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American Medical Security Life Insurance Company Health Insurance in KANSAS – Health Plan Options

American Medical Security Life Insurance Company — MedOne Plus- PPO Benefit Plan

A comparison of the MedOne Plus- PPO Benefit Plan offered by American Medical Security Life Insurance Company is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	$40 Copay then 100%	Subject to deductible, then coinsurance
Copay	$40	N/A
Deductible	$5,000(2 per family maximum)	$10,000(2 per family maximum)

American Medical Security Life Insurance Company — MedOne Plus- PPO Benefit Plan w/Rx Opt $0/$15/50%

A comparison of the MedOne Plus- PPO Benefit Plan w/Rx Opt $0/$15/50% offered by American Medical Security Life Insurance Company is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	$30 Copay then 100%	Subject to deductible, then coinsurance.
Copay	$30	N/A
Deductible	$2,500(2 per family maximum)	$5,000(2 per family maximum)

American Medical Security Life Insurance Company — MedOne- HSAvings Individual

A comparison of the MedOne- HSAvings Individual offered by American Medical Security Life Insurance Company is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	Plan pays 100%	Plan pays 70%
Office Visit	Subject to deductible, then coinsurance.	Subject to deductible, then coinsurance.
Copay	N/A	N/A
Deductible	$2,800	$5,600

American Medical Security Life Insurance Company — MedOne Plus- PPO Benefit Plan

A comparison of the MedOne Plus- PPO Benefit Plan offered by American Medical Security Life Insurance Company is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	$40 Copay then 100%	Subject to deductible, then coinsurance
Copay	$40	N/A
Deductible	$5,000(2 per family maximum)	$10,000(2 per family maximum)

American Medical Security Life Insurance Company — MedOne- HSAvings Individual with Wellness

A comparison of the MedOne- HSAvings Individual with Wellness offered by American Medical Security Life Insurance Company is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Subject to deductible, then coinsurance.	Subject to deductible, then coinsurance.
Copay	N/A	N/A
Deductible	$2,600	$5,200

American Medical Security Life Insurance Company — MedOne Plus- PPO Benefit Plan w/Rx Opt $0/$15/50%

A comparison of the MedOne Plus- PPO Benefit Plan w/Rx Opt $0/$15/50% offered by American Medical Security Life Insurance Company is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	$30 Copay then 100%	Subject to deductible, then coinsurance.
Copay	$30	N/A
Deductible	$2,500(2 per family maximum)	$5,000(2 per family maximum)

American Medical Security Life Insurance Company — MedOne Security- PPO Facility Copay Plan

A comparison of the MedOne Security- PPO Facility Copay Plan offered by American Medical Security Life Insurance Company is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	Subject to deductible, then coinsurance.
Copay	see brochure	see brochure
Deductible	$2,000(2 per family maximum)	$4,000(2 per family maximum)

American Medical Security Life Insurance Company — MedOne Security- PPO Facility Copay Plan w/Rx Opt $0/$15/50%

A comparison of the MedOne Security- PPO Facility Copay Plan w/Rx Opt $0/$15/50% offered by American Medical Security Life Insurance Company is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	Subject to deductible, then coinsurance.
Copay	see brochure	see brochure
Deductible	$2,000(2 per family maximum)	$4,000(2 per family maximum)

American Medical Security Life Insurance Company — MedOne Security- PPO Facility Copay Plan

A comparison of the MedOne Security- PPO Facility Copay Plan offered by American Medical Security Life Insurance Company is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	Subject to deductible, then coinsurance.
Copay	see brochure	see brochure
Deductible	$2,000(2 per family maximum)	$4,000(2 per family maximum)

American Medical Security Life Insurance Company — MedOne Plus- PPO Benefit Plan

A comparison of the MedOne Plus- PPO Benefit Plan offered by American Medical Security Life Insurance Company is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	$40 Copay then 100%	Subject to deductible, then coinsurance
Copay	$40	N/A
Deductible	$5,000(2 per family maximum)	$10,000(2 per family maximum)

American Medical Security Life Insurance Company — MedOne Security- PPO Facility Copay Plan w/Rx Opt $0/$15/50%

A comparison of the MedOne Security- PPO Facility Copay Plan w/Rx Opt $0/$15/50% offered by American Medical Security Life Insurance Company is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	Subject to deductible, then coinsurance.
Copay	see brochure	see brochure
Deductible	$2,000(2 per family maximum)	$4,000(2 per family maximum)

American Medical Security Life Insurance Company — MedOne Plus- PPO Benefit Plan w/Rx Opt $0/$15/50%

A comparison of the MedOne Plus- PPO Benefit Plan w/Rx Opt $0/$15/50% offered by American Medical Security Life Insurance Company is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	$30 Copay then 100%	Subject to deductible, then coinsurance.
Copay	$30	N/A
Deductible	$2,500(2 per family maximum)	$5,000(2 per family maximum)