Outpatient Mental/Nervous
In-Network: After a $30 Copay per visit, 100% of eligible charges are paid for by the Plan.
Out-of-Network: After a $30 Copay per visit, 60% of eligible charges are paid for by the Plan; the remaining 40% of charges are the responsibility of the student.
Inpatient Mental/Nervous and Chemical Dependency
In-Network: 80% of eligible charges are paid for by the Plan; the remaining 20% of charges are the responsibility of the student.
Out-of-Network: 60% of eligible charges are paid for by the Plan; the remaining 40% of charges are the responsibility of the student.