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WorldIns - ExpressMed – ExpressMed Premier Plus PPO ($15,000 SL) – VIRGINIA
A comparison of the ExpressMed Premier Plus PPO ($15,000 SL) offered by WorldIns - ExpressMed is detailed out below for both Network and Non-Network coverage.
| Network | Non-Network | |
|---|---|---|
|
||
| Network | See Provider | See Provider |
| Application | ExpressMed Premier Plus PPO ($15,000 SL) Application | ExpressMed Premier Plus PPO ($15,000 SL) Application |
| Brochure | ExpressMed Premier Plus PPO ($15,000 SL) Brochure | ExpressMed Premier Plus PPO ($15,000 SL) Brochure |
| Copay | $50 Copay, First 2 copays waived | Subject to Deductible and Coinsurance |
| Office Visit | $50 Copay, First 2 copays waived | Subject to Deductible and Coinsurance |
| Deductible | $7,500 | $15,000 |
| Coinsurance | ExpressMed Premier Plus PPO ($15,000 SL) | ExpressMed Premier Plus PPO ($15,000 SL) |
| Coinsurance Limit | ExpressMed Premier Plus PPO ($15,000 SL) | ExpressMed Premier Plus PPO ($15,000 SL) |
| Out-of-Pocket Maximum | ExpressMed Premier Plus PPO ($15,000 SL) | ExpressMed Premier Plus PPO ($15,000 SL) |
| Lifetime Maximum | $3,000,000 | $3,000,000 |
| Prescription Drugs | ||
| Emergency Room | $150 access fee then World pays 100% of the next $1000, after that, deductible and coinsurance | $150 access fee then World pays 100% of the next $1000, after that, deductible and coinsurance |
| Adult Preventative Care | $300 Calendar Year Maximum after $50 Copay, 6 month waiting period | $300 Calendar Year Maximum after $50 Copay, 6 month waiting period |
| Child Preventative Care | $300 Calendar Year Maximum after $50 Copay, 6 month waiting period | $300 Calendar Year Maximum after $50 Copay, 6 month waiting period |
| Lab / X-Ray | $25 Copay per test, up to $200 per test (MRI, CAT, PET Scans covered at 100% up to $1,000 per test) | $25 Copay per test, up to $200 per test (MRI, CAT, PET Scans covered at 100% up to $1,000 per test) |
| Maternity | Not covered unless optional rider selected | Not covered unless optional rider selected |
| Physical Therapy | ExpressMed Premier Plus PPO ($15,000 SL) | ExpressMed Premier Plus PPO ($15,000 SL) |
| Skilled Nursing | Up to 60 visits per calendar year | Up to 60 visits per calendar year |
| Home Health Care | Up to 40 days | Up to 40 days |
| Mental Health | Not Covered - Optional Benefits Available | Not Covered - Optional Benefits Available |
| Hospital Care | Subject to Deductible and Coinsurance | Subject to Deductible and Coinsurance |
| Optional Benefits | ||