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Celtic Health Insurance in PENNSYLVANIA – Health Plan Options

Celtic — CeltiCare Select PPO Plan

A comparison of the CeltiCare Select PPO Plan offered by Celtic 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	Non-preventive: $10	Non-preventive: $10
Copay	Non-preventive: $10	Non-preventive: $10
Deductible	Individual: $1,500, Family: $4,500	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare Select PPO Plan

A comparison of the CeltiCare Select PPO Plan offered by Celtic 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	Non-preventive: $10	Non-preventive: $10
Copay	Non-preventive: $10	Non-preventive: $10
Deductible	Individual: $1,500, Family: $4,500	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare Select PPO Plan

A comparison of the CeltiCare Select PPO Plan offered by Celtic 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	Non-preventive: $10	Non-preventive: $10
Copay	Non-preventive: $10	Non-preventive: $10
Deductible	Individual: $1,500, Family: $4,500	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare Select PPO Plan

A comparison of the CeltiCare Select PPO Plan offered by Celtic 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	Non-preventive: $10	Non-preventive: $10
Copay	Non-preventive: $10	Non-preventive: $10
Deductible	Individual: $1,500, Family: $4,500	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare Select PPO Plan

A comparison of the CeltiCare Select PPO Plan offered by Celtic 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	Non-preventive: $10	Non-preventive: $10
Copay	Non-preventive: $10	Non-preventive: $10
Deductible	Individual: $1,500, Family: $4,500	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare Select PPO Plan

A comparison of the CeltiCare Select PPO Plan offered by Celtic 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	Non-preventive: $10	Non-preventive: $10
Copay	Non-preventive: $10	Non-preventive: $10
Deductible	Individual: $1,500, Family: $4,500	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare Select PPO Plan

A comparison of the CeltiCare Select PPO Plan offered by Celtic 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	Non-preventive: $10	Non-preventive: $10
Copay	Non-preventive: $10	Non-preventive: $10
Deductible	Individual: $1,500, Family: $4,500	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare "Any Doc" PPO Plan

A comparison of the CeltiCare "Any Doc" PPO Plan offered by Celtic 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	Non-preventive: $25, $30 copay (for CT only)	Non-preventive: $25, $30 copay (for CT only)
Copay	Non-preventive: $25, $30 copay (for CT only)	Non-preventive: $25, $30 copay (for CT only)
Deductible	Individual: $2,500, Family: $7,500	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare "Any Doc" PPO Plan

A comparison of the CeltiCare "Any Doc" PPO Plan offered by Celtic 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	Non-preventive: $25, $30 copay (for CT only)	Non-preventive: $25, $30 copay (for CT only)
Copay	Non-preventive: $25, $30 copay (for CT only)	Non-preventive: $25, $30 copay (for CT only)
Deductible	Individual: $2,500, Family: $7,500	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare "Any Doc" PPO Plan

A comparison of the CeltiCare "Any Doc" PPO Plan offered by Celtic 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	Non-preventive: $25, $30 copay (for CT only)	Non-preventive: $25, $30 copay (for CT only)
Copay	Non-preventive: $25, $30 copay (for CT only)	Non-preventive: $25, $30 copay (for CT only)
Deductible	Individual: $2,500, Family: $7,500	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare "Any Doc" PPO Plan

A comparison of the CeltiCare "Any Doc" PPO Plan offered by Celtic 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	Non-preventive: $25, $30 copay (for CT only)	Non-preventive: $25, $30 copay (for CT only)
Copay	Non-preventive: $25, $30 copay (for CT only)	Non-preventive: $25, $30 copay (for CT only)
Deductible	Individual: $2,500, Family: $7,500	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare "Any Doc" PPO Plan

A comparison of the CeltiCare "Any Doc" PPO Plan offered by Celtic 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	Non-preventive: $25, $30 copay (for CT only)	Non-preventive: $25, $30 copay (for CT only)
Copay	Non-preventive: $25, $30 copay (for CT only)	Non-preventive: $25, $30 copay (for CT only)
Deductible	Individual: $2,500, Family: $7,500	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare "Any Doc" PPO Plan

A comparison of the CeltiCare "Any Doc" PPO Plan offered by Celtic 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	Non-preventive: $25, $30 copay (for CT only)	Non-preventive: $25, $30 copay (for CT only)
Copay	Non-preventive: $25, $30 copay (for CT only)	Non-preventive: $25, $30 copay (for CT only)
Deductible	Individual: $2,500, Family: $7,500	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare "Any Doc" PPO Plan

