Indiana University Bloomington |
̱бIndiana University Bloomington |
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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. |
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Indiana University Bloomington б .
Insurance Provider
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б |
DBغ |
Life Maximum
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$100,000 |
Unlimited |
Major Benefit
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$100,000 |
$50,000 per Sickness or Injury |
Copayment
ȸ翡
ϴº |
In Network: 100%
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100% |
Out of Network: 50%
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Deductible
δ |
In Network :
$500 Per Covered Person Per Policy Year.
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No deductible |
Out of Network:
$750 Per Covered Person Per Policy Year
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OUT-OF-POCKET
MAXIMUMS
Ⱓ δ
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Individual $1,000 |
$0 |
Prescription Drug
పδ |
In Network : ౹
100% of the Negotiated Charge, following a $20 copay for each Brand
Name Prescription Drug or
a $10 copay for each Generic Prescription Drug.
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$0 |
Out of Network : ౹
Not applicable.
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$0 |
Premium
(Annual)
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Student:$892
Spouse:$2,133
Children:$1,619
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Student:$480
Spouse:$480
Child:$480
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ʴ
1. (谡 ִ ȯ̳ ü ġ ˻縦 ) 2. ӽ, õ 3. ܼ ǰ ˻縦 ϴ (÷ ˻ ǰ ) 4 . (б н Immunization )
5. Ű ȯ/ൿ
6. HIV()
7. (ΰἮ)
8. ȯN39 Ǵ DZ
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