University of California - Los Angeles
International Student Health Insurance
Showing full year premium difference
| School Plan | Blue 80CA | Blue 90CA | Blue 100CA | |
|---|---|---|---|---|
| Plan Type | ACA Comliant | ACA comparable | ACA comparable | ACA comparable |
| Maximum | Unlimited | Unlimited | Unlimited | Unlimited |
| Co-insurance (Network) | 80% | 80% | 90% | 100% |
| Co-insurance (Out-of Network) | 60% | 70% | 70% | 80% |
| Deductible in Student Health Center | $0 | $0 | $0 | $0 |
| Deductible in Network | $300 | $500 | $100 | $0 |
| Copay in SHC | $0 | $0 | $0 | $0 |
| Prescription Drug | Direc-billing | Direct-billing | Direct-billing | Direct-billing |
| Preventive care (Network/SHC) | 100% | 100% | 100% | 100% |
| Out of Pocket Max (Network) | $3,000 | $8,000 | $7,000 | $5,000 |
| Medical Network | Blue Care | Aetna | Aetna | Aetna |
| Yearly rates (17~24) | $3,885 | $1,145 | $1,567 | $1,907 |
| Yearly rates (25~29) | $3,885 | $1,802 | $2,190 | $2,879 |
| Yearly rates (30~45) | $3,885 | $2,940 | $4,863 | $6,279 |
| Detail | Detail | Detail | Detail | |
| Individual | Buy | Buy | Buy | |
|
Group
(Partner Member Savings)
If you are a member of an international student organization or club, contact dian@dianins.com to apply for preferred group rates. |
Group | Group | Group |
