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Texas Tech University ̱бTexas Tech University
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.

 

 

  Texas Tech University  б .

 

 

 

Insurance  Provider

б޺

DBغ

 

 

Life Maximum

 

 

$100,000

Unlimited

 

 

Major Benefit

 

 

$100,000

 

$50,000 per Sickness or Injury

Copayment

 

ȸ翡

 

ϴº

 

 

In Network: 80%

 

 

100%

 

 

Out of Network: 60%

 

 

 

Deductible

 

δ

 

$250 per policy year

No deductible

 

 

 

 

Prescription Drugs

 

పδ

 

In Network:

 

 

AT TTU SHS

 

$15 copay Generic/ $30 Brand Name

At Prime Therapeutics participating pharmacies:

$20 copay Generic/ $40 Brand Name

 

($1,500 maximum

per Policy year)

 

 

 

 

 

ѵ

 

δ

 

Out of Network:

 

70% of Usual & Customary Charge after $20 Deductible Generic/ $40 Deductible Name

 

($1,500 maximum

 per Policy year)

 

 

Premium

(Annual)

 

 

Student:$1,390

Spouse:$3,849

Child:$1,301

 

 

Student:$480

Spouse:$480

Child:$480

 

 



 

 

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