Benefit Comparison Chart for 2025-2026 Academic Year
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| Comparison Points | Benefit with T-SHIP at The Health Center on Campus | T-SHIP In-Network | T-SHIP Out of Network | Your Plan |
|---|---|---|---|---|
| Annual Deductible | No Deductible | $250 | $500 | ? |
| Family Deductible | N/A | $750 | $1,500 | ? |
| Maximum Out of Pocket Limit | No Limit | $5,000 Per Insured Person, Per policy year $10,000.00 for all Insureds in a family Per Policy year | $5,000 Per Insured Person, Per policy year $10,000 for all Insureds in a family Per Policy year | ? |
| Office Visit | No Co-pay | Community Referral: $30 Co-Pay | Community Referral: $30 Co-Pay | ? |
| Emergency Room | N/A | $100 Co-pay | Co-pay + 60% of Usual and Customary Charges for Medical Expense | ? |
| Urgent Care | N/A | $30 Co-Pay in addition to Policy Deductible | $30 Co-Pay in addition to Policy Deductible | ? |
| In-House Laboratory Services | No Co-pay | 90% of Preferred Allowance for Covered Medical Expense after deductible is met | 60% of Usual and Customary charges for covered expense after deductible is met | ? |
| Inpatient Medical Visit | N/A | 90% of Preferred Allowance for Covered Medical Expense after deductible is met | 60% of Usual and Customary charges for covered expense after deductible is met | ? |
| Prescription Drugs | $15.00 Co-pay | Tier 1 $20 Co-pay Tier 2 $50 Co-pay Tier 3 $80 Co-pay | $20 Deductible per generic drug When Specialty Prescription Drugs are dispensed at a Non-Preferred Specialty Network Pharmacy, the Insured is required to pay 2 times the retail co-pay (up to 50% of the Prescription Drug Charge). | ? |
| Physical Therapy Visit | N/A | Community Referral: $30 Co-Pay in addition to Policy Deductible | Community Referral: $30 Co-Pay in addition to Policy Deductible | ? |
| Medical Coverage while Studying Abroad | N/A | 90% of Preferred Allowance for Covered Medical Expense after deductible is met | 60% of Usual and Customary charges for covered expense after deductible is met | ? |
