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Benefits Of Going With The HMO 100% Plan |
When it comes to comprehensive benefits that you can derive from your health plan, nothing could beat the coverage offered by the HMO 100% Plan of Blue Cross of California. The good news about the HMO 100% Plan is that there is no plan maximum benefit for this type of coverage. If you are one of those employees who need high-level medical coverage, this type of health plan is best for you.
There are many advantages when you go for the HMO 100% Plan for your employees. Although this type of plan may be a bit higher in terms of cost as compared to other plans that Blue Cross of California has to offer, the benefits that you and your employees could derive form this program is really every penny that you pay.
Deductible Medical Fees
For most health care plans, there is an annual deductible, which refers to the annual out-of-pocket minimum expenses of the plan holder. In the case of HMO 100% plan, One of the big advantages being offered under the HMO 100% plan is that there are no annual deductible amount for medical services. However, when it comes to prescription dugs, the policyholder of HMO 100% plan is needs to pay $10 for generic charges and $20 brand-name after annual $150 brand-name prescription drug deductible per member. Note that where a member selects a brand-name drug over its generic counterpart, the policyholder shall be liable to pay for the difference between the prices of the brand-name drug and the generic drug. Such rule applies even where the attending physician specifically prescribed the brand-name drug and stated therein that no substitute should be taken.
Care Of Patients In The Hospital
Unlike other types of health coverage where the patient needs to go to an affiliate hospital only to enjoy coverage, the policyholder of the HMO 100% plan may in cases of emergencies go to a non-affiliate hospital for treatment. In the case the policyholder is confined in the non-participating hospital, the $100 deductible shall be waived under this plan.
In the event where the policyholder is confined in an affiliate hospital, his or her treatment shall be covered by the plan. There is no need for a pre-service review in cases like these.
In case where the employee will need to undergo some special care before he or she can function normally again, the HMO 100% plan covers the expenses that would be incurred for highly skilled nursing care. Your employees need not worry about their care after they have been discharged from the hospital since this plan provides for their care.
Outpatient Care Of Policyholders
Unlike in the emergencies cases where there is no need for pre-service review, an outpatient treatment or any diagnostic procedures should undergo pre-service review before the policyholder can avail of the benefits of the plan. However, the good news is that where the pre-service review finds out that the policyholder needs the medical treatment or diagnostic procedures, any cost related thereon shall be covered by the insurance policy.
Learn more at: www.baahealth.com
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