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Benefits Schedule.pdf

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Preview of Benefits Schedule
🔗 Source: piercegroupbenefits.com
📊 Size: 124 KB
👤 Author: Althea Johnson
⬇️ Downloads: 54

Summary

- In-network family deductible is $0 per year, out-of-network is $1,000 per year.
- Deductible waivers apply to preventive care, family planning services, risk-reducing breast cancer prescription drugs, and contraceptives.
- Maximum out-of-pocket limits are $3,000 per year for in-network individual, $4,500 per year for out-of-network individual, $6,000 per year for in-network family, and $9,000 per year for out-of-network family.
- Per admission copayment is $400 for in-network, not applicable for out-of-network.
- Outpatient prescription drug maximum out-of-pocket limits are $3,350 per year for individual and $6,700 per year for family.

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Description

- In-network family deductible is $0 per year, out-of-network is $1,000 per year.
- Deductible waivers apply to preventive care, family planning services,...

Technical Information

  • File Format: PDF
  • File Size: 124 KB
  • Pages: 22
  • Language: EN
  • Author: Althea Johnson
  • Total Downloads: 54
  • Last Updated: 1 week ago

Document Overview

This PDF document about Benefits Schedule provides comprehensive information and guidance. Whether you're a beginner or advanced user, this resource offers valuable insights into Benefits Schedule.

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