A comparison of the CeltiCare "Any Doc" PPO Plan offered by Celtic 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	Non-preventive: $25, $30 copay (for CT only)	Non-preventive: $25, $30 copay (for CT only)
Copay	Non-preventive: $25, $30 copay (for CT only)	Non-preventive: $25, $30 copay (for CT only)
Deductible	Individual: $2,500, Family: $7,500	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare Managed Indemnity Plan

A comparison of the CeltiCare Managed Indemnity Plan offered by Celtic 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	Non-preventive: Deductible then coinsurance	Non-preventive: Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $250, Family: $750	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare Managed Indemnity Plan

A comparison of the CeltiCare Managed Indemnity Plan offered by Celtic 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	Non-preventive: Deductible then coinsurance	Non-preventive: Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $250, Family: $750	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare Managed Indemnity Plan

A comparison of the CeltiCare Managed Indemnity Plan offered by Celtic 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	Non-preventive: Deductible then coinsurance	Non-preventive: Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $250, Family: $750	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare Managed Indemnity Plan

A comparison of the CeltiCare Managed Indemnity Plan offered by Celtic 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	Non-preventive: Deductible then coinsurance	Non-preventive: Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $250, Family: $750	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare Managed Indemnity Plan

A comparison of the CeltiCare Managed Indemnity Plan offered by Celtic 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	Non-preventive: Deductible then coinsurance	Non-preventive: Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $250, Family: $750	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare Managed Indemnity Plan

A comparison of the CeltiCare Managed Indemnity Plan offered by Celtic 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	Non-preventive: Deductible then coinsurance	Non-preventive: Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $250, Family: $750	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare Managed Indemnity Plan

A comparison of the CeltiCare Managed Indemnity Plan offered by Celtic 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	Non-preventive: Deductible then coinsurance	Non-preventive: Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $250, Family: $750	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare Select PPO Plan - Plus Option

A comparison of the CeltiCare Select PPO Plan - Plus Option offered by Celtic 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	Non-preventive: $10	Non-preventive: $10
Copay	Non-preventive: $10	Non-preventive: $10
Deductible	Individual: $1,500, Family: $4,500	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare Select PPO Plan - Plus Option

A comparison of the CeltiCare Select PPO Plan - Plus Option offered by Celtic 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	Non-preventive: $10	Non-preventive: $10
Copay	Non-preventive: $10	Non-preventive: $10
Deductible	Individual: $1,500, Family: $4,500	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare Select PPO Plan - Plus Option

A comparison of the CeltiCare Select PPO Plan - Plus Option offered by Celtic 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	Non-preventive: $10	Non-preventive: $10
Copay	Non-preventive: $10	Non-preventive: $10
Deductible	Individual: $1,500, Family: $4,500	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare Select PPO Plan - Plus Option

A comparison of the CeltiCare Select PPO Plan - Plus Option offered by Celtic 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	Non-preventive: $10	Non-preventive: $10
Copay	Non-preventive: $10	Non-preventive: $10
Deductible	Individual: $1,500, Family: $4,500	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare Select PPO Plan - Plus Option

A comparison of the CeltiCare Select PPO Plan - Plus Option offered by Celtic 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	Non-preventive: $10	Non-preventive: $10
Copay	Non-preventive: $10	Non-preventive: $10
Deductible	Individual: $1,500, Family: $4,500	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare Select PPO Plan - Plus Option

A comparison of the CeltiCare Select PPO Plan - Plus Option offered by Celtic 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	Non-preventive: $10	Non-preventive: $10
Copay	Non-preventive: $10	Non-preventive: $10
Deductible	Individual: $1,500, Family: $4,500	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare Select PPO Plan - Plus Option

A comparison of the CeltiCare Select PPO Plan - Plus Option offered by Celtic 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	Non-preventive: $10	Non-preventive: $10
Copay	Non-preventive: $10	Non-preventive: $10
Deductible	Individual: $1,500, Family: $4,500	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare "Any Doc" PPO Plan - Plus Option

A comparison of the CeltiCare "Any Doc" PPO Plan - Plus Option offered by Celtic 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	Non-preventive: $25, $30 copay (for CT only)	Non-preventive: $25, $30 copay (for CT only)
Copay	Non-preventive: $25, $30 copay (for CT only)	Non-preventive: $25, $30 copay (for CT only)
Deductible	Individual: $10,000, Family: $30,000	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare "Any Doc" PPO Plan - Plus Option

A comparison of the CeltiCare "Any Doc" PPO Plan - Plus Option offered by Celtic 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	Non-preventive: $25, $30 copay (for CT only)	Non-preventive: $25, $30 copay (for CT only)
Copay	Non-preventive: $25, $30 copay (for CT only)	Non-preventive: $25, $30 copay (for CT only)
Deductible	Individual: $10,000, Family: $30,000	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare "Any Doc" PPO Plan - Plus Option

