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Benefits Of Going With The Classic HMO Plan |
Of the four types of Healthcare maintenance organization (HMO) plan of Blue Cross of California, the Classic HMO plan has the mid-range affordability. This plan is well suited for employees who are expecting to visit the hospital frequently and don’t want to fall short when it comes to their coverage. Like other HMO plans, this plan affords the employee a lot of peace of mind when it comes to his or her health coverage and that of his or her family.
Annual Deductible And Out-Of-Pocket Maximum
The Classic HMO has no annual deductible, unlike the Powerselect HMO and the Saver HMO, which allows for annual deductible. In terms of annual out-of-pocket maximum, which often refers to those expenses that contribute to the maximum co-payment limit, the Classic HMO allows for $1,750 per member deductible while the aggregate amount for the whole family is pegged at $3,500. Note that when we say family aggregate expense, we mean the combined amount of medical expenses of the members of the family. Where the total amount of $3,500 has been reached, the requirement is deemed as met even if some of the members of the family have not even used their allocated amount yet.
Visits To The Doctor’s Office Or The Hospital
A $20 co pay is charged on in-network office visits. This means that every time the plan holder or a member of his or her family goes for an office visit to a doctor in a network or affiliated hospital, he or she shall pay be charged a co pay of $20 per visit including those maternity related visits. However, when it comes to professional services such as diagnostic laboratory and x-ray, these will free of charge. Maternity professional services however are still charged with the co pay.
Hospital In-Patient And outpatient
Under the Classic HMO plan, the holder will be charged $250 co pay for admission to the hospital. Of the patient is not admitted to the hospital a co pay of 20% of the $250 will still be charged.
Prescription Drugs
There is $10 copay for generic prescription drugs under this plan. If the employee would prefer to use brand-medicine instead of the generic drugs, there is a 25$ copay for bran-name medicine. Note that in the vent where there is a generic medicine available but the patient would still want to use the brand-name medicine, the copay will be $10 and the difference between the prices of the generic medicine and the brand-medicine will be paid by the plan holder.
Ambulance Ride And Skilled Nursing Care
In cases of emergencies where the plan holder needs to take the ambulance to go to the hospital, the plan shall pay the cost of the ambulance ride. This is true even in those cases where there is no accident but the physician of the plan holder had ordered that the plan holder be transported to the hospital on an ambulance.
There are some instances where the patient would need specialized care after he or she has suffered injuries from an accident. In cases like these, the plan will pay for the nursing care for a maximum of 100 days provided that the patient availed of such care not more than 60 days from the time the accident happened.
Learn more at: www.baahealth.com
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