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Dartmouth College ̱бDartmouth College
Ȩ л, ȯ, ýĮ, Ʈ, ⱹϽô ݰ е ϽǼ ִ Դϴ.
Ͻø û ۼ ֽðų ̸ ֽø ˴ϴ.
ǽð Ͻø MSN ȭ ߰ ֽø ܱ ô Ǹ ϽǼ ֽϴ.

 

 

 

 

 Dartmouth College   Ͽϴ

 

 

 

 

Insurance  Provider

 

 

б޺

CO-INSURANCE COVERAGE

 

 

DBغ

 

 

Life Maximum

 

 

    $2,000,000

Unlimited

 

 

 

benefits

 

 

 

$2,000,000

 

$50,000 per Sickness or Injury

Deductible

δ

 

$50    (л)

 

$0

 

$100  ()

 

Out of Pocket Maximum

 

δ

 

л: $750

δݾ100%

: $1,000

 

 

Hanover Area

In-Network1

 

º̿úȸ纸

 

80%~100%

100% ȸ翡

 

 

Out of Hanover Area

In-Network

 

º̿úȸ纸

 

80%

 

Non-PPO Network

 

º̿úȸ纸

 

70%~80%

 

 

Prescription Drug

 

ప δ

 

80%

ѵ

 

 

Emergency Room Services

 

 

 

 

100% after $50

co-payment

 

100%

 

Ambulance

 

 

100% after $100

co-payment

 

100%

Premium

(Annual)

 

Student:$1,929

Dependent:$3,273

2 Or More Dependents: $4,672

 

Student : $480

Spouse: $480

Child: $480



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   3. ܼ ǰ ˻縦 ϴ (÷ ˻ ǰ
   4 . (б н Immunization

5. Ű ȯ/ൿ

6. HIV()

7. 񴢱(ΰἮ)

8. 񴢱 ȯN39 Ǵ DZ