how to choose the health plan that s right for you

Size: px
Start display at page:

Download "how to choose the health plan that s right for you"

Transcription

1 how to choose the health plan that s right for you

2 It s easy to feel a little confused about where to start when choosing a health plan. Some people ask their friends, family, or co-workers for advice. Knowing the right questions to ask can help you make an informed decision and find the right plan for you and your family. Take a moment to review the following questions. They discuss topics from which types of plans exist to what kind of coverage you might expect from these plans. Answering these questions can help you select a health plan that meets your specific needs.

3 Q: How can I figure out which health plan is right for me? A: First, consider how much coverage you need. Are you single, or do you have a family? Do you or a family member have a chronic condition? It s important to look at the full range of services and copayments (or copays ) you will spend out of pocket for doctors visits, surgery, hospital stays, or other types of care. And it s important to know whether your plan covers preventive services, prescription drugs, new glasses, or other services you may need. Q: Does this health plan s network include the doctors and hospitals I want? A: If you already have a family doctor, you may want to check to see if your doctor is included in the health plan s network. Q: What about cost? Should it be a factor in the decision? A: The cost of coverage is an important issue. You need to understand how much you will pay for your coverage in monthly premiums, how much your employer contributes, and what you will pay when you visit the doctor or go to an urgent care facility. Also, is there an annual deductible? Will you pay a dollar copay, or a percentage of the costs for services you receive?

4 Q&A Q: What are my options? A: You can choose an HMO or PPO health plan. There are many differences between these two types of plans, but the most significant is how you access covered services and how much you will pay out-of-pocket for these services, including any applicable deductibles. With an HMO, you must live or work within the service area covered by the plan. You also need to access all care from a medical group in the HMO provider network and designate a primary care physician or Personal Physician to coordinate all your healthcare needs. Check to see if your health plan offers a direct referral option to specialists within your medical group for a slightly higher copay. With a PPO plan, you can visit any licensed doctor, including specialists, without a referral. However, though a PPO plan might pay for services received outside the preferred network, you will pay more than if you had received care from a doctor within the network. Not all physicians accept both HMO and PPO plans. If there are particular doctors you want to see, make sure they accept the health plan you re considering.

5 questions? Q: What if you have a lot of options and are confused about how to narrow down your choices? A: Start with the basics. You need to know what types of doctors visits, surgery, or hospital services are covered in the benefit plan. Find out if the plan covers prescription drugs. And, of course, you need to know how much you re going to pay out of pocket, if there is a copayment or deductible you need to meet, or if there s an overall limit or cap on benefits. The bottom line is that it s important to know how the plan works. Don t wait until you need health care to ask those important questions.

6 Questions to consider... Consider these other questions when comparing plan options. Does the health plan help keep you well? 1. Cover preventive care to help you stay well? 2. Offer member programs and wellness discounts? 3. Offer incentives to stay well and adopt healthy habits? 4. Provide wellness programs to encourage a healthy pregnancy? 5. Offer access to resources related to women s health, men s health, and the health of children and seniors? Does the health plan make it easy for you to find quality care? 1. Have tools and resources to find local providers online? 2. Offer a hospital comparison tool to help you evaluate hospitals that are available to you? Does the health plan help you manage your prescriptions? 1. Allow you to a pharmacist for drug information? 2. Offer a mail order benefit that not only saves you money but is convenient?

7 does your health plan... Does the health plan keep your family covered? 1. Offer coverage to families living apart and dependent college students living outside California? 2. Are your children s pediatricians or specialists in the network? Does the health plan offer additional value-added services 1. Provide tools and resources to help you save money? 2. Provide you access to life management resources? 3. Offer discounts to services you use regularly? Does the health plan make it easy to do business with them? 1. Let you change doctors, order new ID cards, and view your claims history online? 2. Have dedicated calling centers to help you with claims and questions?

8 Health plan cost comparison Compare benefits Annual physical/ preventive care Office visits Diagnostics (such as lab work) Maternity coverage Well-baby exams Emergency room visits Hospital care (outpatient services) Prescription drug costs Copayment for alternative care visits (such as chiropractic) Mental health services Annual deductible Annual out-of-pocket maximum or copayment maximum Lifetime maximum Monthly rate Total costs Plan A How much is covered? You pay

9 What will you pay in total for your health plan coverage? Once you ve narrowed down your top health plan picks, be sure to compare costs side by side. Include in your total copayments, out-of-paycheck premium, and any deductibles or coinsurance that may be required by your health plan. Plan B Plan C How much is covered? You pay How much is covered? You pay Annual physical/ preventive care Office visits Diagnostics (such as lab work) Maternity coverage Well-baby exams Emergency room visits Hospital care (outpatient services) Prescription drug costs Copayment for alternative care visits (such as chiropractic) Mental health services Annual deductible Annual out-of-pocket maximum or copayment maximum Lifetime maximum Monthly rate Total costs

10 glossary Brand-name drugs: FDA-approved drugs under patent to the original manufacturer and available only under the original manufacturer s branded name. Calendar year: A period beginning at 12:01 a.m. on January 1 and ending at 12:01 a.m. of the next year. Claim: A notification to your health plan that a service has been provided and payment is requested. Copayment: The dollar amount that a member is required to pay for certain benefits. Also called a copay. Emergency services: Services for an unexpected medical condition, including a psychiatric emergency medical condition, manifesting itself by acute symptoms of sufficient severity (including severe pain) such that a layperson who possesses an average knowledge of health and medicine could reasonably assume that the absence of immediate medical attention could be expected to result in any of the following: placing the member s health in serious jeopardy; serious impairment to bodily functions; or serious dysfunction of any bodily organ or part.

