Sorry to side track this a bit, I am a total noob with this insurance stuffs, and I just got a new job that offer PPO/HMO. I wanna try PPO but there are alot of terms that I am not sure what it means, and google researches has got me no where. Can anyone tell me what the following is and if thats consider good?
Calendar Year Deductible
Individual
In-Network $500
Out-of-Network $1,000
Calendar Year Out-of-Pocket Maximum In-Network and out-of-network combined (does not include the deductible)
Individual $2,000
Family $4,000
Routine Office Visits
In-Network 100% after $20 copay/visit with no deductible; 90% after deductible for any procedures as part of visit
Out-of-Network 70% of R&C** after deductible
Hospitalization and surgery
In-Network 90% after deductible; must be precertified***
Out-of-Network 70% of R&C** after deductible and $500 / stay; must be precertified**
Prescription Drugs
In-Network 100% after $5 copay/prescription for up to 30-day supply if prescribed by in-network physician and filled at participating pharmacy
Out-of-Network Same as in-network if you go to a participating pharmacy; no benefits if you go to a non-participating pharmacy
The thing that gets me confused the most is the term deductible, what does it mean it has a $500 calendar year deductible?