Medical Rates | Penn State Student Affairs

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Coverage Dates for 2020-2021

Annual
- August 13, 2020 - August 12, 2021
Fall
- August 13, 2020 - December 31, 2020
Spring
- January 1, 2021 - August 12, 2021

Student Rates for 2020-2021

Student Rates for 2020-2021
	Annual	Fall	Spring
Total: 100%	$3,393.00	$1,314.00	$2,079.00
Penn State: 80%	$2,714.40	$1,051.20	$1,663.20
Student: 20%	$678.60	$262.80 divded by 4 = $65.70	$415.80 divided by 5 = $83.16

Student & Spouse Rates for 2020-2021
	Annual	Fall	Spring
Total: 100%	$6,786.00	$2,628.00	$4,158.00
Penn State: 80%/75%	$5,259.17	$2,036.72	$3,222.45
Student: 20%/25%	$1,526.83	$591.28 divided by 4 = $147.82	$935.55 divided by 5 = $187.11

Student & 1 Child Rates for 2020-2021
	Annual	Fall	Spring
Total: 100%	$6,786.00	$2,628.00	$4,158.00
Penn State: 80%/75%	$5,259.17	$2,036.72	$3,222.45
Student: 20%/25%	$1,526.83	$591.28 divided by 4 = $147.82	$935.55 divided by 5 = $187.11

Student & 2 or More Children Rates for 2020-2021
	Annual	Fall	Spring
Total: 100%	$10,179.00	$3,942.00	$6,237.00
Penn State: 80%/76%	$7,871.78	$3,048.48	$4,823.10
Student: 20%/24%	$2,307.22	$893.52 divided by 4 = $223.38	$1,413.70 divided by 5 = $282.74

Student & Spouse & 1 Child Rates for 2020-2021
	Annual	Fall	Spring
Total: 100%	$10,179.00	$3,942.00	$6,237.00
Penn State: 80%/76%	$7,871.78	$3,048.48	$4,823.30
Student: 20%/24%	$2,307.22	$893.52 divided by 4 = $223.38	$1,413.70 divided by 5 = $282.74

Student & Spouse & 2 or More Children Rates for 2020-2021
	Annual	Fall	Spring
Total: 100%	$13,572.00	$5,256.00	$8,316.00
Penn State: 80%/76%	$10,450.47	$4,047.12	$6,403.35
Student: 20%/24%	$3,121.53	$1,208.88 divided by 4 = $302.22	$1,912.65 divided by 5 = $382.53

Payroll Deductions Will Appear on Paycheck as Follows
	Fall (Sept - Dec)	Spring (Jan - May)
Single Student	$65.70	$83.16
Student & Spouse	$147.82	$187.11
Student & Child	$147.82	$187.11
Student & Children	$223.38	$282.74
Family (Child)	$223.38	$282.74
Family (Children)	$302.22	$382.53