March 18, 2010

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

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
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Network See Provider See Provider
Application MedOne Plus- PPO Benefit Plan Application MedOne Plus- PPO Benefit Plan Application
Brochure MedOne Plus- PPO Benefit Plan Brochure MedOne Plus- PPO Benefit Plan Brochure
Copay $40 N/A
Office Visit $40 Copay then 100% Subject to deductible, then coinsurance
Deductible $5,000(2 per family maximum) $10,000(2 per family maximum)
Coinsurance MedOne Plus- PPO Benefit Plan MedOne Plus- PPO Benefit Plan
Coinsurance Limit MedOne Plus- PPO Benefit Plan MedOne Plus- PPO Benefit Plan
Out-of-Pocket Maximum $7,000 per person $14,000 per person
Lifetime Maximum $5,000,000 $5,000,000
Prescription Drugs
  • Non-Insurance Drug Discount Program
    		•
  • Non-Insurance Drug Discount Program
    		•
    Emergency Room MedOne Plus- PPO Benefit Plan MedOne Plus- PPO Benefit Plan
    Adult Preventative Care $40 Copay then 100% Not covered
    Child Preventative Care $40 Copay then 100% Not covered
    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. Subject to deductible, then coinsurance.
    Optional Benefits MedOne Plus- PPO Benefit Plan MedOne Plus- PPO Benefit Plan