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Dissecting a Health Plan

DISSECTING A HEALTH PLAN GENDER: FEMALE AGE: 31 (BIRTH DATE: 10.10.1980) STATE: IL 60202 PLAN: AETNA MANAGED CHOICE OPEN ACCESS VALUE 5000 MONTHLY COST: $134.00 PLAN TYPE DEDUCTIBLE PPO ((Preferred Provider Organization) includes coverage to in-network and out-of-network health care providers. You pay less for services when visiting in-network providers but have the flexibility to see out-of-network providers. Amount an individual or family has to pay before health insurance coverage kicks-in and starts paying for services. Warning: This can double for out-of-network health care providers. CO-PAY COINSURANCE The amount you pay for visiting the doctor or a specialist. Percentage you pay for a medical bill. For example, an individual would pay 20% once the deductible is met and the insurance company would pay the remaining 80%. MANAGED CHOICE OPEN ACCESS VALUE 5000 OUT-OF-POCKET MAXIMUM INFORMATION BELOW DESCRIBES THE IN-NETWORK COVERAGE POR THIS PLAN. THE AMOUNTS SHOWN ARE YOUR SHARE OF THE COSTS FOR COVERED BENEITS LIFETIME MAXIMUM Also known as the OOP, is the maximum a consumer will have to pay for a health care service. In this plan, the maximum an individual would have to pay is $10,000 and the family would pay a max of $20,000 Pan Type mo There is no maximum put in place for this health plan. CoPay Nan-Specialn Ofice Vit General Physician, Famly Practitioner, Peda can ernternie Vats 1a S0 Cnoes, deductle wied: Thereefte Mer ba pas 100 Ata Pa 100% ance OCPrhed nniad viut Specialat Viat 20% after deductitie (Unimad viata Invial S5.000. Fami S10,000 - ----------- Colrsurance 20% atar deductible up to out ol gocket ma 30 once ouol gociet men s setla OFFICE VISIT Celmuran Linit ndvidal S.00. Famiy St0,c0 - Outof-fadoet Maimum Individuat $1000, Famie sm neludes deductible Uetime Meimum unted ---- ----- ----- ---- PRESCRIPTION DRUGS Offe Vist Non Specialen Ofice Vk General Physiien. Fermily Practitiones, Pedn cian erintervi Vsts 1a S0 Cepes dedatle wved Thereeter Aa Explains cost of physician visits. Poys once COPaached iked visit Speialst Vat 20 ter dedtibe imted vi Note whether or not prescription drugs are covered and differences between generic and brand-name costs. Will you have to pay and Presription Orugs Phamecy Dedurtbie (per individuat Non Agolcabie Does net apply to ge revid GeneriD Co tes ndee s20 oe de e waived. Prefered Brand Dral Comaceptives indudet Nor Covered Non Prefered BrandOral Contracepti incdet No Covered Selljecbie Not Covered out-of-pocket for certain prescriptions a how much? Emergency Room so0 copay eaiedif adnitted ENERGENCY Aduh Prevertive Care Arra Ratina Oyn Eam No mting periad, no clender ye man Annual ROOM Pap/Mammogramt S0 capry deductible wavect heentve Heth - Routire - Pyeical (No watng periodt 0 cpry deductble waived ncluden leb work and K Chid Praventive Care 0 copy Age and frequanay achedde appi: No durga for immuniationa up to the ape of Amount you are responsible for if you visit the emergency room and aren't admitted. If you are admitted, this fee will be waived. Lay 20 tr dedestle onrevervel ADULT PREVENTIVE CARE -Manermity Not overed Eonpt for pregrency complicetionsl hyieal Therapy 20 tar deduesle per alender paw, Maimumles te contined in and out-atewart bereft Skled Nursing 40% ater dedubie Orad of hotal 0 dayn per clerder yea Mainum ples to contined innd o ret banete There is no out-of-pocket charge for routine exams or physicals. Home Health Care 20% ter deductible (rateed