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American Medical Security Life Insurance Company – MedOne- HSAvings Individual with Wellness – KANSAS
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 |
| Application | MedOne- HSAvings Individual with Wellness Application | MedOne- HSAvings Individual with Wellness Application |
| Brochure | MedOne- HSAvings Individual with Wellness Brochure | MedOne- HSAvings Individual with Wellness Brochure |
| Copay | N/A | N/A |
| Office Visit | Subject to deductible, then coinsurance. | Subject to deductible, then coinsurance. |
| Deductible | $2,800 | $5,600 |
| Coinsurance | MedOne- HSAvings Individual with Wellness | MedOne- HSAvings Individual with Wellness |
| Coinsurance Limit | $0 | $10,000 |
| Out-of-Pocket Maximum | $2,800 per person | $8,600 per person |
| Lifetime Maximum | $5,000,000 | $5,000,000 |
| Prescription Drugs | ||
| Emergency Room | Subject to deductible, then coinsurance. | Subject to deductible, then coinsurance. |
| Adult Preventative Care | Wellness (Routine) Benefit: Pays 100% up to $300 per covered person, per calender year for network routine physical exams, X-rays and laboratory tests, mammograms, Pap smears, and prostate screenings. Eligible charges in excess of this benefit are subject to deductible and coinsurance. | Eligible only when received from a network provider unless otherwise mandated. |
| Child Preventative Care | Wellness (Routine) Benefit: Pays 100% up to $300 per covered person, per calender year for network routine physical exams, X-rays and laboratory tests, mammograms, Pap smears, and prostate screenings. Eligible charges in excess of this benefit are subject to deductible and coinsurance. | Eligible only when received from a network provider unless otherwise mandated. |
| Lab / X-Ray | Subject to deductible, then coinsurance. | Subject to deductible, then coinsurance. |
| Maternity | Not Covered. | Not Covered. |
| Physical Therapy | Subject to deductible, then coinsurance. | Subject to deductible, then coinsurance. |
| Skilled Nursing | Subject to deductible, then coinsurance. Limited to 30 days per calendar year. | Subject to deductible, then coinsurance. Limited to 30 days per calendar year. |
| Home Health Care | Subject to deductible, then coinsurance. Limited to 20 visits per calendar year. | Subject to deductible, then coinsurance. Limited to 20 visits per calendar year. |
| Mental Health | Not covered. | Not covered. |
| Hospital Care | Subject to deductible, then coinsurance. (Inpatient, outpatient care, and urgent care) | Subject to deductible, then coinsurance. (Inpatient, outpatient care, and urgent care) |
| Optional Benefits | If purchased (Additional cost), your eligible prescription drug expenses apply to your medical deductible and coinsurance limit. | If purchased (Additional cost), your eligible prescription drug expenses apply to your medical deductible and coinsurance limit. |