March 12, 2010

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Humana – Autograph Total Plus Rx/HSA – MICHIGAN

A comparison of the Autograph Total Plus Rx/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 Plus Rx/HSA Application Autograph Total Plus Rx/HSA Application
Brochure Autograph Total Plus Rx/HSA Brochure Autograph Total Plus Rx/HSA Brochure
Copay N/A N/A
Office Visit 100% after deductible 70% after deductible
Deductible $1,500 $3,000
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 $5,000,000 per covered person $5,000,000 per covered person
Prescription Drugs 100% after deductible 70% after deductible
Emergency Room 100% after deductible 70% after deductible
Adult Preventative Care Autograph Total Plus Rx/HSA Autograph Total Plus Rx/HSA
Child Preventative Care Autograph Total Plus Rx/HSA Autograph Total Plus Rx/HSA
Lab / X-Ray Autograph Total Plus Rx/HSA Autograph Total Plus Rx/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
  • Inpatient and Outpatient care (Combined $2,500 per calendar year maximum.
  • Outpatient care not to exceed $500 of the $2,500 calendar year maximum.)- 50% after deductible.
    		•
  • Inpatient and Outpatient care (Combined $2,500 per calendar year maximum.
  • Outpatient care not to exceed $500 of the $2,500 calendar year maximum.)- 50% after deductible.
    		•
    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