March 18, 2010

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Imerica - AHU – The Edge HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million – ARIZONA

A comparison of the The Edge HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million offered by Imerica - AHU is detailed out below for both Network and Non-Network coverage.

  Network Non-Network
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Network See Provider See Provider
Application The Edge HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million Application The Edge HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million Application
Brochure The Edge HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million Brochure The Edge HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million Brochure
Copay None None
Office Visit Subject to deductible and coinsurance Subject to deductible and coinsurance
Deductible $5,500 $11,000
Coinsurance 100% after deductible 80% after deductible
Coinsurance Limit $5,500 $15,000
Out-of-Pocket Maximum (includes deductible)$5,500 (includes deductible)$9,500
Lifetime Maximum $2 Million Base, Optional Buy-up $5 Million or $8 Million $2 Million Base, Optional Buy-up $5 Million or $8 Million
Prescription Drugs Subject to deductible and coinsurance Subject to deductible and coinsurance
Emergency Room Subject to deductible and coinsurance Subject to deductible and coinsurance
Adult Preventative Care (Subject to coinsurance only)
  • Routine Physical Exam- Up to $500, no waiting period
  • Preventive Services- No maximum, no waiting period(Mammograms, Pap test screening, Prostate cancer screening, Colorectal cancer screening)
  • Benefit available after the individual has been covered for at least 12 months.
    		•  (Subject to coinsurance only)
  • Routine Physical Exams- Up to $500, no waiting period
  • Childhood Immunizations- No maximum, no waiting period
    		•
    Child Preventative Care (Subject to coinsurance only)
  • Routine Physical Exams- Up to $500, no waiting period
  • Childhood Immunizations- No maximum, no waiting period
    		•  (Subject to coinsurance only)
  • Routine Physical Exams- Up to $500, no waiting period
  • Childhood Immunizations- No maximum, no waiting period
    		•
    Lab / X-Ray The Edge HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million The Edge HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million
    Maternity Optional Benefit Optional Benefit
    Physical Therapy The Edge HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million The Edge HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million
    Skilled Nursing The Edge HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million The Edge HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million
    Home Health Care The Edge HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million The Edge HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million
    Mental Health The Edge HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million The Edge HSA Platinum Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million
    Hospital Care Subject to deductible and coinsurance. Subject to deductible and coinsurance.
    Optional Benefits
  • Life
  • Maternity
    		•
  • Life
  • Maternity
    		•