11 glossary Formulary: A comprehensive list of drugs maintained by Blue Shield s Pharmacy and Therapeutics Committee for use under the Blue Shield Prescription Drug Program, which is designed to assist physicians in prescribing drugs that are medically necessary and cost-effective. The formulary is updated periodically. If not otherwise excluded, the formulary includes all generic drugs. Generic drugs: Drugs that (1) are approved by the FDA as a therapeutic equivalent to the brand-name drug, (2) contain the same active ingredient as the brandname drug, and (3) cost less than the brand-name drug equivalent Health maintenance organization (HMO): A prepaid health plan that provides a comprehensive array of medical services, emphasizing prevention and early detection through contracted physicians, hospitals, and other providers. Members must select a primary care physician from the plan s network who coordinates all care with the exception of a true medical emergency. Inpatient: An individual who has been admitted to a hospital as a registered bed patient, and is receiving services under the direction of a physician.

12 glossary Non-formulary drugs: Drugs determined by the health plan as being duplicative or as having preferred formulary drug alternatives available. Benefits may be provided for non-formulary drugs and are always subject to the non-formulary copayment. Outpatient: An individual receiving services but not as an inpatient. Out-of-pocket maximum: Your maximum copayment responsibility each calendar year for covered services. However, copayments for a very small number of covered services do not apply to the annual out-of-pocket maximum, and you continue to be responsible for copayments for those services when the out-of-pocket maximum is reached. Preferred provider organization (PPO): A PPO is similar to a traditional fee-for-service plan, but you must use doctors in the PPO provider network or pay higher co-insurance (percentage of charges). A PPO allows you to select a primary care provider and specialists without referral. In these plans, you typically must meet an annual deductible before some benefits apply. You are responsible for a certain co-insurance amount, and the plan pays the balance up to the allowable amount. As a PPO health plan member, you get maximum benefit coverage when you use the PPO network of physicians and hospitals.

13 glossary Personal Physician (also known as a primary care physician): A general practitioner, board-certified or eligible family practitioner, internist, obstetrician/ gynecologist, or pediatrician who has contracted with the plan as a Personal Physician to provide primary care to members and to refer, authorize, supervise and coordinate the provision of all benefits to members in accordance with the agreement. Preventive care: Medical services provided by a physician for the early detection of disease when no symptoms are present and for routine physical examinations, usually limited to one visit per calendar year for members ages 18 and over. Services: Includes medically necessary healthcare services and medically necessary supplies furnished incident to those services.

14 notes

15

16 Now take the next step Use this guide to help you make the smart choice for your coverage. If you need more information about choosing the Blue Shield health plan that s right for you, our 24/7 Shield Helps hotline is available to you during open enrollment to answer your specific questions, at (888) 678-SHIELD. Or you can visit us online at blueshieldca.com Blue Shield of California is an Independent Member of the Blue Shield Association A37809 (7/09)

benefit summary BAXTER COUNTY

benefit summary BAXTER COUNTY benefit summary BAXTER COUNTY benefit summary Effective Date: BAXTER COUNTY 01/01/2015 welcome Arkansas Blue Cross and Blue Shield is pleased to be your health insurance company. This Benefit Summary gives

More information

Terms Defined. Participating/Non-Participating Provider. Benefits Coverage Charts. Prescription Drug Purchases. Pre-Authorization

Terms Defined. Participating/Non-Participating Provider. Benefits Coverage Charts. Prescription Drug Purchases. Pre-Authorization Medical Coverage Terms Defined Participating/Non-Participating Provider Benefits Coverage Charts Prescription Drug Purchases Section Two MEDICAL COVERAGE Pre-Authorization Coordination of Benefits Questions

More information

Carpenters Health & Welfare Trust Fund for California Retiree Plan Comparison

Carpenters Health & Welfare Trust Fund for California Retiree Plan Comparison Carpenters Health & Welfare Trust Fund for California Retiree Plan Comparison Information Needed: Eligibility, Benefits, COBRA or Disability Claims: Indemnity Medical Plan Indemnity Hearing Aid Benefit

More information

Medical Plan Comparison - Retirees Age 65 or Over

Medical Plan Comparison - Retirees Age 65 or Over * Plan Type Medicare Cost Plan with Prescription Coordinates with Medicare and includes Medicare prescription drug program Medicare Cost Plan with Prescription Medicare Advantage Plan with Prescription

More information

Health Insurance Marketplace in Illinois Plan Comparison Charts

Health Insurance Marketplace in Illinois Plan Comparison Charts 2015 Independent Authorized Agent for An Independent Licensee of the Blue Cross Blue Shield Association Health Insurance Marketplace in Illinois Plan Comparison Charts preventive services and maternity

More information

Northeastern University 2015 Medical Benefits

Northeastern University 2015 Medical Benefits Northeastern University 2015 Medical Benefits Northeastern s 2015 Open Enrollment Effective Date: January 1, 2015 2015 Medical Plan Options Blue Choice New England Core POS Plan New Plan Blue Choice New

More information

2016 HealthFlex Plan Comparison: PPO B1000 with HRA and HDHP H1500 with HSA

2016 HealthFlex Plan Comparison: PPO B1000 with HRA and HDHP H1500 with HSA Caring For Those Who Serve 1901 Chestnut Avenue Glenview, Illinois 60025-1604 1-800-851-2201 www.gbophb.org 2016 HealthFlex Plan Comparison: PPO B1000 with HRA and HDHP H1500 with HSA Please note: This