of hopital deya per calerder year, Menimum pplen to conbined in nd outret beelte Inperient and Ourparient Covernge s only provided tar sev biologicaly badmertal ore drdes Deueand ireooy LAB | X-RAY Hoapital Care Honpita Adrision 40% aher dedactible. Opatiere Surgey a% aher deductibie, Urgert Cere Fecity. S5 copay deductibie waived CHD PREVONE Once you meet the deductible, you will only have to pay 20% of the lab or x-ray cost. qej a CARE No charge for immunizations. MATERNITY PHYSICAL THERAPY Maternity coverage is not provided by this plan except for pregnancy complications. Once you meet the deductible, you will only have to pay 20% for a physical therapy session. There are a maximum of 24 visits in one year. DISSECTING A HEALTH PLAN GENDER: FEMALE AGE: 31 (BIRTH DATE: 10.10.1980) STATE: IL 60202 PLAN: AETNA MANAGED CHOICE OPEN ACCESS VALUE 5000 MONTHLY COST: $134.00 PLAN TYPE DEDUCTIBLE PPO ((Preferred Provider Organization) includes coverage to in-network and out-of-network health care providers. You pay less for services when visiting in-network providers but have the flexibility to see out-of-network providers. Amount an individual or family has to pay before health insurance coverage kicks-in and starts paying for services. Warning: This can double for out-of-network health care providers. CO-PAY COINSURANCE The amount you pay for visiting the doctor or a specialist. Percentage you pay for a medical bill. For example, an individual would pay 20% once the deductible is met and the insurance company would pay the remaining 80%. MANAGED CHOICE OPEN ACCESS VALUE 5000 OUT-OF-POCKET MAXIMUM INFORMATION BELOW DESCRIBES THE IN-NETWORK COVERAGE POR THIS PLAN. THE AMOUNTS SHOWN ARE YOUR SHARE OF THE COSTS FOR COVERED BENEITS LIFETIME MAXIMUM Also known as the OOP, is the maximum a consumer will have to pay for a health care service. In this plan, the maximum an individual would have to pay is $10,000 and the family would pay a max of $20,000 Pan Type mo There is no maximum put in place for this health plan. CoPay Nan-Specialn Ofice Vit General Physician, Famly Practitioner, Peda can ernternie Vats 1a S0 Cnoes, deductle wied: Thereefte Mer ba pas 100 Ata Pa 100% ance OCPrhed nniad viut Specialat Viat 20% after deductitie (Unimad viata Invial S5.000. Fami S10,000 - ----------- Colrsurance 20% atar deductible up to out ol gocket ma 30 once ouol gociet men s setla OFFICE VISIT Celmuran Linit ndvidal S.00. Famiy St0,c0 - Outof-fadoet Maimum Individuat $1000, Famie sm neludes deductible Uetime Meimum unted ---- ----- ----- ---- PRESCRIPTION DRUGS Offe Vist Non Specialen Ofice Vk General Physiien. Fermily Practitiones, Pedn cian erintervi Vsts 1a S0 Cepes dedatle wved Thereeter Aa Explains cost of physician visits. Poys once COPaached iked visit Speialst Vat 20 ter dedtibe imted vi Note whether or not prescription drugs are covered and differences between generic and brand-name costs. Will you have to pay and Presription Orugs Phamecy Dedurtbie (per individuat Non Agolcabie Does net apply to ge revid GeneriD Co tes ndee s20 oe de e waived. Prefered Brand Dral Comaceptives indudet Nor Covered Non Prefered BrandOral Contracepti incdet No Covered Selljecbie Not Covered out-of-pocket for certain prescriptions a how much? Emergency Room so0 copay eaiedif adnitted ENERGENCY Aduh Prevertive Care Arra Ratina Oyn Eam No mting periad, no clender ye man Annual ROOM Pap/Mammogramt S0 capry deductible wavect heentve Heth - Routire - Pyeical (No watng periodt 0 cpry deductble waived ncluden leb work and K Chid Praventive