected Medical maximum
|
After You pay the Deductible, the plan pays 80% of the next
$5,000 of eligible expenses, then 100% to the selected Medical
maximum |
| Emergency Medical
Evacuation |
up to $100,000 |
up to $100,000 |
| Repatriation of mortal
remains |
up to $25,000 |
up to $25,000 |
| Pre-existing condition
coverage |
No coverage
for
Pre-existing medical condition, sickness, Injury, Illness,
disease, Mental Illness or Mental Nervous Disorder, regardless
of the cause including any congenital, chronic, subsequent, or
recurring complications or consequences related thereto or
resulting therefrom that with reasonable medical certainty
existed at the time of application or any time during the 36
months prior to the effective date of coverage under this policy, whether or not previously manifested, symptomatic, known,
diagnosed, treated or disclosed.
|
No coverage for Pre-existing medical condition, sickness,
Injury, Illness, disease, Mental Illness or Mental Nervous
Disorder, regardless of the cause including any congenital,
chronic, subsequent, or recurring complications or consequences
related thereto or resulting therefrom that with reasonable
medical certainty existed at the time of application or any time
during the 36 months prior to the effective date of coverage
under this policy, whether or not previously manifested, symptomatic, known, diagnosed, treated or disclosed.
|
| AD&D - Accidental Death
& Dismemberment |
$25,000 per
Insured/Spouse $5,000 per Dependent Child |
$25,000 per
Insured/Spouse $5,000 per Dependent Child |
| Maternity coverage |
No coverage |
No coverage |
| Home Country coverage |
60 days per 12 months
of coverage up to $50,000 |
60 days per 12 months
of coverage up to $50,000 |
|
Dental (Accident Coverage only) |
To a maximum
of $500 (available only if purchased for 1 month or more) |
To a maximum
of $500 (available only if purchased for 1 month or more) |
| Personal
Liability |
$100,000 /
$25,000 Property Damage |
$100,000 / $25,000 Property Damage |
Hazardous Sports
coverage
(Includes: Hang gliding, parachuting,
bungee jumping, snowmobiling, jet skiing, water skiing, snow
skiing, spelunking, parasailing, and snowboarding.) |
No coverage |
included
for an additional fee |
| Trip Interruption |
up to $5,000 |
up to $5,000 |
| Return of minor child |
up to $10,000 |
up to $10,000 |
| Lost baggage |
up to $250 |
up to $250 |
| Assistance
Services |
Included |
Included |
| View Policy
Details |
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