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Basic PPO 1000 Provides Just the Basics |
For those looking for low premiums with coverage for hospitalization and emergency services, a Basic PPO may be acceptable. Typically, a plan for young, unmarried adults or those who may have additional coverage through another family member, include mainly benefits for medical emergencies. The Basic PPO 1000 provides just that capability with low premiums and low annual deductions, but offers protection for major medical concerns.
The annual deductible is just $1,000 for each member and once two members each reach the deductible it is satisfied for all enrolled members of the plan. Annual maximum out-of-pocket expenses is just $3,500 pre member, again with two or members reaching the member maximum, it is considered satisfied for the remaining enrolled family members.
There are no benefits for doctor’s office visits until the annual maximum expense has been met, at which time the plan will pay 100 percent of the negotiated fee for doctor visits.
For inpatient or surgical procedures only, the member will pay 20 percent of the negotiated fees. Member must pay office visit charges until the annual maximum out-of-pocket amount is reached when the plan will pay 100 percent of the negotiated office visit fee.
Hospital inpatient or outpatient fees will have the member pay 20 percent of the negotiated fee and emergency room visits are charged at 20 percent of the negotiate fee along with a $100 copay which is waived if the patient is admitted by the attending physician. There is no coverage for maternity and no prescription benefits with this plan although prescription coverage is available through the PPO Saver plan.
For health maintenance purposes, basic screenings at HealthyCheck centers are available for a $25 copay. There is a $75 copay for premium screenings. Twenty percent of the negotiated fee will be charged for routine testing such as mammograms, Pap and PSA if ordered by a physician.
Learn more at: www.baahealth.com
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