Care 0 copy Age and frequanay achedde appi: No durga for immuniationa up to the ape of Amount you are responsible for if you visit the emergency room and aren't admitted. If you are admitted, this fee will be waived. Lay 20 tr dedestle onrevervel ADULT PREVENTIVE CARE -Manermity Not overed Eonpt for pregrency complicetionsl hyieal Therapy 20 tar deduesle per alender paw, Maimumles te contined in and out-atewart bereft Skled Nursing 40% ater dedubie Orad of hotal 0 dayn per clerder yea Mainum ples to contined innd o ret banete There is no out-of-pocket charge for routine exams or physicals. Home Health Care 20% ter deductible (rateed of hopital deya per calerder year, Menimum pplen to conbined in nd outret beelte Inperient and Ourparient Covernge s only provided tar sev biologicaly badmertal ore drdes Deueand ireooy LAB | X-RAY Hoapital Care Honpita Adrision 40% aher dedactible. Opatiere Surgey a% aher deductibie, Urgert Cere Fecity. S5 copay deductibie waived CHD PREVONE Once you meet the deductible, you will only have to pay 20% of the lab or x-ray cost. qej a CARE No charge for immunizations. MATERNITY PHYSICAL THERAPY Maternity coverage is not provided by this plan except for pregnancy complications. Once you meet the deductible, you will only have to pay 20% for a physical therapy session. There are a maximum of 24 visits in one year. DISSECTING A HEALTH PLAN GENDER: FEMALE AGE: 31 (BIRTH DATE: 10.10.1980) STATE: IL 60202 PLAN: AETNA MANAGED CHOICE OPEN ACCESS VALUE 5000 MONTHLY COST: $134.00 PLAN TYPE DEDUCTIBLE PPO ((Preferred Provider Organization) includes coverage to in-network and out-of-network health care providers. You pay less for services when visiting in-network providers but have the flexibility to see out-of-network providers. Amount an individual or family has to pay before health insurance coverage kicks-in and starts paying for services. Warning: This can double for out-of-network health care providers. CO-PAY COINSURANCE The amount you pay for visiting the doctor or a specialist. Percentage you pay for a medical bill. For example, an individual would pay 20% once the deductible is met and the insurance company would pay the remaining 80%. MANAGED CHOICE OPEN ACCESS VALUE 5000 OUT-OF-POCKET MAXIMUM INFORMATION BELOW DESCRIBES THE IN-NETWORK COVERAGE POR THIS PLAN. THE AMOUNTS SHOWN ARE YOUR SHARE OF THE COSTS FOR COVERED BENEITS LIFETIME MAXIMUM Also known as the OOP, is the maximum a consumer will have to pay for a health care service. In this plan, the maximum an individual would have to pay is $10,000 and the family would pay a max of $20,000 Pan Type mo There is no maximum put in place for this health plan. CoPay Nan-Specialn Ofice Vit General Physician, Famly Practitioner, Peda can ernternie Vats 1a S0 Cnoes, deductle wied: Thereefte Mer ba pas 100 Ata Pa 100% ance OCPrhed nniad viut Specialat Viat 20% after deductitie (Unimad viata Invial S5.000. Fami S10,000 - ----------- Colrsurance 20% atar deductible up to out ol gocket ma 30 once ouol gociet men s setla OFFICE VISIT Celmuran Linit ndvidal S.00. Famiy St0,c0 - Outof-fadoet Maimum Individuat $1000, Famie sm neludes deductible Uetime Meimum unted ---- ----- ----- ---- PRESCRIPTION DRUGS Offe Vist Non Specialen Ofice Vk General Physiien. Fermily Practitiones, Pedn cian erintervi Vsts 1a S0 Cepes dedatle wved Thereeter Aa Explains cost of physician visits. Poys once COPaached iked visit Speialst Vat 20 ter dedtibe imted vi Note whether or not prescription drugs are covered and differences between generic and