A comparison of the CeltiCare "Any Doc" PPO Plan - Plus Option offered by Celtic 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	Non-preventive: $25, $30 copay (for CT only)	Non-preventive: $25, $30 copay (for CT only)
Copay	Non-preventive: $25, $30 copay (for CT only)	Non-preventive: $25, $30 copay (for CT only)
Deductible	Individual: $10,000, Family: $30,000	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare "Any Doc" PPO Plan - Plus Option

A comparison of the CeltiCare "Any Doc" PPO Plan - Plus Option offered by Celtic 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	Non-preventive: $25, $30 copay (for CT only)	Non-preventive: $25, $30 copay (for CT only)
Copay	Non-preventive: $25, $30 copay (for CT only)	Non-preventive: $25, $30 copay (for CT only)
Deductible	Individual: $10,000, Family: $30,000	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare "Any Doc" PPO Plan - Plus Option

A comparison of the CeltiCare "Any Doc" PPO Plan - Plus Option offered by Celtic 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	Non-preventive: $25, $30 copay (for CT only)	Non-preventive: $25, $30 copay (for CT only)
Copay	Non-preventive: $25, $30 copay (for CT only)	Non-preventive: $25, $30 copay (for CT only)
Deductible	Individual: $10,000, Family: $30,000	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare "Any Doc" PPO Plan - Plus Option

A comparison of the CeltiCare "Any Doc" PPO Plan - Plus Option offered by Celtic 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	Non-preventive: $25, $30 copay (for CT only)	Non-preventive: $25, $30 copay (for CT only)
Copay	Non-preventive: $25, $30 copay (for CT only)	Non-preventive: $25, $30 copay (for CT only)
Deductible	Individual: $10,000, Family: $30,000	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare "Any Doc" PPO Plan - Plus Option

A comparison of the CeltiCare "Any Doc" PPO Plan - Plus Option offered by Celtic 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	Non-preventive: $25, $30 copay (for CT only)	Non-preventive: $25, $30 copay (for CT only)
Copay	Non-preventive: $25, $30 copay (for CT only)	Non-preventive: $25, $30 copay (for CT only)
Deductible	Individual: $10,000, Family: $30,000	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare Managed Indemnity Plan - Plus Option

A comparison of the CeltiCare Managed Indemnity Plan - Plus Option offered by Celtic 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	Non-preventive: Deductible then coinsurance	Non-preventive: Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $1,000, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare Managed Indemnity Plan - Plus Option

A comparison of the CeltiCare Managed Indemnity Plan - Plus Option offered by Celtic 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	Non-preventive: Deductible then coinsurance	Non-preventive: Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $1,000, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare Managed Indemnity Plan - Plus Option

A comparison of the CeltiCare Managed Indemnity Plan - Plus Option offered by Celtic 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	Non-preventive: Deductible then coinsurance	Non-preventive: Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $1,000, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare Managed Indemnity Plan - Plus Option

A comparison of the CeltiCare Managed Indemnity Plan - Plus Option offered by Celtic 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	Non-preventive: Deductible then coinsurance	Non-preventive: Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $1,000, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare Managed Indemnity Plan - Plus Option

A comparison of the CeltiCare Managed Indemnity Plan - Plus Option offered by Celtic 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	Non-preventive: Deductible then coinsurance	Non-preventive: Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $1,000, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare Managed Indemnity Plan - Plus Option

A comparison of the CeltiCare Managed Indemnity Plan - Plus Option offered by Celtic 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	Non-preventive: Deductible then coinsurance	Non-preventive: Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $1,000, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CeltiCare Managed Indemnity Plan - Plus Option

A comparison of the CeltiCare Managed Indemnity Plan - Plus Option offered by Celtic 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	Non-preventive: Deductible then coinsurance	Non-preventive: Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $1,000, Family: $3,000	Out of Network Deductible is $1500 + Annual Deductible

Celtic — Celtic Basic - Prescription Drug Card Option

A comparison of the Celtic Basic - Prescription Drug Card Option offered by Celtic is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80/20 Coverage after deductible of the next $10,000	60/40 Coverage after deductible of the next $10,000
Office Visit	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	Subject to annual deductible and coinsurance.
Copay	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	N/A
Deductible	Individual: $2,500, Family: $5,000	Out of Network Deductible is $1500 + Annual Deductible

