Features | SC Essential | SC Basic | SC Plus | SC Elite |
Primum (Start From) |
$47.33/Month |
$62/Month |
$87/Month |
$107.83/Month |
Policy Maximum | $100,000 (For Each Injury Or Sickness) | $500,000 (For Each Injury Or Sickness) | No Overall Maximum Limit | No Overall Maximum Limit |
TPA & In-Network Provider | UnitedHealthcare Student Resources UHC Option PPO | UnitedHealthcare Student Resources UHC Option PPO | UnitedHealthcare Student Resources UHC Option PPO | UnitedHealthcare Student Resources UHC Option PPO |
Co-Insurance |
80% In-Network and 70% Out of Network |
80% In-Network and 70% Out of Network |
80% In-Network and 70% Out of Network |
90% In-Network and 70% Out of Network |
Deductibles (Per Person Per Policy Year) |
Option 1: $150 In-Network/$500 Out of Network Option 2: $500 In-Network/$750 Out of Network |
Option 1: $100 In-Network/$500 Out of Network Option 2: $500 In-Network/$750 Out of Network |
Option 1: $100 In-Network/$500 Out of Network Option 2: $500 In-Network/$750 Out of Network Option 3: $1,500 In-Network/$2500 Out of Network Option 4: $2,000 In-Network/$3,000 Out of Network |
Option 1: $100 In-Network/$500 Out of Network Option 2: $500 In-Network/$750 Out of Network |
Out of Pocket Maximum | Not Applicable | Not Applicable | $6,850 (In-Network Providers, Per Insured Per Policy Year) | $5,000 (In-Network Providers, Per Insured Per Policy Year) |
Co-payments (Per Visit) |
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Student Health Center Benefits* | Deductibles & Copays: Waived | Deductibles & Copays: Waived | Deductibles & Copays: Waived | Deductibles & Copays: Waived |
Pre-Existing Coverage | $1000 for 1st 6 months then upto policy maximum | $1000 for 1st 6 months then upto policy maximum | Covered from Day 1 without any Limitations | Covered from Day 1 without any Limitations |
Mental Illness & Substance Abuse Benefits | Paid as any other sickness | Paid as any other sickness | Paid as any other sickness | Paid as any other sickness |
Repatriations & Evacuations Benefits | Unlimited | Unlimited | Unlimited | Unlimited |
Prescriptions Drugs | Preferred Provide: No Benefits Out of Network Providers: 70% of Usual & Customary charges |
Tier 1: $20 Copays Tier 2: 30% Co-insurance Tier 3: 40% Co-insurance (Per Prescription) |
Tier 1: $15 Copays Tier 2: 30% Co-insurance Tier 3: 45% Co-insurance (Per Prescription) |
Tier 1: $15 Copays Tier 2: 30% Co-insurance Tier 3: 45% Co-insurance (Per Prescription) |
Preventive Care Services(not Subject to Deductible) | No Benefits |
100% of Preferred Allowance $1000 Maximum (Per Policy Year) |
100% of Preferred Allowance | 100% of Preferred Allowance |
Titers Benefits** | Preferred Allowance after Deductible | Preferred Allowance after Deductible | Preferred Allowance after Deductible | Preferred Allowance after Deductible |
Download Flyer | Download File | Download File | Download File | Download File |
Download Brochure | Download File | Download File | Download File | Download File |
Apply Now | Apply Now | Apply Now | Apply Now | |
Note: # It is always recommended to check the benefit summary and exclusions given in the brochure # Premium depends as per the age bracket: 22 & Below, 23-26, 27-30, Above – 30 # Different Plans may be accepted in the different universities, check the plans accepted in your university *The Deductible and Copays will be waived and benefits will be paid at preferred provider level of benefits when treatment is rendered at Student Health Center ** Titers Benefits include immunization for the following: Polio Virus Immune Status, Varicella-Zoster AB, IgG, Hepatitis B Surf AB, MMR, Hep B, Hep A, Tdap and Rubella |