| View
and Compare Plan Details |
| Plan |
| One
Deductible PPO or Traditional Non-Network |
|
| Premium
Payment Options |
Monthly,
Quarterly, Semi-Annual, Annual |
| |
| Deductible
Individual Plan |
Network |
Non-Network |
| $1,100,
$1,600, $2,100, $2,600 or $5,000 |
Additional
$500 |
| Deductible
Family Plan |
Network |
Non-Network |
| $2,200,
$3,200, $4,200, $5,200 or $10,000 |
Additional
$1,000 |
| |
| Lifetime
Maximum |
$3,
$6 or $8 Million Per Covered Person |
| |
| Coinsurance |
100/0 |
80/20 |
| |
| Out-of-pocket
Maximum |
Equal
to your deductible |
$13,000 |
| |
| Annual
Maximum |
N/A |
| |
| Outpatient
Services Maximum |
N/A |
| |
|
| |
None. |
| |
| Plan
Description |
- A single
deductible for the whole family rather than
one for each person — easy to meet the
deductible and easy to track!
- Add a Health
Savings Account (HSA) for tax benefits
- "HealthyDiscount"
when you renew — offered only by Assurant
Health (HealthyDiscounts Not available in
CO, DC, FL, KS, LA, MN, NV, ND, NH, NM, OR,
SD, VA and WV)
|
| |
| Preventative
Care / Wellness / Routine Physical |
After
you pay your deductible and coinsurance, you pay
nothing for covered expenses. $500 calendar year
maximum. (Pap smears, mammograms and PSA tests
do not apply toward maximum.) |
| |
| Doctor's
Office Visits |
After
you pay your deductible and coinsurance, you pay
nothing for covered expenses. |
| |
| Outpatient
Lab Tests & X-rays |
After
you pay your deductible and coinsurance, you pay
nothing for covered expenses. |
| |
| Outpatient
Surgical |
After
you pay your deductible and coinsurance, you pay
nothing for covered expenses. |
| |
| Prescription
Drug |
Expenses
applied to annual plan deductible. Rx Drug
Discount Card included in plan and offers
savings up to 25%. |
| |
| Inpatient
Services/Hospitalization |
After
you pay your deductible and coinsurance, you pay
nothing for covered expenses. Benefits include
the hospital semiprivate room rate and covered
ancillary charges. ICU services have no special
limit. |
| |
| Emergency
Room Services |
$75
access fee (waived if admitted) then, after you
pay your deductible and coinsurance, you pay
nothing for covered expenses. |
| |
| Ambulance
Services |
Ground
or Air ambulance to nearest hospital equipped to
provide appropriate care. After you pay your
deductible and coinsurance, you pay nothing for
covered expenses. |
| |
| Rehabilitation
Services |
After
you pay your deductible and coinsurance, you pay
nothing for covered expenses. Inpatient: 180-day
calendar year maximum. Outpatient: Occupational,
physical and speech therapies and cardiac
rehabilitation with a $3,000 calendar year
maximum. |
| |
| Chiropractic
Services |
After
you pay your deductible and coinsurance, you pay
nothing for covered expenses; $750 calendar year
maximum |
| |
| Mental
Nervous/Substance Abuse |
You
pay your deductible and 50% coinsurance. $2500
calendar year maximum (up to $500 of this
benefit is available for outpatient treatment). |
| |
| Complications
of Pregnancy |
After
you pay your deductible and coinsurance, you pay
nothing for covered expenses. |
| |
| Calendar
Year Maximum |
None. |
| |
| Plan
Exclusions |
Exclusions
consist of the following but are not limited to:
Charges reimbursable by Medicare, Workers'
Compensation or an automobile carrier; charges
incurred due to a pre-existing condition,
illness or injury caused by war, commission of a
crime, attempted suicide or influence of an
illegal substance; routine hearing, vision or
foot care; cosmetic services; services provided
by a family member; custodial care; dental care
not related to a dental injury; correction of
the jaws; growth hormone treatment; diagnosis
and treatment of infertility; maternity and
routine nursery care; surrogate pregnancy;
educational or vocational testing or treatment,
treatment of “quality of life” or
“lifestyle” concerns; sex transformation;
sexual dysfunction; treatment to improve memory
or to slow aging; over-the-counter products;
contraceptive drugs and devices; genetic
testing, counseling and services; telemedicine. |