More information

The International Student & NIU Student Health Insurance

The International Student & NIU Student Health Insurance The International Student & NIU Student Health Insurance 2010 2011 Student Health Insurance Coverage offered through International Students are required to maintain health insurance coverage throughout

More information

Sherwin-Williams Medical, Prescription Drug and Dental Plans Plan Comparison Charts

Sherwin-Williams Medical, Prescription Drug and Dental Plans Plan Comparison Charts Sherwin-Williams Medical, Prescription Drug and Dental Plans Plan Comparison Charts You and Sherwin-Williams share the cost of certain benefits including medical and dental coverage and you have the opportunity

More information

Thinking Health Forward. Self-Funded Health Plans Level-Funding Administration and Stop-Loss Insurance for Employer Groups

Thinking Health Forward. Self-Funded Health Plans Level-Funding Administration and Stop-Loss Insurance for Employer Groups Thinking Health Forward Self-Funded Health Plans Level-Funding Administration and Stop-Loss Insurance for Employer Groups A Smart, Affordable, Simple Plan for Your Business from Cox HealthPlans Cox HealthPlans

More information

Medical Plan Comparison - Retirees Age 65 or Over

Medical Plan Comparison - Retirees Age 65 or Over l Plan Comparison - Retirees Age 65 or Over Program Name U of M Retiree Plan with Group reblue SM Rx Group Platinum Blue SM Plan C withgroup reblue SM Rx Freedom Plan & Retiree National Choice Freedom

More information

Understanding Health Insurance

Understanding Health Insurance Understanding Health Insurance Health insurance can play an important role when it comes to medical bills and prescription medications it can help protect you from high expenses. There are many types of

More information

Who are you healthy for?

Who are you healthy for? Who are you healthy for? Be there for those you care about Health plans for individuals and families 1/1/2016 WE RE HERE FOR YOU EVERY STEP OF THE WAY For help choosing and enrolling in a plan 877-PREMERA

More information

STATE OF IOWA HEALTH INSURANCE PLAN COMPARISON EFFECTIVE JANUARY 1, 2016

STATE OF IOWA HEALTH INSURANCE PLAN COMPARISON EFFECTIVE JANUARY 1, 2016 This comparison is only a summary of benefits. Benefits will be administered as described in each plan s Summary of Benefits & Coverage. For further details, refer to those documents or call Wellmark Blue

More information

NO DEDUCTIBLE FOR MANY SERVICES

NO DEDUCTIBLE FOR MANY SERVICES KAISER PERMANENTE FOR INDIVIDUALS AND FAMILIES Deductible Plans How Deductible plans work Deductible plans generally offer lower monthly premiums in exchange for higher out-of-pocket payments for covered

More information

Comparison of Health Care Plans Metro Interagency Insurance Program Effective Date: July 1, 2015

Comparison of Health Care Plans Metro Interagency Insurance Program Effective Date: July 1, 2015 Comparison of Health Care Plans Metro Interagency Insurance Program Effective Date: July 1, 2015 Wellmark Blue Cross Blue Shield Customer Service: 1-800-277-8380 Participating Provider Directory Information:

More information

Regence BlueCross BlueShield of Utah: Regence Direct Silver HSA

Regence BlueCross BlueShield of Utah: Regence Direct Silver HSA Regence BlueCross BlueShield of Utah: Regence Direct Silver HSA Coverage Period: 01/01/2015-12/31/2015 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual &

More information

HEALTH INSURANCE FOR INDIVIDUALS AND FAMILIES. Insuring Minnesota One Life At A Time. www.preferredone.com

HEALTH INSURANCE FOR INDIVIDUALS AND FAMILIES. Insuring Minnesota One Life At A Time. www.preferredone.com foreveryone HEALTH INSURANCE FOR INDIVIDUALS AND FAMILIES Insuring Minnesota One Life At A Time www.preferredone.com for EveryOne Insuring Minnesota One Life At A Time Thank you for your interest in the

More information

The State Health Benefits Program Plan

The State Health Benefits Program Plan State of New Jersey Department of the Treasury Division of Pensions and Benefits STATE HEALTH BENEFITS PROGRAM PLAN COMPARISON SUMMARY FOR STATE EMPLOYEES EFFECTIVE APRIL 1, 2008 (March 29, 2008 for State

More information

Blue Care Elect Preferred 90 Copay Coverage Period: on or after 09/01/2015

Blue Care Elect Preferred 90 Copay Coverage Period: on or after 09/01/2015 Blue Care Elect Preferred 90 Copay Coverage Period: on or after 09/01/2015 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual Only Plan Type: PPO This is only

More information

2016 Plan Comparison For HealthFlex Exchange Participants

2016 Plan Comparison For HealthFlex Exchange Participants 2016 Plan Comparison For HealthFlex Exchange Participants This comparison highlights key differences and similarities between plans offered through HealthFlex Exchange in 2016. All plans use the same network

More information

CENTERS FOR MEDICARE & MEDICAID SERVICES. Cost

CENTERS FOR MEDICARE & MEDICAID SERVICES. Cost CENTERS FOR MEDICARE & MEDICAID SERVICES Things to Think about when You Compare Medicare Drug Coverage You have two options to get Medicare coverage for your prescription drugs. If you have Original Medicare,

More information

C Calendar-year deductible An amount that the insured person must pay before insurance payments for covered services begin.

