Attachment J.6 - Plan 1 Cost Reimbursement Fee Schedule.pdf

Attachment J.6.

Plan 1 Cost Reimbursement Fee Schedule

US Peace Corps Office of Health Services (OHS)

J.6 - Plan 1 Cost Reimbursement

The current cost reimbursements allowed under Plan I (as of May 2016):

Female Under 50 Female Over 50 Male Under 50 Male Over 50 Medical $165 $290 $125 $175 Dental $60 $60 $60 $60 Vision $12 $12 $12 $12 Total $217 $342 $177 $227

Yellow Fever Vaccination: $150. These applicants will receive an additional cost-share form at the time of their invitation to service if they will be serving in a country where Yellow Fever vaccination is required. It is noted that dental and vision reimbursements do not change based on age or gender. The reimbursements for individuals qualifying under Plan I are: dental at $60 and the vision reimbursement at $12. The two variables in the pricing medical reimbursement pricing are related to age and gender.