Physicians Plus Offers Health Insurance Options in Five Categories
Rate Table for New Individual Plans
Meriter Choice Reward Plan Office visits are subject to a member copayment at one of two tiers.
If necessary inpatient and outpatient surgery & services are performed at a Meriter Choice facility,
the deductible does not apply, saving the member up to $1,000 (family plan) in annual out-of-pocket costs.
HMO Office visits are subject to a member copayment. Members have an annual deductible for inpatient
and outpatient surgery and services.
HealthShare An annual policy deductible must be met before the plan pays anything toward most services.
When the policy deductible is met, the member pays 20% of charges and P+ pays 80% for most services.
HealthShare Complete There is a copayment for most office visits; a policy deductible must be met before
P+ pays toward most other services. When the policy deductible is met, except for office visits, the member
pays 20% of charges and P+ pays 80% for most services.
High-Deductible Health Plans (HSA-Compatible) The member may contribute tax-advantaged dollars to a Health Savings Account (HSA)
and pay health care costs from the account; unused funds can roll from one year into the next. The plan has
an annual policy deductible that must be met before it pays toward most services. On the $1,250 and $2,500 deductible plans, when the deductible is met, the
member pays 20% of charges and P+ pays 80% for most services.
* If you purchase prescription drug or maternity coverage along with a High-Deductible Health Plan, please consult your accountant or financial institution to verify that your plan will meet Federal Tax Guidelines for Health Savings Accounts.
Make your health plan more robust by adding coverage for:
Prescription Drugs Three drug plan designs are available:
- $10 Generic Rx: The member pays a $10 copay for prescribed generics on the Physicians Plus drug
formulary; P+ covers the balance. The member pays 100% for all other prescriptions.
- $10/30%/50%: The member pays a $10 copay for Physicians Plus formulary generics, 30% of total cost for
brand name formulary medications and 50% of total cost for drugs not on the formulary.
- $10 Generic Rx/$50 Reverse Copay: The member pays a $10 copay for formulary generics;
P+ pays up to $50 for brand name formulary prescriptions, the member pays the balance.
- Behavioral Health (BH) & Alcohol and Other Drug Abuse (AODA) services are covered according to
policy copays, deductibles, coinsurance and maximums.
- The member pays a $1,000 deductible, then the member pays 20% coinsurance; there is no maximum out of pocket.
- There is a 10-month waiting period before the benefit eligibility begins.
- If the benefit is not added when you enroll, it cannot be added at a later date unless a new application
is submitted for underwriting review.
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