C Calendar-year deductible An amount that the insured person must pay before insurance payments for covered services begin. Page 1 A Accidental Death and Dismemberment (AD&D) Rider A supplement to many life insurance policies that provides an additional cash benefit to the insured or his/her beneficiaries if an accident causes

More information

$500 Individual / $1,500 Family Does not apply to preventive care and pharmacy

$500 Individual / $1,500 Family Does not apply to preventive care and pharmacy This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.mhhealthplan.org or by calling 1-713-338-6535 or 1-888-642-5040.

More information

2015 IBM Health Benefit Comparison Charts for IBM Active Employees

2015 IBM Health Benefit Comparison Charts for IBM Active Employees 2015 IBM Health Benefit Comparison Charts for IBM Active Employees These Health Benefit Comparison Charts provide a summary overview of the coverage available for medical, mental health/substance care

More information

Medicare Part D Prescription Drug Coverage

Medicare Part D Prescription Drug Coverage Medicare Part D Prescription Drug Coverage GENERAL INFORMATION Coverage Medicare Part D coverage is available to everyone enrolled in Medicare Drug plans are offered by insurance companies and other private

More information

Boston College Student Blue PPO Plan Coverage Period: 2015-2016

Boston College Student Blue PPO Plan Coverage Period: 2015-2016 Boston College Student Blue PPO Plan Coverage Period: 2015-2016 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual and Family Plan Type: PPO This is only a

More information

GLOSSARY OF MEDICAL AND INSURANCE TERMS

GLOSSARY OF MEDICAL AND INSURANCE TERMS GLOSSARY OF MEDICAL AND INSURANCE TERMS At Westfield Family Physicians we are aware that there are lots of words and phrases we used every day that may not be familiar to you, our patients. We are providing

More information

Small group and CalChoice benefit comparison

Small group and CalChoice benefit comparison Small group and CalChoice benefit comparison effective July 1, 2015 We believe in choice. A guide to choosing the right plan for your business US health plan 1 San Diegans choose Sharp Health Plan With

More information

KAISER PERMANENTE PLAN (Non-Medicare Eligible)

KAISER PERMANENTE PLAN (Non-Medicare Eligible) CEMENT MASONS HEALTH AND WELFARE TRUST FUND FOR NORTHERN CALIFORNIA RETIRED CEMENT MASONS AND THEIR ELIGIBLE DEPENDENTS EFFECTIVE JANUARY 1, 2015 GENERAL When You Can Change Plans Type of Plan, Service

More information

Guide to Purchasing Health Insurance

Guide to Purchasing Health Insurance Guide to Purchasing Health Insurance What are your health insurance choices? Which type is right for you? Sample questions Looking for insurance in specific situations Tips for shopping for health coverage

More information

Your Retiree Health Care Travel Guide

Your Retiree Health Care Travel Guide SPECIAL EDITION for Individuals Not Yet Eligible for Medicare Your Retiree Health Care Travel Guide 2010 Enrollment for BorgWarner Pre-Medicare Health Care Coverage Welcome to 2010 Pre-Medicare enrollment!

More information

Understanding your. Medicare options. Medicare Made Clear TM. Get Answers Series. Y0066_120629_084915 CMS Accepted

Understanding your. Medicare options. Medicare Made Clear TM. Get Answers Series. Y0066_120629_084915 CMS Accepted Understanding your Medicare options. Medicare Made Clear TM Get Answers Series Y0066_120629_084915 CMS Accepted learning about Medicare Choices. Eligibility Coverage options When to enroll Next steps and

More information

Understanding Group Health Insurance Anthem KeyCare 15+ Plan

Understanding Group Health Insurance Anthem KeyCare 15+ Plan Understanding Group Health Insurance Anthem KeyCare 15+ Plan January 12, 2010 Although it is the intent of the University to continue current benefit plans, the University reserves the right to modify,

More information

CSAC/EIA Health Small Group Access+ HMO 15-0 Inpatient Benefit Summary

CSAC/EIA Health Small Group Access+ HMO 15-0 Inpatient Benefit Summary CSAC/EIA Health Small Group Access+ HMO 15-0 Inpatient Benefit Summary (Uniform Health Plan Benefits and Coverage Matrix) Blue Shield of California THIS MATRIX IS INTENDED TO BE USED TO HELP YOU COMPARE

More information

Options Blue affordable coverage with a tax-advantaged account

Options Blue affordable coverage with a tax-advantaged account Options Blue SM Options Blue affordable coverage with a tax-advantaged account A smart move for individuals and families who like to plan and save 2010 The health plans that help you save money Options

More information

Benefit Coverage Chart & Rates Effective July 1, 2014 June 30, 2015

Benefit Coverage Chart & Rates Effective July 1, 2014 June 30, 2015 Benefit Coverage Chart & Rates Effective PPO Medical Coverage by Category The following coverages are included with the PPO plan: o Prescription o Vision Additional Benefits o Dental o Dental & Orthodontia

More information

Solutions for Today Flexibility for Tomorrow.