brand-name costs. Will you have to pay and Presription Orugs Phamecy Dedurtbie (per individuat Non Agolcabie Does net apply to ge revid GeneriD Co tes ndee s20 oe de e waived. Prefered Brand Dral Comaceptives indudet Nor Covered Non Prefered BrandOral Contracepti incdet No Covered Selljecbie Not Covered out-of-pocket for certain prescriptions a how much? Emergency Room so0 copay eaiedif adnitted ENERGENCY Aduh Prevertive Care Arra Ratina Oyn Eam No mting periad, no clender ye man Annual ROOM Pap/Mammogramt S0 capry deductible wavect heentve Heth - Routire - Pyeical (No watng periodt 0 cpry deductble waived ncluden leb work and K Chid Praventive Care 0 copy Age and frequanay achedde appi: No durga for immuniationa up to the ape of Amount you are responsible for if you visit the emergency room and aren't admitted. If you are admitted, this fee will be waived. Lay 20 tr dedestle onrevervel ADULT PREVENTIVE CARE -Manermity Not overed Eonpt for pregrency complicetionsl hyieal Therapy 20 tar deduesle per alender paw, Maimumles te contined in and out-atewart bereft Skled Nursing 40% ater dedubie Orad of hotal 0 dayn per clerder yea Mainum ples to contined innd o ret banete There is no out-of-pocket charge for routine exams or physicals. Home Health Care 20% ter deductible (rateed of hopital deya per calerder year, Menimum pplen to conbined in nd outret beelte Inperient and Ourparient Covernge s only provided tar sev biologicaly badmertal ore drdes Deueand ireooy LAB | X-RAY Hoapital Care Honpita Adrision 40% aher dedactible. Opatiere Surgey a% aher deductibie, Urgert Cere Fecity. S5 copay deductibie waived CHD PREVONE Once you meet the deductible, you will only have to pay 20% of the lab or x-ray cost. qej a CARE No charge for immunizations. MATERNITY PHYSICAL THERAPY Maternity coverage is not provided by this plan except for pregnancy complications. Once you meet the deductible, you will only have to pay 20% for a physical therapy session. There are a maximum of 24 visits in one year. DISSECTING A HEALTH PLAN GENDER: FEMALE AGE: 31 (BIRTH DATE: 10.10.1980) STATE: IL 60202 PLAN: AETNA MANAGED CHOICE OPEN ACCESS VALUE 5000 MONTHLY COST: $134.00 PLAN TYPE DEDUCTIBLE PPO ((Preferred Provider Organization) includes coverage to in-network and out-of-network health care providers. You pay less for services when visiting in-network providers but have the flexibility to see out-of-network providers. Amount an individual or family has to pay before health insurance coverage kicks-in and starts paying for services. Warning: This can double for out-of-network health care providers. CO-PAY COINSURANCE The amount you pay for visiting the doctor or a specialist. Percentage you pay for a medical bill. For example, an individual would pay 20% once the deductible is met and the insurance company would pay the remaining 80%. MANAGED CHOICE OPEN ACCESS VALUE 5000 OUT-OF-POCKET MAXIMUM INFORMATION BELOW DESCRIBES THE IN-NETWORK COVERAGE POR THIS PLAN. THE AMOUNTS SHOWN ARE YOUR SHARE OF THE COSTS FOR COVERED BENEITS LIFETIME MAXIMUM Also known as the OOP, is the maximum a consumer will have to pay for a health care service. In this plan, the maximum an individual would have to pay is $10,000 and the family would pay a max of $20,000 Pan Type mo There is no maximum put in place for this health plan. CoPay Nan-Specialn Ofice Vit General Physician, Famly Practitioner, Peda can ernternie Vats 1a S0 Cnoes, deductle wied: Thereefte Mer ba pas 100 Ata Pa 100% ance OCPrhed nniad viut Specialat Viat 20% after deductitie (Unimad viata