| Coverages |
GEO BLUE NAVIGATOR |
Accident & Sickness
Medical
|
Unlimited |
Annual Deductible
For a covered
medical expense, the Deductible is the portion of your medical
bill that is your responsibility. |
Choice
of $0, $250, $500, $1,000, $2,500, $5,000
(J1 visa holders
must choose a $500 deductible or less) |
|
Copayments |
$30 copay per visit |
Co-insurance
Co-insurance: Your share of the costs of
a covered health care service, calculated as a percent of
the allowed amount for the service. |
GeoBlue Navigator has three tiers of
coinsurance: 100% outside the U.S., 80% in network in the U.S.,
60% out of network inside the U.S. |
Emergency Medical
Evacuation
(Must be approved in advance by the company) |
$250,000 maximum benefit for emergency medical evacuation |
Repatriation of mortal
remains
(Must be approved in advance by the company) |
$25,000 |
|
Pre-existing condition coverage |
The GeoBlue Navigator plan
does not cover services for treatment of a medical condition for
which medical advice, diagnosis, care, or treatment was
recommended or received during 365 days immediately preceding
the member’s eligibility date.
The 365-day pre-existing
conditions period can be reduced or eliminated if you have been
covered by a creditable group or individual health insurance
plan.
|
Preventive Care
Preventative Care For
Adults: (Age 19 and Older)
a. Routine Pap Smears, annual
mammogram
b. PSA For Men
c. Annual Physical
Examination/Health Screening
d. Diagnostic lab work & X-rays
e. Immunizations as recommended by the Center for Disease
Control (CDC) |
80% to Coinsurance Maximum then 100% |
|
Travel Vaccinations |
80% to Coinsurance Maximum then 100% |
|
Annual Physical Examination/Health Screening |
80% to Coinsurance Maximum then 100% Maximum Covered Expense of
$250 and limited to one per Calendar Year. |
| AD&D - Accidental Death
& Dismemberment |
Maximum Benefit: Principal Sum up to $10,000 |
| Maternity coverage |
12 month waiting period. Must request coverage at renewal |
| Assistance
Services |
Included |
|
View Policy
Details |
|
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