Solutions for Today Flexibility for Tomorrow. Solutions for Today Flexibility for Tomorrow. Medicare Products and Services For More Information call our Senior Care Specialist, Raun Lynch at 856.380.5079 Or visit us on the web at www.cbdi-inc.com

More information

Important Questions Answers Why this Matters:

Important Questions Answers Why this Matters: BridgeSpan Health Company: Exchange Silver Coverage Period: Beginning on or after 01/01/2014 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual & Eligible

More information

Blue Care Elect Saver with Coinsurance Northeastern University HDHP Coverage Period: on or after 01/01/2016

Blue Care Elect Saver with Coinsurance Northeastern University HDHP Coverage Period: on or after 01/01/2016 Blue Care Elect Saver with Coinsurance Northeastern University HDHP Coverage Period: on or after 01/01/2016 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual

More information

California Ironworkers Field Welfare Plan 1/1/2014 Open Enrollment Benefit Plan Comparison Non-Medicare Retired Participants Residing in Nevada

California Ironworkers Field Welfare Plan 1/1/2014 Open Enrollment Benefit Plan Comparison Non-Medicare Retired Participants Residing in Nevada Non- Choice of Providers Calendar Year Deductible *The Fund s Calendar Year Deductible is never waived. However, some services are not subject to the Deductible. If you live in Nevada, your network of

More information

2013 IBM Health Benefit Comparison Charts

2013 IBM Health Benefit Comparison Charts 203 IBM Health Benefit Comparison Charts for IBM Active Employees These Health Benefit Comparison Charts provide a summary overview of the coverage available for medical services, mental health/substance

More information

Understanding Your Health Insurance Plan

Understanding Your Health Insurance Plan Understanding Your Health Insurance Plan Slide Catalog for Assisters Updated May 6, 2015 Health Insurance Costs Terms to Know: Premium Premium: The monthly bill you pay to your health insurance company.

More information

Self-Insured Schools of California: SISC PPO (HSA Eligible)

Self-Insured Schools of California: SISC PPO (HSA Eligible) Helping SISC III SELF-INSURED SCHOOLS OF CALIFORNIA Self-Insured of California: Helping SISC PPO (HSA Eligible) Administered by Blue Shield of California 2013/2014 Enrollment Guide Blue Shield of California

More information

Banner Health - Choice Plus Coverage Period: 1/1/2015-12/31/2015

Banner Health - Choice Plus Coverage Period: 1/1/2015-12/31/2015 This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the plan document at www.bannerbenefits.com by clicking on the Resources tab and then Plan

More information

ElderCare Medicare Health Plan Analyzer

ElderCare Medicare Health Plan Analyzer ElderCare Medicare Health nalyzer 1999 Prism Innovations, Inc. All Rights Reserved ElderCare Medicare Health nalyzer Table of Contents Introduction 2 Explanations of New Health Plan Options 3 Analysis

More information

Reliability and predictable costs for individuals and families

Reliability and predictable costs for individuals and families INDIVIDUAL & FAMILY PLANS HEALTH NET HMO PLANS Reliability and predictable costs for individuals and families If you re looking for a health plan that s simple to use and easy to understand, you ve found

More information

Self-Insured Schools of California: SISC PPO

Self-Insured Schools of California: SISC PPO Helping SISC III SELF-INSURED SCHOOLS OF CALIFORNIA Self-Insured of California: Helping SISC PPO Administered by Blue Shield of California 2013/2014 Enrollment Guide Blue Shield of California is proud

More information

In-network: $5,000 per insured/ $10,000 per family per calendar year. Out-of-network: $10,000 per insured / $20,000

In-network: $5,000 per insured/ $10,000 per family per calendar year. Out-of-network: $10,000 per insured / $20,000 Regence BlueShield of Idaho: Coverage Period: Beginning on or after 01/01/2014 Regence Individual Direct Bronze HSA Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for:

More information

Blue Care Elect Preferred Amherst College Coverage Period: on or after 07/01/2014

Blue Care Elect Preferred Amherst College Coverage Period: on or after 07/01/2014 Blue Care Elect Preferred Amherst College Coverage Period: on or after 07/01/2014 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual and Family Plan Type:

More information

welcome to 2016 Annual Enrollment! OCTOBER 15 NOVEMBER 18, 2015

welcome to 2016 Annual Enrollment! OCTOBER 15 NOVEMBER 18, 2015 welcome to 2016 Annual Enrollment! OCTOBER 15 NOVEMBER 18, 2015 The purpose of this guide is to help you take a closer look at the five health plan options available to you and show you what s changing,

More information

What is the overall deductible? Are there other deductibles for specific services? Is there an out-ofpocket

What is the overall deductible? Are there other deductibles for specific services? Is there an out-ofpocket Regence BlueShield: Regence Direct Gold with Dental, Vision, Individual Assistance Program Coverage Period: Beginning on or after 01/01/2014 Summary of Benefits and Coverage: What this Plan Covers & What

More information

Fee-for-Service. Medicare Supplemental Retiree Health Plans

Fee-for-Service. Medicare Supplemental Retiree Health Plans Sheet Metal Workers Health Plan of Southern California, Arizona & Nevada April 2011 Summary Comparison Of Benefits Available under the Fee-for-Service and Medicare Supplemental Retiree Health Plans Important:

More information

NO DEDUCTIBLE FOR MANY SERVICES

NO DEDUCTIBLE FOR MANY SERVICES How Deductible plans work Deductible plans generally offer lower monthly premiums in exchange for higher out-of-pocket payments for covered services. With these plans, you pay full charge for certain covered

More information

I Have Health Insurance! Now What?