Invial S5.000. Fami S10,000 - ----------- Colrsurance 20% atar deductible up to out ol gocket ma 30 once ouol gociet men s setla OFFICE VISIT Celmuran Linit ndvidal S.00. Famiy St0,c0 - Outof-fadoet Maimum Individuat $1000, Famie sm neludes deductible Uetime Meimum unted ---- ----- ----- ---- PRESCRIPTION DRUGS Offe Vist Non Specialen Ofice Vk General Physiien. Fermily Practitiones, Pedn cian erintervi Vsts 1a S0 Cepes dedatle wved Thereeter Aa Explains cost of physician visits. Poys once COPaached iked visit Speialst Vat 20 ter dedtibe imted vi Note whether or not prescription drugs are covered and differences between generic and brand-name costs. Will you have to pay and Presription Orugs Phamecy Dedurtbie (per individuat Non Agolcabie Does net apply to ge revid GeneriD Co tes ndee s20 oe de e waived. Prefered Brand Dral Comaceptives indudet Nor Covered Non Prefered BrandOral Contracepti incdet No Covered Selljecbie Not Covered out-of-pocket for certain prescriptions a how much? Emergency Room so0 copay eaiedif adnitted ENERGENCY Aduh Prevertive Care Arra Ratina Oyn Eam No mting periad, no clender ye man Annual ROOM Pap/Mammogramt S0 capry deductible wavect heentve Heth - Routire - Pyeical (No watng periodt 0 cpry deductble waived ncluden leb work and K Chid Praventive Care 0 copy Age and frequanay achedde appi: No durga for immuniationa up to the ape of Amount you are responsible for if you visit the emergency room and aren't admitted. If you are admitted, this fee will be waived. Lay 20 tr dedestle onrevervel ADULT PREVENTIVE CARE -Manermity Not overed Eonpt for pregrency complicetionsl hyieal Therapy 20 tar deduesle per alender paw, Maimumles te contined in and out-atewart bereft Skled Nursing 40% ater dedubie Orad of hotal 0 dayn per clerder yea Mainum ples to contined innd o ret banete There is no out-of-pocket charge for routine exams or physicals. Home Health Care 20% ter deductible (rateed of hopital deya per calerder year, Menimum pplen to conbined in nd outret beelte Inperient and Ourparient Covernge s only provided tar sev biologicaly badmertal ore drdes Deueand ireooy LAB | X-RAY Hoapital Care Honpita Adrision 40% aher dedactible. Opatiere Surgey a% aher deductibie, Urgert Cere Fecity. S5 copay deductibie waived CHD PREVONE Once you meet the deductible, you will only have to pay 20% of the lab or x-ray cost. qej a CARE No charge for immunizations. MATERNITY PHYSICAL THERAPY Maternity coverage is not provided by this plan except for pregnancy complications. Once you meet the deductible, you will only have to pay 20% for a physical therapy session. There are a maximum of 24 visits in one year. DISSECTING A HEALTH PLAN GENDER: FEMALE AGE: 31 (BIRTH DATE: 10.10.1980) STATE: IL 60202 PLAN: AETNA MANAGED CHOICE OPEN ACCESS VALUE 5000 MONTHLY COST: $134.00 PLAN TYPE DEDUCTIBLE PPO ((Preferred Provider Organization) includes coverage to in-network and out-of-network health care providers. You pay less for services when visiting in-network providers but have the flexibility to see out-of-network providers. Amount an individual or family has to pay before health insurance coverage kicks-in and starts paying for services. Warning: This can double for out-of-network health care providers. CO-PAY COINSURANCE The amount you pay for visiting the doctor or a specialist. Percentage you pay for a medical bill. For example, an individual would pay 20% once the deductible is met and the insurance company would pay the remaining 80%. MANAGED CHOICE OPEN ACCESS VALUE 5000 OUT-OF-POCKET MAXIMUM INFORMATION