Check What Matters Most.
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1 Check What Matters Most. SILVER COST SHARE REDUCTION PLANS VANTAGE HEALTH PLAN HEALTH INSURANCE MARKETPLACE PLAN FINDER
2 Healthcare savings chart Please refer to the chart below to find out if you may qualify for lower premiums and out-of-pocket costs for Marketplace insurance plans. Number of people in your household Private Marketplace health plans You may qualify for lower premiums on a Marketplace insurance plan if your yearly income is between... See next row if your income is at the lower end of this range. You may qualify for lower premiums AND lower out-of-pocket costs for Marketplace insurance if your yearly income is between... $11,670 - $46,680 $11,670 - $29,175 $15,730 - $62,920 $15,730 - $39,325 $19,790 - $79,160 $19,790 - $49,475 $23,850 - $95,400 $23,850 - $59,625 $27,910 - $111,640 $27,910 - $69,775 $31,970 - $127,880 $31,970 - $79,925 Eligibility for these subsidies is based on your 2015 estimated household annual income.
3 2015 silver COST SHARE REDUCTION plans BENEFITS SILVER VALUE* SILVER BASIC* SILVER SELECT* Deductible $100 Individual; $200 Family $500 Individual; $1,000 Family $2,900 Individual; $5,800 Family Medical Out-of-Pocket Maximum $1,850 Individual; $3,700 Family $1,850 Individual; $3,700 Family $4,550 Individual; $9,100 Family Medical Home-Primary Care Physician (MH-PCP) $5 copay per visit, no deductible $10 copay per visit, no deductible $25 copay per visit, no deductible $15 copay per visit, no deductible $20 copay per visit, no deductible $75 copay per visit, no deductible Inpatient Hospital $100 copay per day for days 1-3 $600 copay per day for days 1-3 $1,500 copay per day for days 1-3 Radiologist / Anesthesiologist Covered 100% Covered 100% Covered 100% Outpatient Surgery Services $25 copay $500 copay $1,000 copay Emergency Room $75 copay $175 copay $300 copay Major Diagnostic Test (MRI, CT Scan, Stress Test, Bone Density Scan, Pet Scan and Others) $50 copay per test $175 copay per test $300 copay per test X-Rays 100% coinsurance up to $50 per day 100% coinsurance up to $175 per day 100% coinsurance up to $300 per day Home Health & Hospice 5% coinsurance 10% coinsurance 20% coinsurance Radiation & Chemotherapy 5% coinsurance 10% coinsurance 20% coinsurance Flu Shots Covered 100%, no deductible Covered 100%, no deductible Covered 100%, no deductible Prescription Drugs Non-Preferred Generics: $5 copay Preferred Brand: $10 copay Non-Preferred Brand: $30 copay Non-Preferred Generics: $10 copay Preferred Brand: $20 copay Non-Preferred Brand: $65 copay Non-Preferred Generics: $15 copay Preferred Brand: $45 copay Non-Preferred Brand: $95 copay Rx Out-of-Pocket Maximum: $400 Individual; $800 Family Rx Out-of-Pocket Maximum: $400 Individual; $800 Family Rx Out-of-Pocket Maximum: $650 Individual; $1,300 Family Vision Included with plan (see right panel) Included with plan (see right panel) Included with plan (see right panel) Dental Included with plan (see right panel) Included with plan (see right panel) Included with plan (see right panel) This comparison is not a complete comparison.
4 VANTAGE VISION & DENTAL BENEFITS INCLUDED IN ALL PLANS Adult and Children Vision Benefits All Silver Plans Adult and Children Dental Benefits All Silver Plans Specialist copay for 1 routine eye exam per year Children - 50% coinsurance for a 12-month supply of contacts or 1 pair of basic glasses per year Adults - 20% coinsurance with a maximum benefit of $100 per year for a 12-month supply of contacts or 1 pair of glasses. 100% coverage for routine dental exams and cleanings, 1 exam every 6 months Children - Basic Dental Services (including cleaning and bitewing x-rays) and Major Dental Services - 50% coinsurance after deductible Adults - 100% coverage for bitewing x-rays, 1 set of x-rays per year with a maximum benefit of $50
5 NEED MORE INFORMATION? Call us at (855) or TTY at (866) (for the hearing impaired) Ask a Vantage representative about a one-on-one home visit Come by our office Visit our website at CONTACT DETAILS Phone & Website Toll-Free: (855) TTY (866) (for the hearing impaired) Monroe Location 130 DeSiard Street, Suite 300 Monroe, LA Shreveport Location 855 Pierremont Road, Suite 109 Shreveport, LA Baton Rouge Location 5778 Essen Lane, Suite B Baton Rouge, LA Vantage Health Plan, Inc. is a Qualified Health Plan in the Health Insurance Marketplace. VHP866 R Approved
Vantage Health Plan. Nationwide Coverage. Nationwide Care. Nationwide Service. 2016 OGB Medical Home HMO Plan. OGB Approved. VHP517 R090415 Approved
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Operating Engineers Public Employees Health and Welfare Trust Fund Plan D vs PERS CHOICE and PERS SELECT PPO Plan
Calendar Year Deductible $500 Individual / $1,000 Family per calendar year Does not apply to PPO physician office visits, PPO preventive care or hospital emergency room charges for an emergency medical
Highmark Delaware: Blue EPO $40 - $2,400/$4,800 Coverage Period: Beginning on or after 01/01/2013
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.highmarkbcbsde.com or by calling 1-800-633-2563. Important
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.anthem.com/cuhealthplan or by calling 1-800-735-6072.
National Guardian Life Insurance Company: Kenyon College Student Health Insurance Plan Coverage Period: 08/15/2015-08/15/2016
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.studentplanscenter.com or by calling 1-800-756-3702.
Important Questions Answers Why this Matters:
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.studentplanscenter.com or by calling 1-800-756-3702.
St Olaf College Coverage Period: Beginning on or after 09-01-2014
St Olaf College Summary of Benefits and Coverage: What this Plan covers & What it Costs Coverage Period: Beginning on or after 09-01-2014 Coverage for: Single and family coverage Plan Type: PPO This is