Affordable Choice Enhanced

Affordable Choice Fixed-Benefit Plans Affordable Choice plans pay a set of daily benefits for covered services, regardless of what your provider charges.

Hospital Stay Description of Transaction Total Charges - 7 days

EXAMPLE 1 ELITE

Amount:* $41,660.41 -$18,747.18 $22,913.23

Total Adjustments/Network Discounts

Current Balance

Affordable Choice Pays Description of Transaction

Amount:* $2,000.00

Admission Benefit

Hospital Days at $4,000

+$28,000.00 $30,000.00

Total Paid

*Amounts based on Affordable Choice claims data. Results may vary.

EXAMPLE 2 CLASSIC

Routine preventive care exam with labs - Service received:

Cost:

Plan pays:

Preventive care/office visit

$95

$75

Laboratory test

+$90 $185 $130 -$125

+$50 $125

Total Bill

Balance after Network discounts*

Classic pays Your balance

$5

EXAMPLE 3 ELITE

Broken radius in arm Service received: Follow-up office visits (4) Follow-up x-rays (1) Emergency room/physician charge

Cost: $1,444

Plan pays:

$300 $700 +$250 $1,250

$465 +$95

Total Bill

$2,004

Balance after Network discounts*

$1,503 -$1,250 $253

Elite pays

Your balance

* Amounts based upon Affordable Choice claims data. Results may vary. These are contractually negotiated discounts between a network and the hospitals and doctors. Discounts can vary among providers. Hospital discounts can be as much as 40% to 50% and doctors vary between 25% and 35%.

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