Select Health Value Gold $0 Medical Deductible

SelectHealth
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Plan overview
Medical deductible

Individual: $0

Family: $0

Per Person: $0


Prescription drug deductible

Individual: $1200

Family: $3600

Per Person: $1200


Combined medical and drug out of pocket maximum

Individual: $10200

Family: $20400

Per Person: $10200

Office visit
Primary Doctor

CoPay: $20.00

CoInsurance: Not Applicable

Covered: Covered

Benefit Explanation:


Specialist

CoPay: $90.00

CoInsurance: Not Applicable

Covered: Covered

Prescription drug information
Preferred brand drugs

CoPay: Not Applicable

CoInsurance: 25.00% Coinsurance after deductible

Covered: Covered

Limit Quantity:

Limit Unit:

Benefit Explanation:


Non preferred brand drugs

CoPay: Not Applicable

CoInsurance: 50.00% Coinsurance after deductible

Covered: Covered

Limit Quantity:

Limit Unit:

Benefit Explanation:


Generic drugs

CoPay: $10.00

CoInsurance: Not Applicable

Covered: Covered

Limit Quantity:

Limit Unit:

Benefit Explanation: Certain generic and brand name drugs have lower cost sharing than the generic tier


Specialty drugs

CoPay: Not Applicable

CoInsurance: 50.00% Coinsurance after deductible

Covered: Covered

Limit Quantity:

Limit Unit:

Benefit Explanation:

Inpatient coverage
Hospital services

CoPay: Not Applicable

CoInsurance: 30.00%

Covered: Covered


Inpatient services

CoPay: Not Applicable

CoInsurance: 30.00%

Covered: Covered

Emergency and urgent care
Emergency room

CoPay: Not Applicable

CoInsurance: 30.00%

Covered: Covered


Urgent care facility

CoPay: $70.00

CoInsurance: Not Applicable

Covered: Covered

Benefit Explanation:

Maternity
Labor and delivery hospital stay

CoPay: Not Applicable

CoInsurance: 30.00%

Covered: Covered


Pre and Postnatal office visit

CoPay: $20.00

CoInsurance: Not Applicable

Covered: Covered

Vision
Routine Eye Exams for Children

CoPay: No Charge

CoInsurance: No Charge

Covered: Covered

Limit Quantity: 1

Limit Unit: Visit(s) per Year

Benefit Explanation: Covers one (1) comprehensive routine eye exam per year, to age nineteen (19)

Major dental care
Routine dental checkups for children

CoPay:

CoInsurance:

Covered: Not Covered

Limit Quantity:

Limit Unit:

Benefit Explanation: Dental Only Plan Available


Routine dental checkups for adults

CoPay:

CoInsurance:

Covered:

Limit Quantity:

Limit Unit:

Benefit Explanation:

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These policies have exclusions, limitations, reduction of benefits, terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, call or write your insurance agent or the company (whichever is applicable).