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Select HMO Simplifies Decisions And Allows Predictable Costs |
Of all the plans designed to offer some of the better benefits for the premium paid is the Select HMO plan from Blue Cross of California. All fees charged by network health care providers are negotiated by the plan to achieve the lowest possible costs for the plan members. Network providers will accept plan payments as payment in full for service they render to enrolled plan members.
With the Select HMO there is no annual deductible to meet, regardless of the number of family members on the plan. An annual maximum out-of-pocket expense is $3,000 per plan member; however the maximum out-of-pocket expense is considered satisfied for the entire family once two members have reached the maximum.
Visits to the doctor’s office require a $25 copay for each visit, however there is no charge for visits to offices for related medical expenses for other professional services such as X-ray, lab work and anesthesia.
Hospital inpatient services require a $250 per day copay for the first four days and then the plan pays 100 percent of the negotiated fees, per admission. Outpatient services require payment of 20 percent of the negotiated fee plus $250 per surgery. For emergency room services there is a $100 copay, which is waived if the patient is admitted by the attending physician and the member pays 20 percent of negotiated fees.
Preventive care benefits include a $25 copay for health maintenance services. For maternity, office visits require a $25 copay for office visits. For inpatient care there is a $250 per day charges for the first four days, per admission, and it is then covered by the plan for 100 percent of the negotiated costs. Outpatient maternity care will cost 20 percent of the negotiated fee.
Under the Select HMO plan, Blue Cross formulary drugs are available with a $10 copay. Name brand drugs are available for a $35 copay after a $250 name brand drug deductible is met. Members selecting a name brand drug when a generic equivalent is available, will be responsible for the $10 generic drug copay as well as the difference in cost between the cost of the generic drug and the cost of the name brand drug. All self-administered injectable drugs require payment of 30 percent of the negotiated price, with the exception of insulin.
Learn more at: www.baahealth.com
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