Health Insurance 5

Question 1

1. What is the name of this insurance plan?

Answer 1

BlueOptions with Integrated Prescription Drug Coverage

Question 2

2. When was this Schedule of Benefits received?

Answer 2

on or about 6-30-15

Question 3

3. What is the Plan Number?

Answer 3

Plan 5042 (Single Coverage)

Question 4

4. What is the Deductible for Preventive Health Services?

Answer 4

$0 in-network and 40% out-of-network (except routine colonoscopy, which is $0)

Question 5

5. What is the typical deductible for office services?

Answer 5

Deductible+10%, except for Medical Pharmacy Services (Ded+20%)

Question 6

6. From what insurance package was all this information acquired?

Answer 6

Package B, received on or about 6-30-15

Question 7

7. What is the typical OUT-OF-NETWORK deduction OFFICE SERVICES?

Answer 7

Deductible + 40%, except for MEDICAL PHARMACY SERVICES, which is Ded + %50