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GeoBlue Navigator Student Medical Insurance
Please use this high level information as a guide only and do not make any decisions solely based on this information. If you have any concerns, doubts or questions, please refer to the individual policy details for complete information, as it is not possible to accurately represent all the details in concise information such as follows, or call us for further details. If there is any discrepancy between this information and the actual policy details, the policy details will override.
All the amounts are in U.S. dollars.
Vision (eyeglasses, etc.) is not covered in any of the plans.
General
Navigator® Student
Within PPO: After deductible, pays 80% until co-insurance maximum, then covers at 100%.
Outside PPO: After deductible, pays 60% until co-insurance maximum, then covers at 100%.
Outside US: After deductible, covers at 100%.
Co-insurance maximum is based on deductible chosen.
To policy maximum
Medical - Outpatient
Within PPO network: $30 Copay: Deductible waived.
Otherwise, to policy maximum. 8 visits per year.
Within PPO network: $75 Copay: Deductible waived. Otherwise, to policy maximum.
To policy maximum
Extra $100 copay for visit that does not result in hospital admission.
$5,000, maximum supply of 90 days per prescription - Not subject to deductible.
To policy maximum
To policy maximum
To policy maximum
To policy maximum
To policy maximum
To policy maximum
Medical - Inpatient
To policy maximum, average semi-private room including nursing services.
To policy maximum
To policy maximum
To policy maximum
To policy maximum
To policy maximum
To policy maximum
Medical - Other Treatment And Services
10 days
To policy maximum
Same as any other eligible medical expense. Professional sports and SCUBA diving in excess of 20 meters in depth excluded.
To policy maximum
Only the complications of pregnancy.
To policy maximum, 60 day maximum.
$10 copay outside U.S., $30 copay within U.S. PPO network.
Included in the Mental & Nervous Disorder benefit
Physical Therapy: To policy maximum, 6 visits per year.
BlueCross BlueShield PPO
Network of physicians, hospitals, urgent cares, labs and other healthcare providers.
No network for pharmacies, dentists, ambulance.
After 12 month waiting period, same as any other eligible medical expense.
-
To policy maximum
-
Routine physical: $250 maximum 1 per year. Other Wellness: To policy maximum, deductible wavied.
-
Included
Dental
Optional
$500
Travel
Life
$10,000
$10,000
Other
-
-
-
-
-
-
Included
Outside Home Country
Plan Features
Before effective date, full refund.
After effective date, no refund.
3 months up to 12 months - after that members may re-enroll up to age 75
$0
Family Deductible limited to 2.5 times individual
Travel Vaccinations: $500
Email
Annual
$0 0-74
$250 0-74
$500 0-74
$1,000 0-74
$2,500 0-74
$5,000 0-74
Unlimited
-$1 0-74
GeoBlue
4 Ever Life International Limited
Get instant quotes for this plan and purchase today!
- For medical benefits, to policy maximum, refer to the Usual, Reasonable and Customary Charges. Deductible and coinsurance apply, unless otherwise noted.
- Whenever there is a difference in benefits levels within PPO network and outside PPO network, the benefits shown above are applicable when availing treatment within PPO network.
- Coverages shown are per person unless noted otherwise.
- The dash (-) in the fields above means Not Applicable (N/A).