March 21, 2010

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Humana – Autograph Total/HSA – KANSAS

A comparison of the Autograph Total/HSA offered by Humana is detailed out below for both Network and Non-Network coverage.

  Network Non-Network
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Network See Provider See Provider
Application Autograph Total/HSA Application Autograph Total/HSA Application
Brochure Autograph Total/HSA Brochure Autograph Total/HSA Brochure
Copay N/A N/A
Office Visit 100% after deductible 70% after deductible
Deductible $3,000 $6,000
Coinsurance 100% 70%
Coinsurance Limit Maximum Out-of-Pocket Expense Limit: $0 Individual and $0 Family. Maximum Out-of-Pocket Expense Limit: $6,000 Individual and $12,000 Family.
Out-of-Pocket Maximum Maximum Out-of-Pocket Expense Limit: $0 Individual and $0 Family. Maximum Out-of-Pocket Expense Limit: $6,000 Individual and $12,000 Family.
Lifetime Maximum $2,000,000 per covered person $2,000,000 per covered person
Prescription Drugs
  • Discount Card included
  • There is no coverage for retail and/or mail order prescription drugs unless stated in the policy.
    		•  Not covered
    Emergency Room 100% after deductible 70% after deductible
    Adult Preventative Care
  • Routine annual physical exam and Pap Smears (Age and/or frequency limits apply)- 100% (Benefit payable after 90-day waiting period, $300 of covered expenses per person per calendar year, subject to applicable coinsurance)
  • Routine mammograms and PSA (Age and/or frequency limits apply)- 100%
    		•
  • Routine immunizations (to age 18)- Not Covered
    		•
    Child Preventative Care
  • Routine immunizations (to age 18)- 100% (Benefit payable after 90-day waiting period, $300 of covered expenses per person per calendar year, subject to applicable coinsurance)
    		•
  • Routine immunizations (to age 18)- Not Covered
    		•
    Lab / X-Ray Autograph Total/HSA Autograph Total/HSA
    Maternity Pregnancy Complications and Sick Baby Services (No prior authorization required): 100% after deductible Pregnancy Complications and Sick Baby Services (No prior authorization required): 70% after deductible
    Physical Therapy N/A N/A
    Skilled Nursing 100% after deductible (Up to 30 days admission, prior authorization required in order to be eligible for these benefits) 70% after deductible (Up to 30 days admission, prior authorization required in order to be eligible for these benefits)
    Home Health Care 100% after deductible (up to 60 days per calendar year) 70% after deductible (up to 60 days per calendar year)
    Mental Health Not Covered Not Covered
    Hospital Care 100% after deductible 70% after deductible
    Optional Benefits Optional Benefits-
    • Lifetime Maximum Benefit
    • Supplemental Accident Benefit
    		 Optional Benefits-
    • Lifetime Maximum Benefit
    • Supplemental Accident Benefit