Page 3 - StudentSecure_Products-Comparison
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2/4/2019 https://quote.hccmis.com/content/studentsecure/help/PolicyHelpStd.htm#diff
BENEFIT ELITE SELECT BUDGET SMART
Coinsurance - Within the PPO: We will Within the Within the PPO: Within the PPO:
claims incurred pay 100% of eligible PPO: We will
inside the U.S. expenses, after the pay 80% of the We will pay 80% We will pay 80%
deductible, up to the overall next $5,000 of
maximum limit. eligible expenses of the next of eligible
Outside the PPO: Usual, after deductible,
reasonable, and customary. then 100% to the $25,000 of expenses after the
You may be responsible for overall
any charges exceeding the maximum limit. eligible expenses deductible up to
payable amount. Outside the
PPO: Usual, after deductible, the overall
reasonable, and
customary. You then 100% to the maximum limit.
may be
responsible for overall maximum Outside the
any charges
exceeding the limit. PPO: Usual,
payable amount.
Outside the reasonable, and
PPO: Usual, customary. You
reasonable, and may be
customary. You responsible for
may be any charges
responsible for exceeding the
any charges payable amount.
exceeding the
payable amount.
Coinsurance - After the deductible, 100% of eligible expenses to the certificate period maximum.
claims incurred
outside the U.S.
Eligible expenses are subject to deductible, coinsurance, overall maximum limit, and are per certificate
period unless specifically indicated otherwise.
BENEFIT ELITE Limit SELECT Limit BUDGET Limit SMART Limit
Hospital room & Average semi-private room rate, including nursing services.
board
Local ambulance Up to $750 per injury / illness if hospitalized as Up to $500 per Up to $300 per
(Not subject to injury / illness if
coinsurance) inpatient injury / illness if hospitalized as
inpatient
hospitalized as
inpatient
Intensive care unit Up to the overall maximum limit
Outpatient treatment Up to the overall maximum limit
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BENEFIT ELITE SELECT BUDGET SMART
Coinsurance - Within the PPO: We will Within the Within the PPO: Within the PPO:
claims incurred pay 100% of eligible PPO: We will
inside the U.S. expenses, after the pay 80% of the We will pay 80% We will pay 80%
deductible, up to the overall next $5,000 of
maximum limit. eligible expenses of the next of eligible
Outside the PPO: Usual, after deductible,
reasonable, and customary. then 100% to the $25,000 of expenses after the
You may be responsible for overall
any charges exceeding the maximum limit. eligible expenses deductible up to
payable amount. Outside the
PPO: Usual, after deductible, the overall
reasonable, and
customary. You then 100% to the maximum limit.
may be
responsible for overall maximum Outside the
any charges
exceeding the limit. PPO: Usual,
payable amount.
Outside the reasonable, and
PPO: Usual, customary. You
reasonable, and may be
customary. You responsible for
may be any charges
responsible for exceeding the
any charges payable amount.
exceeding the
payable amount.
Coinsurance - After the deductible, 100% of eligible expenses to the certificate period maximum.
claims incurred
outside the U.S.
Eligible expenses are subject to deductible, coinsurance, overall maximum limit, and are per certificate
period unless specifically indicated otherwise.
BENEFIT ELITE Limit SELECT Limit BUDGET Limit SMART Limit
Hospital room & Average semi-private room rate, including nursing services.
board
Local ambulance Up to $750 per injury / illness if hospitalized as Up to $500 per Up to $300 per
(Not subject to injury / illness if
coinsurance) inpatient injury / illness if hospitalized as
inpatient
hospitalized as
inpatient
Intensive care unit Up to the overall maximum limit
Outpatient treatment Up to the overall maximum limit
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