I Have Health Insurance! Now What? I Have Health Insurance! Now What? A Guide to Using Your Private Health Insurance Plan Brought to you by: Congratulations on Your New Health Plan! This guide is an overview of private insurance plans and

More information

FREQUENTLY ASKED QUESTIONS ID CARDS / ELIGIBILITY / ENROLLMENT

FREQUENTLY ASKED QUESTIONS ID CARDS / ELIGIBILITY / ENROLLMENT FREQUENTLY ASKED QUESTIONS ID CARDS / ELIGIBILITY / ENROLLMENT BENEFIT INFORMATION CLAIMS STATUS/INFORMATION GENERAL INFORMATION PROVIDERS THE SIGNATURE 90 ACCOUNT PLAN THE SIGNATURE 80 PLAN USING YOUR

More information

MAYFLOWER MUNICIPAL HEALTH GROUP ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ PPO REVIEW OF BENEFITS

MAYFLOWER MUNICIPAL HEALTH GROUP ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ PPO REVIEW OF BENEFITS Fiscal Year 2015 2016 MAYFLOWER MUNICIPAL HEALTH GROUP ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ PPO REVIEW OF S ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

More information

More value Thank you for considering KPS You Need a Plan that Offers a Free Prescription Drug Discount Program

More value Thank you for considering KPS You Need a Plan that Offers a Free Prescription Drug Discount Program More value Thank you for considering KPS KPS Health Plans was established in Bremerton, Washington in 1946. We are a Washington state nonprofit health care service contractor offering preferred provider

More information

Outline of Coverage SmartHealth Balance Gold 1000

Outline of Coverage SmartHealth Balance Gold 1000 Outline of Coverage SmartHealth Balance Gold 1000 This outline of coverage provides a very brief description of the important features of the policy. Please note this outline is not intended to be part

More information

Schedule of Benefits Summary. Health Plan. Out-of-network Provider

Schedule of Benefits Summary. Health Plan. Out-of-network Provider Schedule of Benefits Summary University Name: University of Nebraska - Student Plan Health Plan : 2014/2015 Academic Year (see attached) Payment for Services Covered Services are reimbursed based on the

More information

Self-Insured Schools of California:

Self-Insured Schools of California: Helping SISC III SELF-INSURED SCHOOLS OF CALIFORNIA Self-Insured of California: Helping Access+ HMO SaveNet 2013/2014 Enrollment Guide Blue Shield of California offers health benefits to school districts

More information

Get healthy. Stay healthy. Kaiser Permanente. Kaiser Permanente. Health Plan. kp.org

Get healthy. Stay healthy. Kaiser Permanente. Kaiser Permanente. Health Plan. kp.org Get healthy. Stay healthy. Kaiser Permanente Kaiser Permanente Student Student Health Plan Health Plan w i t h d e d u c t i b l e kp.org Table of Contents The Basics 3 How It Works 4 Frequently Asked

More information

Annual Notice of Changes for 2016

Annual Notice of Changes for 2016 Healthy Advantage Plus HMO offered by Molina Healthcare of Utah Annual Notice of Changes for 2016 You are currently enrolled as a member of Healthy Advantage Plus HMO. Next year, there will be some changes

More information

Medicare. What you need to know. Choose the plan that s right for you GNHH2ZTHH_15

Medicare. What you need to know. Choose the plan that s right for you GNHH2ZTHH_15 Medicare What you need to know Choose the plan that s right for you GNHH2ZTHH_15 Choosing a Medicare plan is a lot like buying a car. There are lots of options to consider. And what s right for you may

More information

HEALTH PLAN COMPARISON

HEALTH PLAN COMPARISON City of San José HEALTH PLAN COMPARISON For Employees Represented by AEA, AMSP, CAMP, CEO, IAFF, IBEW, MEF and OE#3 SERVICE Kaiser Permanente Blue Shield HMO QUESTIONS ABOUT PLAN DESIGN AND PROVIDER NETWORKS

More information

BlueSelect Silver ValueTwo for Individuals

BlueSelect Silver ValueTwo for Individuals BlueSelect Silver ValueTwo for Individuals Coverage Period: 1/1/2015-12/31/2015 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Single Plan Type: PPO This is only

More information

Highmark Health Insurance Company: Shared Cost Blue PPO 3200

Highmark Health Insurance Company: Shared Cost Blue PPO 3200 This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.highmarkblueshield.com or by calling 1-888-510-1064.

More information

Individual and Family Plans

Individual and Family Plans Effective: January 1, 2015 Individual and Family Plans find a plan that fits you live by your own plan a plan for your life Everyone s needs are unique, and it s important to find a plan that best fits

More information

ROCHESTER INSTITUTE OF TECHNOLOGY 2014 Medical Benefits Comparison Chart Medicare-Eligible Retirees in the Rochester Area

ROCHESTER INSTITUTE OF TECHNOLOGY 2014 Medical Benefits Comparison Chart Medicare-Eligible Retirees in the Rochester Area Contacting the Carrier Voice: (877) 883-9577 TTY: (585) 454-2845 Website: Voice: (800) 665-7924 TTY: (800) 252-2452 Website: www.excellusbcbs.com www.mvphealthcare.com Deductible Carry Over None None Deductible,

More information

CIS - Plan V E PPP RX4 with Alternative Care

CIS - Plan V E PPP RX4 with Alternative Care CIS - Plan V E PPP RX4 with Alternative Care Summary of Benefits and Coverage: What this Plan Covers & What it Costs City of Tigard Insurance Summary Management 2015: Page 1 Coverage Period: 01/01/2015-12/31/2015

