International Student, Exchange Visitor & OPT Insurance

After deductible, pays 100% to policy maximum, or
After deductible, pays 80% to policy maximum.
Outside PPO Network: After deductible, pays Usual, Reasonable, and Customary to policy maximum.

Through United Healthcare PPO Network

Within PPO network:
Elite: After copayments, plan pays 80% up to $10,000, then 100% up to the policy maximum.
Select: After copayments, plan pays 80% up to $25,000, then 100% up to the policy maximum.
Budget: After copayments, plan pays 80% up to $45,000, then 100% up to the policy maximum.
Smart: After copayments, plan pays 80% up to $100,000, then 100% up to the policy maximum.

Through United Healthcare PPO Network