BELOW DESCRIBES THE IN-NETWORK COVERAGE POR THIS PLAN. THE AMOUNTS SHOWN ARE YOUR SHARE OF THE COSTS FOR COVERED BENEITS LIFETIME MAXIMUM Also known as the OOP, is the maximum a consumer will have to pay for a health care service. In this plan, the maximum an individual would have to pay is $10,000 and the family would pay a max of $20,000 Pan Type mo There is no maximum put in place for this health plan. CoPay Nan-Specialn Ofice Vit General Physician, Famly Practitioner, Peda can ernternie Vats 1a S0 Cnoes, deductle wied: Thereefte Mer ba pas 100 Ata Pa 100% ance OCPrhed nniad viut Specialat Viat 20% after deductitie (Unimad viata Invial S5.000. Fami S10,000 - ----------- Colrsurance 20% atar deductible up to out ol gocket ma 30 once ouol gociet men s setla OFFICE VISIT Celmuran Linit ndvidal S.00. Famiy St0,c0 - Outof-fadoet Maimum Individuat $1000, Famie sm neludes deductible Uetime Meimum unted ---- ----- ----- ---- PRESCRIPTION DRUGS Offe Vist Non Specialen Ofice Vk General Physiien. Fermily Practitiones, Pedn cian erintervi Vsts 1a S0 Cepes dedatle wved Thereeter Aa Explains cost of physician visits. Poys once COPaached iked visit Speialst Vat 20 ter dedtibe imted vi Note whether or not prescription drugs are covered and differences between generic and brand-name costs. Will you have to pay and Presription Orugs Phamecy Dedurtbie (per individuat Non Agolcabie Does net apply to ge revid GeneriD Co tes ndee s20 oe de e waived. Prefered Brand Dral Comaceptives indudet Nor Covered Non Prefered BrandOral Contracepti incdet No Covered Selljecbie Not Covered out-of-pocket for certain prescriptions a how much? Emergency Room so0 copay eaiedif adnitted ENERGENCY Aduh Prevertive Care Arra Ratina Oyn Eam No mting periad, no clender ye man Annual ROOM Pap/Mammogramt S0 capry deductible wavect heentve Heth - Routire - Pyeical (No watng periodt 0 cpry deductble waived ncluden leb work and K Chid Praventive Care 0 copy Age and frequanay achedde appi: No durga for immuniationa up to the ape of Amount you are responsible for if you visit the emergency room and aren't admitted. If you are admitted, this fee will be waived. Lay 20 tr dedestle onrevervel ADULT PREVENTIVE CARE -Manermity Not overed Eonpt for pregrency complicetionsl hyieal Therapy 20 tar deduesle per alender paw, Maimumles te contined in and out-atewart bereft Skled Nursing 40% ater dedubie Orad of hotal 0 dayn per clerder yea Mainum ples to contined innd o ret banete There is no out-of-pocket charge for routine exams or physicals. Home Health Care 20% ter deductible (rateed of hopital deya per calerder year, Menimum pplen to conbined in nd outret beelte Inperient and Ourparient Covernge s only provided tar sev biologicaly badmertal ore drdes Deueand ireooy LAB | X-RAY Hoapital Care Honpita Adrision 40% aher dedactible. Opatiere Surgey a% aher deductibie, Urgert Cere Fecity. S5 copay deductibie waived CHD PREVONE Once you meet the deductible, you will only have to pay 20% of the lab or x-ray cost. qej a CARE No charge for immunizations. MATERNITY PHYSICAL THERAPY Maternity coverage is not provided by this plan except for pregnancy complications. Once you meet the deductible, you will only have to pay 20% for a physical therapy session. There are a maximum of 24 visits in one year.

Dissecting a Health Plan

shared by GoHealth on Jan 16
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GoHealthInsurance.com dissects a health insurance plan to help make it easier for you to understand.

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