Health Care 

Health Care Plan Medical Option (2008)

Annual Deductible 

Per Individual/Family - $0

Out of Pocket Maximum - Per Individual - $1,500

Out of Pocket Maximum - Per Family - $3,000

 

Wellness Benefit:

$20 copay

 

Primary Care Office Visit:

$20 copay

 

Specialist Office Visit:

$30 copay

 

Inpatient Admission:

·         Per Admission  - $100 copay- first 5 days/calendar year 100% after copay

·         Physical Therapy - $20 copay

·         Emergency Room Visit - $75 copay 

·         Outpatient Surgery $0; plan pays 100%

·         Outpatient Services (MRI, CT Scan, PET Scan) $0; plan pays 100%

·         Durable Medical Equipment $0; plan pays 100%

·         Medical Supplies $0; plan pays 100%

·         Professional Ambulance $0; plan pays 100%

 

Prescription Drug Plan (2008)

Prescription Drugs You Pay

$15 Generic

$35 Brand Formulary

$50 Brand Non-Formulary

Members may use any BCBS pharmacy.

 

 

Vision Plan (2008)

Vision Care- Exam $20 copay, then plan pays 100%

Vision Discounts - Eyewear Vision discounts through EyeMed Vision Care.

Benefits are paid one time every 12 months.

 

Dental Plan (2008)

(Do not have to enroll in Medical Plan to participate in Dental Plan)

Rates per pay period (26):

Employee $8.98 Employee & Child(ren) $15.81

Employee & Spouse $17.97 Family $22.01

 

Service You Pay;  Plan Pays

Preventative Services 20%;  80%

Basic Services 20%;  80%

Major Services 20%;  80%

Orthodontia (under age 19) 50%;  50%

 

Maximum Benefit: $1,000 per person, per year. Maximum benefit includes preventative, basic, major, and orthodontia services.