|
|
Old Benefit |
New Benefit, Effective March 1, 2010 |
|
Primary care physician (PCP) office visits |
$5 copay |
$10 copay (except for preventive care) |
|
Specialist doctor office visits |
$10 copay |
$20 copay |
|
Emergency room copay |
$25 copay |
$50 copay |
|
Inpatient hospital services |
No charge |
10% coinsurance/$1,000 maximum per year for all coinsurance
Two stays per year |
|
Physical, occupational and speech therapy |
$2,500 maximum per year, combined |
10% coinsurance/$1,000 maximum per year for all coinsurance
15 visits per year, combined |
|
Diabetic supplies |
No charge |
10% coinsurance/$1,000 maximum per year for all coinsurance |
|
Outpatient surgery
(short procedure unit & facility) |
No charge |
10% coinsurance/$1,000 maximum per year for all coinsurance |
|
Cardiac rehabilitation
(36 sessions for a 12-week period) |
No charge |
10% coinsurance/$1,000 maximum per year for all coinsurance |
|
Chemotherapy, dialysis or radiation |
No charge |
10% coinsurance/$1,000 maximum per year for all coinsurance |
|
Pulmonary rehabilitation
(18 sessions per calendar year) |
No charge |
10% coinsurance/$1,000 maximum per year for all coinsurance |
|
Respiratory therapy
(18 sessions per calendar year) |
No charge |
10% coinsurance/$1,000 maximum per year for all coinsurance |
|
Home infusion |
No charge |
10% coinsurance/$1,000 maximum per year for all coinsurance |
|
Home health care |
No charge |
10% coinsurance/$1,000 maximum per year for all coinsurance |
|
Skilled nursing facility care
(60 days per calendar year) |
No charge |
10% coinsurance/$1,000 maximum per year for all coinsurance |
|
Inpatient rehabilitation therapy
(45 days per calendar year) |
No charge |
10% coinsurance/$1,000 maximum per year for all coinsurance |
