March 20, 2010

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American Medical Security Life Insurance Company – MedOne- HSAvings Individual – PENNSYLVANIA

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
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Network See Provider See Provider
Application MedOne- HSAvings Individual Application MedOne- HSAvings Individual Application
Brochure MedOne- HSAvings Individual Brochure MedOne- HSAvings Individual 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 MedOne- HSAvings Individual
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
  • Non-Insurance Drug Discount Program
    		•
  • Non-Insurance Drug Discount Program
    		•
    Emergency Room Subject to deductible, then coinsurance. Subject to deductible, then coinsurance.
    Adult Preventative Care Subject to deductible, then coinsurance. Subject to deductible, then coinsurance.
    Child Preventative Care Subject to deductible, then coinsurance. Subject to deductible, then coinsurance.
    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.