Horizons Diagnostics 2022 Benefit Guide

Medical and Pharmacy Coverage

Horizons Diagnostics offers the following plans through Aetna. Please reference the Summary Plan Description for more details.

Insurance Carrier: Medical Plan Number: In-Network: Office Visit Copay - Primary Care

Aetna Medical Insurance

$3,000 / 100% Copay Plan

$5,000 / 100% Copay Plan

$5,000 / 100% HDHP Plan

$30 Copay

$40 Copay

Deductible; then 100% Coinsurance

Office Visit Copay - Specialist Care

$60 Copay

$75 Copay

Deductible; then 100% Coinsurance

Urgent Care Copay

$60 Copay

$75 Copay

Deductible; then 100% Coinsurance

Emergency Room Care

Deductible; then 100% Coinsurance

Deductible; then 100% Coinsurance

Deductible; then 100% Coinsurance

Preventative Visit Copay

$0

$0

$0

Diagnostic Testing & Blood Work

Deductible; then 100% Coinsurance

Deductible; then 100% Coinsurance

Deductible; then 100% Coinsurance

Imaging

Deductible; then 100% Coinsurance

Deductible; then 100% Coinsurance

Deductible; then 100% Coinsurance

Coinsurance

100%

100%

100%

Employee Deductible

$3,000

$5,000

$5,000

Family Deductible

$6,000

$10,000

$10,000

Employee Out-of-Pocket Max

$6,000 (includes deductible)

$8,000 (includes deductible)

$6,900 (includes deductible)

Family Out-of-Pocket Max

$12,000 (includes deductible)

$16,000 (includes deductible)

$13,800 (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

Out-of-Network: Coinsurance

70%

70%

70%

Employee Deductible

$6,000

$10,000

$10,000

Family Deductible

$12,000

$20,000

$20,000

Employee Out-of-Pocket Max

$12,000

$20,000

$20,000

Family Out-of-Pocket Max

$24,000

$40,000

$40,000

Prescription Drugs: ( 30 Day Supply) Rx Deductible

$0

$0

Combined with Medical Deductible

Tier 1 - Generic

$20

$20

Deductible; then 100% Coinsurance

Tier 2 - Preferred

$45

$45

Deductible; then 100% Coinsurance

Tier 3 - Non-Preferred

$90

$90

Deductible; then 100% Coinsurance

Preferred - $250 Non-Preferred - $50

Preferred - $250 Non-Preferred - $50

Tier 4 - Specialty

Deductible; then 100% Coinsurance

Employee Bi-Weekly Deduction Non-Tobacco Tobacco Non-Tobacco Tobacco Non-Tobacco Tobacco Employee Only $97.93 $121.01 $71.76 $94.84 $60.77 $83.85 Employee + Spouse $377.24 $400.32 $315.68 $338.76 $266.01 $289.08 Employee + Child(ren) $358.38 $381.46 $299.90 $322.97 $252.70 $275.78 Family $603.59 $626.66 $505.09 $528.17 $425.61 $448.69

7 Horizons Diagnostics, LLC. 2022 Enrollment Guide

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