Sample Deductible on Summary of Benefits

[alfreda89]

This is considered a Silver, PPO plan, BTW:

For in-network providers $2,750 person/
$5,500 family
For out of-network providers $12,500
person/ $25,000 family

Does not apply to in-network preventive
care, in-network office visits, in-network
urgent care visits, in-network
prescription drugs subject to a copay and
pediatric vision.

Then...what dos it apply to? If this is a hospitalization plan entry fee, why not just say that? Others do.

Comments

[deborahjross.livejournal.com]

The deductible does not apply to the services listed (preventive care, etc.) So the coverage kicks in right away when you see your doctor and preventive care, like mammograms, have no deductible and no copay. Confusing language, much.

[alfreda89.livejournal.com]

Very confusing, Deborah. The "no co-pay" on preventative measures is pretty much universal in these plans, so I am suspicious that this means something else. It's not quite the same as most of them.

The disturbing ones are the ones that charge you $2000/day for hospitalization. And you wonder if that is worse or better than 20% or 30% of cost.