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Anthem Blue Cross and Blue Shield of Ohio – Lumenos Health Incentive Account Plus Plan 1 – OHIO
A comparison of the Lumenos Health Incentive Account Plus Plan 1 offered by Anthem Blue Cross and Blue Shield of Ohio is detailed out below for both Network and Non-Network coverage.
| Network | Non-Network | |
|---|---|---|
|
||
| Network | See Provider | See Provider |
| Application | Lumenos Health Incentive Account Plus Plan 1 Application | Lumenos Health Incentive Account Plus Plan 1 Application |
| Brochure | Lumenos Health Incentive Account Plus Plan 1 Brochure | Lumenos Health Incentive Account Plus Plan 1 Brochure |
| Copay | 100% after deductible | 60% after deductible |
| Office Visit | Subject to deductible and coinsurance | Subject to deductible and coinsurance |
| Deductible | see brochure | see brochure |
| Coinsurance | 100% after deductible | 60% after deductible |
| Coinsurance Limit | SEE OOP Maximum | SEE OOP Maximum |
| Out-of-Pocket Maximum | see brochure | see brochure |
| Lifetime Maximum | Unlimited | Unlimited |
| Prescription Drugs | Subject to deductible and coinsurance(Specialty injectable drugs are limited to 30-day supply, not covered out-of-network) | Subject to deductible and coinsurance(Specialty injectable drugs are limited to 30-day supply, not covered out-of-network) |
| Emergency Room | 100% after deductible | 100% after deductible |
| Adult Preventative Care | 100% covered (deductible waived) | Subject to deductible and coinsurance |
| Child Preventative Care | 100% covered (deductible waived) | Subject to deductible and coinsurance |
| Lab / X-Ray | Subject to deductible and coinsurance | Subject to deductible and coinsurance |
| Maternity | Not covered (Optional Rider available; subject to 12-month waiting period) | Not covered (Optional Rider available; subject to 12-month waiting period) |
| Physical Therapy | ||
| Skilled Nursing | Subject to deductible and coinsurance | Subject to deductible and coinsurance |
| Home Health Care | Subject to deductible and coinsurance (Limited to 60 visits) | Subject to deductible and coinsurance (Limited to 60 visits) |
| Mental Health | Subject to deductible and coinsurance | Subject to deductible and coinsurance |
| Hospital Care | Subject to deductible and coinsuranc | Subject to deductible and coinsuranc |
| Optional Benefits | ||