|Boston University Health Plan||How the service is covered|
|Network Blue New England|
|BMC PCP and referrals||$15 copayment per visit|
|Non-BMC PCP and referrals||$30 copayment per visit|
|BU Health Savings Plan|
|In-network||10% coinsurance after deductible|
|Out-of-network||30% coinsurance after deductible|
|*Annual maximums are combined in-network and out-of-network.