March 17, 2010

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Consumers Life Company – Michigan Value 2500 – MICHIGAN

A comparison of the Michigan Value 2500 offered by Consumers Life 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 Michigan Value 2500 Application Michigan Value 2500 Application
Brochure Michigan Value 2500 Brochure Michigan Value 2500 Brochure
Copay $35 N/A
Office Visit $35 copay, then 100% 50% after deductible
Deductible Single: $2,500, Family: $7,500 Single: $3,500, Family: $10,500
Coinsurance 70% 50%
Coinsurance Limit Michigan Value 2500 Michigan Value 2500
Out-of-Pocket Maximum Single: $4,000, Family: $12,000 (Excluding deductible) Single: $25,000, Family: $50,000 (Excluding deductible)
Lifetime Maximum $2,000,000 $2,000,000
Prescription Drugs
  • Prescription Drug Benefit Period Deductible: $100 per person
  • Retail - 30 Day Supply: $10 copay - Generic drugs only
  • Home Delivery: Not covered
    		•
  • Prescription Drug Benefit Period Deductible: $100 per person
  • Retail - 30 Day Supply: $10 copay - Generic drugs only
  • Home Delivery: Not covered
    		•
    Emergency Room
  • Emergency Use of an Emergency Room: $250 copay, then 70% after deductible
  • Non-Emergency Use of an Emergency Room: Not covered
    		•
  • Emergency Use of an Emergency Room: $250 copay, then 70% after deductible
  • Non-Emergency Use of an Emergency Room: Not covered
    		•
    Adult Preventative Care
  • Routine Physical Exam: Not covered
  • Routine Mammogram (one per benefit period): 70% after deductible
  • Routine Pap Tests (one per benefit period): 70% after deductible
  • Routine PSA Tests: 70% after deductible
    		•  Well Child Care Services (to age nine. Exams and immunizations are limited to a $1,000 per child to age 1, thereafter, $150 per child per birth year to age 9):
    • Well Child Care Exams: 50% after deductible (Coinsurance does not apply to coinsurance out-of-pocket maximums. These services will not be covered at 100% once coinsurance out-of-pocket maximums are met)
    • Well Child Immunizations and Labs: 50% after deductible
    Child Preventative Care Well Child Care Services (to age nine. Exams and immunizations are limited to a $1,000 per child to age 1, thereafter, $150 per child per birth year to age 9):
    • Well Child Care Exams: $35 copay, then 100%
    • Well Child Immunizations and Labs: 70% after deductible
    		 Well Child Care Services (to age nine. Exams and immunizations are limited to a $1,000 per child to age 1, thereafter, $150 per child per birth year to age 9):
    • Well Child Care Exams: 50% after deductible (Coinsurance does not apply to coinsurance out-of-pocket maximums. These services will not be covered at 100% once coinsurance out-of-pocket maximums are met)
    • Well Child Immunizations and Labs: 50% after deductible
    Lab / X-Ray Diagnostic Services: 70% after deductible; Routine EKG, chest X-ray, comprehensive metabolic panel, urinalysis and complete blood count: Not Covered Diagnostic Services: 50% after deductible; Routine EKG, chest X-ray, comprehensive metabolic panel, urinalysis and complete blood count: Not Covered
    Maternity Michigan Value 2500 Michigan Value 2500
    Physical Therapy
  • Physical Therapy (10 visits per benefit period): 70% after deductible
  • Occupational Therapy (10 visits per benefit period): 70% after deductible
  • Speech Therapy: Not covered
    		•
  • Physical Therapy (10 visits per benefit period): 50% after deductible
  • Occupational Therapy (10 visits per benefit period): 50% after deductible
  • Speech Therapy: Not covered
    		•
    Skilled Nursing Skilled Nursing Facility ($10,000 maximum per benefit period): $250 copay per admission, then 70% after deductible Skilled Nursing Facility ($10,000 maximum per benefit period): 50% after deductible
    Home Health Care Home Health Care (60 visits per benefit period): 70% after deductible Home Health Care (60 visits per benefit period): 50% after deductible (Coinsurance does not apply to coinsurance out-of-pocket maximums. These services will not be covered at 100% once coinsurance out-of-pocket maximums are met)
    Mental Health
  • Inpatient and Outpatient Mental Health: Not covered
  • Inpatient and Outpatient Substance Abuse Services ($4,500 limit per benefit period): 70% after deductible
    		•
  • Inpatient and Outpatient Mental Health: Not covered
  • Inpatient and Outpatient Substance Abuse Services ($4,500 limit per benefit period): 50% after deductible (Coinsurance does not apply to coinsurance out-of-pocket maximums. These services will not be covered at 100% once coinsurance out-of-pocket maximums are met)
    		•
    Hospital Care Semi-Private Room and Board: $250 copay per admission, then 70% after deductible Semi-Private Room and Board: 50% after deductible
    Optional Benefits Michigan Value 2500 Michigan Value 2500