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|
Plan Type |
Short-term |
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|
Network |
SuperMed |
|
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|
Network |
|
Non-Network |
Deductible |
$250/$500
$500/$1,000
$1,000/$2,000
$1,500/$3,000
|
$500/$1,000
$1,000/$2,000
$2,000/$4,000
$3,000/$6,000
|
|
|
|
Coinsurance |
80% |
50% |
|
|
|
Office Visit |
Office Visit: $30, then 100%; Specialty Visit: $40, then 100%; Urgent Care: $50, then 100% |
Office Visit: $30 then 50%; Specialty Visit: $40 then 50%; Urgent Care: $50 copay, then 50% |
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|
|
Preventive Services |
80% after deductible |
50% after deductible |
|
|
|
Lifetime Maximum |
$7,500,000 |
$7,500,000 |
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|
|
Prescription Drugs |
included |
included |
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|
|
Emergency Visit |
$100 copay, then 80% |
$100 copay, then 80% (non-emergency - $100 copay, then 50%) |
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