Within PPO network: After copayments, plan pays 80% up to $25,000, then 100% up to the policy maximum.
Outside PPO network: Pays Usual, Reasonable and Customary to policy maximum.
Outside US: After copayments, plan pays 100% to policy maximum.
Before effective date, full refund.
After effective date, must be within first 60 days, pro-rated refund for whole months minus $25 cancellation fee, as long as no claims have been filed since the effective date; form required.
1 month up to 4 years
$0
Optional: Crisis Response Rider $100,000
Air Doctor Included