More information

RETIREE GUIDE TO FY 2016 OPEN ENROLLMENT PERIOD

RETIREE GUIDE TO FY 2016 OPEN ENROLLMENT PERIOD GUIDE TO FY 2016 OPEN ENROLLMENT PERIOD Highlights Inside: Open Enrollment for non-medicare eligible retirees and their dependents begins on May 6, 2015 and ends May 22, 2015. Open enrollment is generally

More information

United States Fire Insurance Company: International Technological University Coverage Period: beginning on or after 9/7/2014

United States Fire Insurance Company: International Technological University Coverage Period: beginning on or after 9/7/2014 or after 9/7/2014 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual Plan Type: PPO This is only a summary. If you want more detail about your coverage and

More information

Benefits Summary UNUM - Group Term Life/AD&D & Voluntary Life/AD&D Plan

Benefits Summary UNUM - Group Term Life/AD&D & Voluntary Life/AD&D Plan UNUM - Group Term Life/AD&D & Voluntary Life/AD&D Plan Benefits Summary Basic employee life insurance 1x base annual earnings rounded to the next higher $1,000 to a maximum benefit of $300,000 Supplemental

More information

BRYN MAWR COLLEGE MEDICAL INSURANCE BENEFITS COMPARISON EFFECTIVE NOVEMBER 1, 2009

BRYN MAWR COLLEGE MEDICAL INSURANCE BENEFITS COMPARISON EFFECTIVE NOVEMBER 1, 2009 BENEFITS Description of Plan Annual Deductible (January - December) - Individual - Family PERSONAL CHOICE PPO BRYN MAWR COLLEGE KEYSTONE HEALTH PLAN EAST KEYSTONE POS Provides comprehensive health Provides

More information

Summary of Benefits and Coverage What this Plan Covers & What it Costs

Summary of Benefits and Coverage What this Plan Covers & What it Costs This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the plan document at www.mpiphp.org or by calling 1-855-275-4674. Important Questions Answers

More information

Parent to Parent of NYS Family to Family Health Care Information and Education Center

Parent to Parent of NYS Family to Family Health Care Information and Education Center Parent to Parent of NYS Family to Family Health Care Information and Education Center September 2005 With funding from Parent to Parent of New York State s Real Choice Systems Change Grant, this publication

More information

CHOOSE A PLAN DEDUCTIBLE PLANS DEDUCTIBLE PLANS. What deductible plans offer and how they work IN THIS BROCHURE. n How our deductible plans work

CHOOSE A PLAN DEDUCTIBLE PLANS DEDUCTIBLE PLANS. What deductible plans offer and how they work IN THIS BROCHURE. n How our deductible plans work DEDUCTIBLE PLANS CHOOSE A PLAN DEDUCTIBLE PLANS What deductible plans offer and how they work IN THIS BROCHURE n How our deductible plans work n Understanding deductibles and out-of-pocket maximums n Benefit

More information

Important Questions Answers Why this Matters: What is the overall deductible? Are there other deductibles for specific services?

Important Questions Answers Why this Matters: What is the overall deductible? Are there other deductibles for specific services? : VIVA HEALTH Access Plan Coverage Period: 01/01/2015 12/31/2015 This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document

More information

2015-16 TRS-ActiveCare Medical Plans

2015-16 TRS-ActiveCare Medical Plans 2015-16 TRS-ActiveCare Medical Plans PISD Contribution for full-time employees Full-Time Employee s Monthly Cost TRS-ActiveCare 1-HD PPO Total Monthly Cost Employee Only $341.00 $259.00 $82.00 Employee

More information

Highmark Blue Shield: Flex Blue PPO 2100 a Community Blue Plan

Highmark Blue Shield: Flex Blue PPO 2100 a Community Blue Plan This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.highmarkblueshield.com or by calling 1-888-510-1084.

More information

Important Questions Answers Why this Matters: What is the overall deductible? Are there other deductibles for specific services?

Important Questions Answers Why this Matters: What is the overall deductible? Are there other deductibles for specific services? This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.etf.wi.gov or by calling 1-877-533-5020. Important Questions

More information

Highmark Health Insurance Company: Comprehensive Care Blue PPO 500

Highmark Health Insurance Company: Comprehensive Care Blue PPO 500 This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.highmarkblueshield.com or by calling 1-888-510-1064.

More information

Human Energy. Yours. TM

Human Energy. Yours. TM Human Energy. Yours. TM Chevron Global Choice Plan (U.S.-Payroll Expatriates) (008) Summary of Benefits and Coverage What This Plan Covers and What it Costs Coverage Period January 1, 2015 December 31,

More information

COPAY PLANS. PreferredOne.com. Welcome to PreferredOne. Health Insurance for Individuals & Families 2014

COPAY PLANS. PreferredOne.com. Welcome to PreferredOne. Health Insurance for Individuals & Families 2014 COPAY PLANS Health Insurance for Individuals & Families 2014 Welcome to PreferredOne PreferredOne.com Your Health, Your Choice, Many Options At PreferredOne, our name says it all you and your family are

More information

2015 WPEG Coinsurance Plan Coverage Period: 1/1/2015-12/31/2015

2015 WPEG Coinsurance Plan Coverage Period: 1/1/2015-12/31/2015 2015 WPEG Coinsurance Plan Coverage Period: 1/1/2015-12/31/2015 Summary of Benefits and Coverage: What this Plan Covers & What it Costs This is only a summary. If you want more detail about your coverage

More information

OPERATING ENGINEERS HEALTH & WELFARE FUND BENEFIT PLANS SUMMARY COMPARISON FOR ACTIVE and RETIRED PARTICIPANTS

OPERATING ENGINEERS HEALTH & WELFARE FUND BENEFIT PLANS SUMMARY COMPARISON FOR ACTIVE and RETIRED PARTICIPANTS Employee Premium None None None None None Explanation of Plans and Options Available to You Deductible Annual Out-of-Pocket Calendar Year (Applicable to members who reside in California & Nevada Only.)

