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Best Benefits For Cost Available With Individual HMO |
For some of the best benefits available with an HMO, an Individual HMO provides them when compared to the cost of the premiums. As health care costs continue to skyrocket in all areas of the field, people are always looking for the best return on their investment.
With the Individual HMO plan there is no annual deductible and the annual out-of-pocket expenses is only $3,000 per member. When two members reach the maximum for out-of-pockets expenses, the maximum is satisfied for all family members enrolled in the Individual HMO plan. The copay for doctor’s office visits is $10 per visit, and there are no additional charges for office related services provided for professional services such as anesthesia, surgery or diagnostic testing.
A $100 copay applies to emergency room visits plus 20 percent of the negotiated fee. The copay is waived if the member is admitted to the hospital by the attending physician. Hospital services are charged at the rate of 20 percent of the negotiated fee for inpatient or outpatient services.
Maternity care is available for just a $10 copay for office visits. Inpatient and outpatient services are billed at 20 percent of the negotiated fees. Preventive care is also available with members being charged a $10 copay for health maintenance services.
Prescription drug coverage offers liberal costs for Blue Cross formulary drugs and charges a copay of $10 for generic drugs. There is a $30 copay for name brand drugs once a $250 name brand deductible has been met. Two people meeting this deductible will deem it satisfied for the remaining members of the enrolled family members. There is a charge of 30 percent of the negotiated price for self-administered injectable drugs, except for insulin.
For members selecting to receive name brand drugs when a generic equivalent is available there will be a charge of the $10 generic copay along with the charge of the difference between the cost of the generic drug and the cost of the name brand drug, even if the doctor wrote on the prescription to dispense as written or do not substitute.
Learn more at: www.baahealth.com
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