First Time Having Insurance
Hello yall this is my first time having insurance because I’ve been in the military for the past ten years. Do you think my new employer is offering a reasonable plan for $142 a month?
Summary: Anthem PPO 1500
• Deductibles: $1,500 per individual or $3,000 per family for both in-network and out-of-network providers. You must meet the overall family deductible if you have multiple family members on the policy. • Services covered before meeting deductible: Includes primary care, specialist visits, and preventive care. Some services have copays or coinsurance even before hitting the deductible. • Out-of-pocket maximums: $5,000 per individual or $10,000 per family for in-network providers; $7,500 per individual or $15,000 per family for out-of-network providers. • Out-of-pocket exclusions: Does not include premiums, balance billing, or non-covered healthcare. • Network benefits: Using in-network providers under the BlueCard PPO network will generally cost less. Out-of-network care may involve balance billing. • Referral requirement: No referrals needed for specialist visits. • Cost examples: • Primary care and specialist visits: $15 per visit (deductible doesn’t apply). • Diagnostic tests: $15 for office visits, $40 for outpatient visits (deductible applies). • Prescription drugs: Varies by tier, with higher costs for non-preferred drugs and out-of-network pharmacies. • Emergency room: $150 per visit plus 20% coinsurance, with in-network coverage even if the hospital is out-of-network.
Is this plan a good deal? What do you think about the deductibles, out-of-pocket limits, and the coverage details?
submitted by /u/supersoldier1776
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