More information

Glossary of Health Coverage and Medical Terms

Glossary of Health Coverage and Medical Terms Glossary of Health Coverage and Medical Terms This glossary defines many commonly used terms, but isn t a full list. These glossary terms and definitions are intended to be educational and may be different

More information

Benefit Coverage Chart & Rates

Benefit Coverage Chart & Rates Benefit Coverage Chart & Rates Effective July 1, 2014- June 30, 2015 PPO Medical Coverage by Category The following coverages are included with the PPO plan: o Prescription o Vision Additional Benefits

More information

Regence BlueCross BlueShield of Oregon: Regence Oregon Standard Bronze Plan Coverage Period: Beginning on or after 01/01/2014

Regence BlueCross BlueShield of Oregon: Regence Oregon Standard Bronze Plan Coverage Period: Beginning on or after 01/01/2014 Regence BlueCross BlueShield of Oregon: Regence Oregon Standard Bronze Plan Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage Period: Beginning on or after 01/01/2014 Coverage

More information

HMO Blue Basic Coinsurance Coverage Period: on or after 01/01/2015

HMO Blue Basic Coinsurance Coverage Period: on or after 01/01/2015 HMO Blue Basic Coinsurance Coverage Period: on or after 01/01/2015 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual and Family Plan Type: HMO This is only

More information

Coverage level: Employee/Retiree Only Plan Type: EPO

Coverage level: Employee/Retiree Only Plan Type: EPO This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan documents at www.dbm.maryland.gov/benefits or by calling 410-767-4775

More information

S c h o o l s I n s u r a n c e G r o u p Health Net Plan Comparison Fiscal Year 7/1/14-6/30/15

S c h o o l s I n s u r a n c e G r o u p Health Net Plan Comparison Fiscal Year 7/1/14-6/30/15 S c h o o l s I n s u r a n c e G r o u p Health Net Plan Comparison Fiscal Year 7/1/14-6/30/15 This information sheet is for reference only. Please refer to Evidence of Coverage requirements, limitations

More information

Cigna Open Access Plans for Tennessee

Cigna Open Access Plans for Tennessee Individual & Family Plans Insured by Connecticut General Life Insurance Company Cigna Open Access Plans for Tennessee medical & PHARMACY INSURANCE with the ONE-AND-ONLY YOU IN MIND. 858436 a 12/12 Services

More information

Self-Insured Schools of California: Schools Helping Schools

Self-Insured Schools of California: Schools Helping Schools Self-Insured Schools of California: Schools Helping Schools FOUNDATION SISC PPO (HSA Eligible) PLAN Administered by Blue Shield of California 2014/2015 Enrollment Guide Blue Shield of California is proud

More information

Health Insurance 101. A brief overview of health insurance 10/15/09

Health Insurance 101. A brief overview of health insurance 10/15/09 Health Insurance 101 A brief overview of health insurance 10/15/09 Health Care vs. Health Insurance Health Care is Provision of Medical Services by Private Physicians and Hospitals (private pay or insurance)

More information

Aetna Medicare Advantage HMO SHBP Summary of Benefits and Coverage: What this Plan Covers & What it Costs

Aetna Medicare Advantage HMO SHBP Summary of Benefits and Coverage: What this Plan Covers & What it Costs This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.state.nj.us/treasury/pensions/health-benefits.shtml or

More information

$500 member / $1,000 family Self- Referred. Does not apply to emergency room, emergency transportation, or acupuncture services.

$500 member / $1,000 family Self- Referred. Does not apply to emergency room, emergency transportation, or acupuncture services. Blue Choice New England Plan 2 MIT Choice Coverage Period: on or after 01/01/2015 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual, Ind.+Spouse, Ind.+Child(ren)

More information

What is the overall deductible? $250 per person/$500 per family. Are there other deductibles for specific services? No.

What is the overall deductible? $250 per person/$500 per family. Are there other deductibles for specific services? No. This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.etf.wi.gov or by calling 1-877-533-5020. Important Questions

More information

OPERATING ENGINEERS HEALTH & WELFARE FUND BENEFIT PLANS SUMMARY COMPARISON FOR ACTIVES and EARLY RETIREES

OPERATING ENGINEERS HEALTH & WELFARE FUND BENEFIT PLANS SUMMARY COMPARISON FOR ACTIVES and EARLY RETIREES PPO Kaiser Permanente For Non-PPO Providers Employee Premium None None None None None Explanation of s and Options Available to You If you choose a doctor who is not contracted with Anthem Blue Cross the

More information

UPMC for Life HMO Deductible with Rx (HMO) offered by UPMC Health Plan

UPMC for Life HMO Deductible with Rx (HMO) offered by UPMC Health Plan UPMC for Life HMO Deductible with Rx (HMO) offered by UPMC Health Plan Annual Notice of Changes for 2016 You are currently enrolled as a member of UPMC for Life HMO Deductible with Rx. Next year, there

More information