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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