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Georgia PHP 3080 750 – Consumers Life Company –

A comparison of the Georgia PHP 3080 750 offered by Consumers Life Company is detailed out below for both Network and Non-Network coverage.

  Network Non-Network
Copay $30 N/A
OfficeVisit Office Visit (Illness/Injury)- $30 copay, then 100% 60% after deductible
Deductible
Coinsurance 80% 60%
Coinsurance Limit
Out-of-Pocket Maximum $7,500,000 $7,500,000
Lifetime Maximum Overall Annual Benefit Period Maximum: $7,500,000 Overall Annual Benefit Period Maximum: $7,500,000
Prescription Drugs
  • Prescription Drug Benefit Period Deductible- $200 Single/$600 Family
  • Retail (30 Day Supply)- $15 Generic/$30 Formulary/50% of cost for Non-Formulary ($45 minimum, $90 maximum)
  • Home Delivery (90 Day Supply)- $37.50 Generic/$75 Formulary/$112.50 Non-Formulary
    		•
  • Prescription Drug Benefit Period Deductible- $200 Single/$600 Family
  • Retail (30 Day Supply)- $15 Generic/$30 Formulary/50% of cost for Non-Formulary ($45 minimum, $90 maximum)
  • Home Delivery (90 Day Supply)- $37.50 Generic/$75 Formulary/$112.50 Non-Formulary
    		•
    Emergency Room $150 copay (waived if admitted), then 80% after deductible
  • Emergency use of an Emergency Room- $150 copay (waived if admitted), then 80% after deductible
  • Non-Emergency use of an Emergency Room- $150 copay (waived if admitted), then 60% after deductible
    		•
    Adult Preventative Care In accordance with state and federal law (1) In accordance with state and federal law (1)
    Child Preventative Care In accordance with state and federal law (1) In accordance with state and federal law (1)
    Lab / X-Ray
  • Diagnostic Services in a Physicians Office- 100%
  • Diagnostic Services (other than a physician's office)- 80% after deductible
    		•
  • Diagnostic Services in a Physicians Office- 70% after deductible
  • Diagnostic Services (other than a physician's office)- 60% after deductible
    		•
    Maternity Optional Rider Optional Rider
    Physical Therapy
  • Physical Therapy, Occupational Therapy, and Chiropractic Services (30 visits combined per benefit period)- 80% after deductible
    		•
  • Physical Therapy, Occupational Therapy, and Chiropractic Services (30 visits combined per benefit period)- 60% after deductible
    		•
    Home Health Care
  • 100 visits per benefit period; 80% after deductible
    		•
  • 100 visits per benefit period; 80% after deductible
    		•
    Mental Health
  • Inpatient Mental Health/Substance Abuse Services (30 days per benefit period; limited to one admission per benefit period and three admissions per lifetime)- 80% after deductible
  • Outpatient Mental Health/Substance Abuse (48 visits per benefit period)- 80% after deductible
    		•
  • Inpatient Mental Health/Substance Abuse Services (30 days per benefit period; limited to one admission per benefit period and three admissions per lifetime)- 80% after deductible
  • Outpatient Mental Health/Substance Abuse (48 visits per benefit period)- 60% after deductible
    		•
    Hospital Care
    Verisign Truste