Description
Coverage for a Couple member household covering all your medical needs
- Members Age at enrollment = 27 Years Old
- Initial Unshareable Amount = $5,000 per Year
You need a doctor, we got you covered.*
Couple Member – Age 27 – $5000 Initial Unshareable Amount
$295.52/ month with a $100.00 sign-up fee. on the 1st of each month with a 14-day free trial and a $100.00 sign-up fee
- All your medical needs are met by this plan.
- The out-of-pocket limit is the IUA you chose: $3,000, $5,000 or $10,000.
- There’s no lifetime maximum.
- For an emergency room visit, you’ll pay a $200 Copay. 100% coverage after IUA met.
Doctor visits will cost you:-
Primary Doctor: Network: $50 Copay, 100% coverage after IUA met.
Specialist: Network: $50 Copay, 100% coverage after IUA met.
Other practitioner: Network:$50 Copay, 100% coverage after IUA met.
Hospital services will cost you:-
Inpatient Hospital Services:
Network: $100 Copay per Day, 100% coverage after IUA met.
Inpatient Physician and Surgical Services:
Network: $100 Copay, 100% coverage after IUA met.
Explanation: All member cost sharing varies based upon Place of Service. Please refer to plan documents for additional information.
First payment: November 1, 2020
Additional information
| Age | 27 |
|---|---|
| Initial Unshareable Amount | $5,000 per Year |
| Coverage | Medical Needs |
| Household Size | 2 Member Household. Coverage for a Primary Member and Spouse or Life Partner |
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