Medical and Pharmacy Coverage
Country’s Barbecue offers the following plans through Humana. Please reference the Summary Plan Description for more details.
Insurance Carrier:
Humana Medical Insurance
Medical Plan:
$5,000 / 100% Copay
$6,350 / 100% HDHP $7,900 / 100% On Hand
In-Network: Office Visit Copay - Primary Care
$35
Deductible; then 100% Coinsurance
Virtual Only - $0
Office Visit Copay - Specialist Care
$50
Deductible; then 100% Coinsurance
Deductible; then 100% Coinsurance
Urgent Care Copay
$100
Deductible; then 100% Coinsurance
Deductible; then 100% Coinsurance
Emergency Room Care
$350 Copay (waived if admitted)
Deductible; then 100% Coinsurance
Deductible; then 100% Coinsurance
Preventative Visit Copay
$0
$0
$0
Diagnostic Testing & Blood Work
$0
Deductible; then 100% Coinsurance
$5
Imaging
Deductible; then 100% Coinsurance
Deductible; then 100% Coinsurance
Deductible; then 100% Coinsurance
Coinsurance
100%
100%
100%
Employee Deductible
$5,000
$6,350
$7,900
Family Deductible
$10,000
$12,700
$15,800
Employee Out-of-Pocket Max
$6,500 (includes deductible)
$6,350 (includes deductible)
$7,900 (includes deductible)
Family Out-of-Pocket Max
$13,000 (includes deductible)
$12,700 (includes deductible)
$15,800 (includes deductible)
Inpatient Hospital
Deductible; then 100% Coinsurance
Deductible; then 100% Coinsurance
Deductible; then 100% Coinsurance
Outpatient Hospital or Facility
Deductible; then 100% Coinsurance
Deductible; then 100% Coinsurance
Deductible; then 100% Coinsurance
Prescription Drugs: ( 30 Day Supply) Tier 1 - Generic
$10 / $40
Deductible; then 100% Coinsurance
$5
Tier 2 - Preferred
$70
Deductible; then 100% Coinsurance
Deductible; then 100% Coinsurance
Tier 3 - Non-Preferred
25%
Deductible; then 100% Coinsurance
Deductible; then 100% Coinsurance
Tier 4 - Specialty
25% / 35%
Deductible; then 100% Coinsurance
Deductible; then 100% Coinsurance
Employee Weekly Deduction Employee Only
$51.50 $151.73 $136.69 $236.92
$25.57 $99.87 $88.73 $163.03
$25.57 $82.77 $72.91 $138.66
Employee + Spouse
Employee + Child(ren)
Family
Country’s Barbecue 2023 Enrollment Guide
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