Plan Details | Health-Gen Gold HMO

ESTIMATED MONTHLY PREMIUM
Individual Premium
300
Family Premium
600

ESTIMATED DEDUCTIBLE
Individual Deductible
1,000
Family Deductible
2,000

ESTIMATED OUT-OF-POCKET MAXIMUM
Individual MOOP
2,000
Family MOOP
4,000

COVERAGE PREMIUMS
Individual (IND) 300
Individual + Spouse 450
Individual + Dependent(s) 375
Family (FAM) 600
PREVENTIVE CARE COVERAGE INCLUDED
Office Visits: Adults Routine Physical Yes
Office Visits: Routine Gynecological Exam N/A
Office Visits: Well child care N/A
Office Visits: All other visits to Primary Care No
Office Visits: Specialist No
PRESCRIPTION DRUG COVERAGE INCLUDED
Brand Prescription Drugs Inpatient Rx- Covered: Outpatient- Not Covered
Non- Formulary Prescription Drugs Inpatient Rx- Covered: Outpatient- Not Covered
Mail Order for Prescription Drugs Inpatient Rx- Covered: Outpatient- Not Covered
Family (FAM) N/A
HOSPITAL SERVICES COVERAGE AMOUNT
Emergency Room 20% Coinsurance after deductible. Extra $50 deductible applies for Sickness if not admitted
Outpatient Lab/X-Rays 40% Coinsurance after deductible.
Outpatient Surgery 60% Coinsurance after deductible.
Hospitalization 80% Coinsurance after deductible.