Benefits in blue: Subject to MSRA
Benefits in black: Not subject to MSRA
(e.g. Hospital Stay or Out-Patient Surgery)
up to $250,000 per incident
(the most the plan pays per incident)
(the most the plan pays per lifetime)
- Surgical services do not include cosmetic surgery.
- Hospitalization, In-Patient and Out-Patient Surgery, Specialty Care, and Emergency Room services for pre-existing conditions have a 24 month waiting period. All other healthcare services for pre-existing conditions are eligible upon effective date.
- Eligibility for cancer conditions is provided after 12 months of continuous membership, if a pre-existing cancer condition did not exist prior to or at the time of application.
- Maternity is not covered.
- ER visits are subject to review, and are meant only for life threatening situations. Maximum out-of-pocket is $500 for the Plus Plan.
- Members under the age of 20 can qualify as dependents. Members ages 20–26 can qualify as a dependent if proven to be a full-time student.
* Annual physicals are available immediately at the cost of a Primary Care (PCP) visit. Free inclusive annual physicals are available after 9 months of continual membership; lifestyle lab testing not included.
** $25 per x-ray read fee at Urgent Care, (may vary by city)