Group Affordable Choice

AFFORDABLE CHOICE PLAN COMPARISON Surgical and Hospitalization Benefits PLAN 1 PLAN 2

Inpatient Hospital Confinement (Per Inpatient Day)

$500

$1,000

12-23 Hours: 25% Inpatient ($125 - $250) 24-47 Hours: 50% Inpatient ($250 - $500) 48 Hours: 75% Inpatient ($375 - $750)

Observation Unit

Hospital Admission Benefits (For the first Inpatient Day per calendar year)

$500

$1,000

Emergency Room (Per day; 1/CY)

$200

$300

Urgent Care (Per day; 2/CY)

$200

$300

Surgery Benefit (Maximum $50,000 benefit per calendar year)

1 X Medicare Fee Schedule

2 X Medicare Fee Schedule

Ambulatory Surgical Benefit

$1,000

$2,000

Daily Assistant Surgeon Benefit

Pays 20% of the eligible surgical benefit

Daily Anesthesiologist Benefit

Pays 25% of the eligible surgical benefit

Doctor's Visits

$75 per day ; 4/CY

$125 per day ; 4/CY

Prescription Benefit (Per Day)

$25 ; $250/CY

$50 ; $500/CY

Outpatient Medical Benefits

Wellness Benefit: (1/CY, 30 day waiting period)

$100

Preventative Services: (Per service)

$250 $250

$300 $300

Pap PSA

Laboratory Services: (Per day)

$200 $50

$300 $50

Surgical Pathology Other Laboratory Services

Therapy Services: (Per day for physical, occupational, speech) Radiology Services: (per day: MRI/PET scan/ CT scan/mammogram/other radiology tests)

$50

$75

$300/$300/ $300/$250/$200

$600/$600/ $600/$300/$250

Calendar year limit for all Outpatient Benefits

$4,000

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