March 12, 2010

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

A comparison of the The Edge HSA Bronze 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 Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million Application The Edge HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million Application
Brochure The Edge HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million Brochure The Edge HSA Bronze 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 $5,000 $5,000
Coinsurance 100% after deductible 80% after deductible
Coinsurance Limit N/A Plan pays 80%
Out-of-Pocket Maximum
  • (includes deductible) $5,000
  • $20,000 maximum per insured per calendar year on outpatient expenses
    		•
  • Plan pays 80%
  • $20,000 maximum per insured per calendar year on outpatient expenses
    		•
    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 Discount Card Only Discount Card Only
    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 Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million The Edge HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million
    Maternity Optional Benefit Optional Benefit
    Physical Therapy The Edge HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million The Edge HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million
    Skilled Nursing The Edge HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million The Edge HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million
    Home Health Care The Edge HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million The Edge HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million
    Mental Health The Edge HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million The Edge HSA Bronze Single Series with 24 Month Rate Guarantee, Lifetime Max $5 Million
    Hospital Care
  • Subject to deductible and coinsurance
  • $20,000 maximum per insured per calendar year on outpatient expenses
    		•
  • Subject to deductible and coinsurance
  • $20,000 maximum per insured per calendar year on outpatient expenses
    		•
    Optional Benefits
  • Life
  • Maternity
    		•
  • Life
  • Maternity
    		•