Travel
Medical Insurance
- STEP3 - Rate Tables
- You must first complete Step 1 (Eligibility Requirements) and Step 2 (Plan Qualification)
home ~ auto ~ new ~ search ~ contents ~ feedback ~ travel
|
Click on the Plan for which you qualify
| PLAN A - No Medical Conditions | ||||||
| (Five (5) Year Pre-Existing Condition) | ||||||
| SINGLE TRIP | RATES PER PERSON PER DAY |
|||||
| Total No. of Days |
|
|
|
|
|
|
| 15-62 Days | 1.50 | 1.90 | 2.60 | 3.05 | 4.80 | 8.50 |
| 63-92 Days | 1.52 | 1.95 | 2.60 | 3.35 | 5.95 | 9.50 |
| 93-122 Days | 1.53 | 1.98 | 2.85 | 3.50 | 6.30 | 10.35 |
| 123-152 Days | 1.55 | 2.15 | 3.05 | 3.65 | 6.55 | 10.75 |
| 153-183 Days | 1.70 | 2.60 | 3.35 | 3.70 | 6.90 | 11.25 |
| ANNUAL MULTI-TRIP | RATES PER PERSON |
|||||
| Maximum Days per Trip |
|
|
|
|
|
|
| 30 Days | $65 | $90 | $130 | $195 | $265 | $475 |
| 60 Days | $140 | $185 | $255 | $395 | $610 | $995 |
| 90 Days | $225 | $288 | $415 | $610 | $995 | $1,615 |
click here to go to the Application Form
| PLAN B - No Medical Conditions | ||||||
| (One (1) Year Pre-Existing Exclusion) | ||||||
| SINGLE TRIP | RATES PER PERSON PER DAY |
|||||
| Total No. of Days |
|
|
|
|
|
|
| 15-62 Days | 1.70 | 2.20 | 2.90 | 4.10 | 5.25 | 9.75 |
| 63-92 Days | 1.75 | 2.25 | 3.20 | 4.20 | 6.35 | 10.50 |
| 93-122 Days | 1.77 | 2.30 | 3.25 | 4.30 | 6.75 | 11.35 |
| 123-152 Days | 1.80 | 2.50 | 3.40 | 4.45 | 7.20 | 12.00 |
| 153-183 Days | 2.00 | 2.95 | 3.55 | 4.55 | 7.50 | 12.60 |
| ANNUAL MULTI-TRIP | RATES PER PERSON |
|||||
| Maximum Days per Trip |
|
|
|
|
|
|
| 30 Days | $70 | $95 | $140 | $208 | $282 | $505 |
| 60 Days | $150 | $198 | $285 | $420 | $640 | $1,055 |
| 90 Days | $240 | $305 | $440 | $635 | $990 | $1,685 |
click here to go to the Application Form
| PLAN C - One (1) Medical Condition Only | ||||||
| (One (1) Year Pre-Existing Exclusion) | ||||||
| SINGLE TRIP | RATES PER PERSON PER DAY |
|||||
| Total No. of Days |
|
|
|
|
|
|
| 15-62 Days | 2.25 | 2.89 | 3.87 | 5.03 | 7.65 | 13.51 |
| 63-92 Days | 2.29 | 3.01 | 4.16 | 5.48 | 8.55 | 13.74 |
| 93-122 Days | 2.33 | 3.07 | 4.29 | 5.71 | 8.85 | 14.68 |
| 123-152 Days | 2.43 | 3.27 | 4.50 | 6.12 | 9.74 | 15.52 |
| 153-183 Days | 2.63 | 3.88 | 4.74 | 6.88 | 10.04 | 15.92 |
| ANNUAL MULTI-TRIP | RATES PER PERSON |
|||||
| Maximum Days per Trip |
|
|
|
|
|
|
| 30 Days | $103 | $144 | $190 | $267 | $400 | $563 |
| 60 Days | $224 | $316 | $425 | $587 | $874 | $1,403 |
| 90 Days | $351 | $466 | $695 | $937 | $1,432 | $1,978 |
click here to go to the Application Form
| PLAN D - Two (2) Medical Conditions | ||||||
| (One (1) Year Pre-Existing Exclusion) | ||||||
| SINGLE TRIP | RATES PER PERSON PER DAY |
|||||
| Total No. of Days |
|
|
|
|
|
|
| 15-62 Days | 3.92 | 4.95 | 6.67 | 9.40 | 13.63 | 21.20 |
| 63-92 Days | 4.00 | 5.27 | 7.19 | 9.49 | 15.04 | 23.18 |
| 93-122 Days | 4.05 | 5.37 | 7.69 | 9.60 | 15.93 | 24.48 |
| 123-152 Days | 4.23 | 5.80 | 7.99 | 10.06 | 17.11 | 25.31 |
| 153-183 Days | 4.66 | 6.78 | 8.28 | 10.35 | 17.70 | 25.66 |
| ANNUAL MULTI-TRIP | RATES PER PERSON |
|||||
| Maximum Days per Trip |
|
|
|
|
|
|
| 30 Days | $150 | $193 | $289 | $442 | $714 | $820 |
| 60 Days | $308 | $442 | $586 | $937 | $1,546 | $1,929 |
| 90 Days | $512 | $655 | $908 | $1,489 | $2,383 | $3,015 |
click here to go to the Application Form
