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|
Benefits Summary
Personal Choice® PPO
| Benefits |
Personal Choice 5 |
Personal Choice 15 |
Personal Choice 10/20/70 |
Personal Choice 1020/80/50 |
| |
In-Network |
Out-of-Network |
In-Network |
Out-of-Network |
In-Network |
Out-of-Network |
In-Network |
Out-of-Network |
| Deductible Ind/Family |
NONE |
$250/$500 |
NONE |
$250/$500 |
NONE |
$300/$600 |
$1,000/$2,000 (in-network/out-of-network combined) |
| After Deductible, Plan Pays |
100% |
80% |
100% |
80% |
100% |
70% |
80% |
50% |
| Out of Pocket Ind/Family |
NONE |
$1,000/$2,000 |
NONE |
$1,000/$2,000 |
NONE |
$2,000/$4,000 |
$3,000/$6,000 |
$10,000/$20,000 |
| Overall Lifetime Maximum |
Unlimited |
$1 Million |
Unlimited |
$1 Million |
Unlimited |
$1 Million |
Unlimited |
$500,000 |
| Primary Care Provider Office Visit |
$5 |
80% |
$15 |
80% |
$10 |
70% |
$20 |
50% |
| Specialist Visit |
$5 |
80% |
$15 |
80% |
$20 |
70% |
$30 |
50% |
| Inpatient Hospital Care |
100% |
80% |
100% |
80% |
$75 per day, $375 per adm |
70% |
80% |
50% |
| Lab |
100% |
80% |
100% |
80% |
100% |
70% |
100% |
50% |
| Preventive Care Office Visits |
$5 |
80% |
$15 |
80% |
$10 |
70% |
$20 |
50% |
| Routine Gyn Exam/Pap Smear |
100% |
80% |
100% |
80% |
100% |
70% |
100% |
50% |
| Maternity Care: First OB Visit |
$5 (100% thereafter) |
80% |
$15 (100% thereafter) |
80% |
$10 (100% thereafter) |
70% |
$20 (100% thereafter) |
50% |
| Maternity care: Inpatient Hospital |
100% |
80% |
100% |
80% |
$75 per day, $375 per adm |
70% |
80% |
50% |
| Emergency Care |
$25 (waived if admitted) |
$25 (waived if admitted) |
$40 (waived if admitted) |
$40 (waived if admitted) |
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