Celtic — Celtic Basic - Prescription Drug Card Option

A comparison of the Celtic Basic - Prescription Drug Card Option offered by Celtic is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80/20 Coverage after deductible of the next $10,000	60/40 Coverage after deductible of the next $10,000
Office Visit	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	Subject to annual deductible and coinsurance.
Copay	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	N/A
Deductible	Individual: $2,500, Family: $5,000	Out of Network Deductible is $1500 + Annual Deductible

Celtic — Celtic Basic - Prescription Drug Card Option

A comparison of the Celtic Basic - Prescription Drug Card Option offered by Celtic is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80/20 Coverage after deductible of the next $10,000	60/40 Coverage after deductible of the next $10,000
Office Visit	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	Subject to annual deductible and coinsurance.
Copay	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	N/A
Deductible	Individual: $2,500, Family: $5,000	Out of Network Deductible is $1500 + Annual Deductible

Celtic — Celtic Basic

A comparison of the Celtic Basic offered by Celtic is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80/20 Coverage after deductible of the next $10,000	60/40 Coverage after deductible of the next $10,000
Office Visit	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	Subject to annual deductible and coinsurance.
Copay	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	N/A
Deductible	Individual: $1,500, Family: Up to 3 times the individual deductible	Out of Network Deductible is $1500 + Annual Deductible

Celtic — Celtic Basic

A comparison of the Celtic Basic offered by Celtic is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80/20 Coverage after deductible of the next $10,000	60/40 Coverage after deductible of the next $10,000
Office Visit	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	Subject to annual deductible and coinsurance.
Copay	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	N/A
Deductible	Individual: $1,500, Family: Up to 3 times the individual deductible	Out of Network Deductible is $1500 + Annual Deductible

Celtic — Celtic Basic

A comparison of the Celtic Basic offered by Celtic is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80/20 Coverage after deductible of the next $10,000	60/40 Coverage after deductible of the next $10,000
Office Visit	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	Subject to annual deductible and coinsurance.
Copay	$30 copay for the first 2 visits per person, per year. After 2 visits, subject to annual deductible and coinsurance.	N/A
Deductible	Individual: $1,500, Family: Up to 3 times the individual deductible	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CelticSaver HSA PPO Health Plan

A comparison of the CelticSaver HSA PPO Health Plan offered by Celtic 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 and Coinsurance	Subject to Deductible and Coinsurance
Copay	N/A	N/A
Deductible	$5,000	$5,000

Celtic — CelticSaver HSA PPO Health Plan

A comparison of the CelticSaver HSA PPO Health Plan offered by Celtic 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 and Coinsurance	Subject to Deductible and Coinsurance
Copay	N/A	N/A
Deductible	$2,600	$2,600

Celtic — CelticSaver HSA PPO Health Plan

A comparison of the CelticSaver HSA PPO Health Plan offered by Celtic 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 and Coinsurance	Subject to Deductible and Coinsurance
Copay	N/A	N/A
Deductible	$1,500	$1,500

Celtic — CelticSaver HSA PPO Health Plan

A comparison of the CelticSaver HSA PPO Health Plan offered by Celtic 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 and Coinsurance	Subject to Deductible and Coinsurance
Copay	N/A	N/A
Deductible	$2,600	$2,600

Celtic — CelticSaver HSA PPO Health Plan

A comparison of the CelticSaver HSA PPO Health Plan offered by Celtic 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 and Coinsurance	Subject to Deductible and Coinsurance
Copay	N/A	N/A
Deductible	$1,500	$1,500

Celtic — CelticSaver HSA Indemnity Health Plan

A comparison of the CelticSaver HSA Indemnity Health Plan offered by Celtic 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 and Coinsurance	Subject to Deductible and Coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $10,000	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CelticSaver HSA Indemnity Health Plan

A comparison of the CelticSaver HSA Indemnity Health Plan offered by Celtic 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 and Coinsurance	Subject to Deductible and Coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $10,000	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CelticSaver HSA Indemnity Health Plan

A comparison of the CelticSaver HSA Indemnity Health Plan offered by Celtic 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 and Coinsurance	Subject to Deductible and Coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $10,000	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CelticSaver HSA Indemnity Health Plan

A comparison of the CelticSaver HSA Indemnity Health Plan offered by Celtic 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 and Coinsurance	Subject to Deductible and Coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $10,000	Out of Network Deductible is $1500 + Annual Deductible

Celtic — CelticSaver HSA Indemnity Health Plan

A comparison of the CelticSaver HSA Indemnity Health Plan offered by Celtic 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 and Coinsurance	Subject to Deductible and Coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $10,000	Out of Network Deductible is $1500 + Annual Deductible