|
|
|
(Available to Washington State Residents Only)
|
SUMMARY OF BENEFITS
WELCOME 3500
FOR INDIVIDUALS & FAMILIES
|
|
|
WELCOME 3500 - IN CASE OF EMERGENCY - Group Health Network
The Welcome 3500 Catastrophic Plan - '10 is the plan to get if you only need catastrophic coverage. Your first five outpatient visits are covered at 50% coinsurance, and you don't need to begin paying toward your $3,500 deductible until after that. If you don't anticipate seeing a doctor very often, this might be the plan for you.
 These plans give you access to the Group Health network of doctors, who practice at more than two dozen medical centers statewide, plus thousands of contracted providers. Also, you can self-refer to most specialists at Group Health medical centers, which makes getting the care you need as easy as possible. The Welcome Plans have no coverage out of network benefits.
Click here to look up a provider.
|
Benefits |
|
Group Health Network |
|
Annual Deductible |
|
$3,500 per member or $10,500 per family
|
 |
|
Memeber Coinsurance |
|
50% |
|
Out-Of-Pocket Limit*
(Deductible does not apply.)
|
|
$10,000 per member or $30,000 per family
|
|
Benefits |
|
After Deductible,
Member Pays |
|
|
First 5 visits: You pay 50% coinsurance. Your deductible does not apply until after the 5th visit for services indicated by  |
|
Office Visits
Includes urgent care and mental health outpatient services.
|
|
50% |
|
Preventive Care Visits
For children and adults; including physicals and immunizations, as established in Group Health's preventive care schedule.
|
|
50%
|
|
Manipulative Therapy
|
|
50%, up to 10 visits PCY** |
|
Acupuncture
|
|
50%, up to 8 visits PCY |
|
| Naturopathy |
|
50%, up to 3 visits PCY |
|
Maternity Care
|
|
Not covered |
|
Lab/X-Ray Services
|
|
50% |
|
Hospital Visits - Inpatient
Hospital room and board; inpatient surgery; anesthesia, intensive and coronary care; laboratory tests; radiology services; drugs while in hospital. Includes mental health inpatient treatment. Maternity care not covered.
|
|
50% |
|
Devices, Equipment & Supplies
(DME and prosthetics.)
|
|
DME — 50% up to $5,000 in charges ($2,500 max. benefit PCY); Prosthetics — 50% up to $40,000 in charges ($20,000 max. benefit PCY) |
|
Prescription Drugs
|
|
Not covered |
|
Emergency Care
Group Health or Group Health-designated facilities:
Non-Group Health or non-Group Health-designated facilities worldwide, including urgent care facilities.
|
|
$100 + 50%
$150 + 50% |
|
Vision Care
|
|
50% for routine eye exam and
$200 hardware benefit per 12 month period.
Hardware not subject to deductible or coinsurance.
|
|
* Member coinsurance applies. Deductible is not included in out-of-pocket limit.
** PCY = per calendar year
Note: This is a summary of benefits. The contents are not to be accepted or construed as a substitute for the provisions of the master policy or agreement. Other terms and conditions apply. Lifetime benefit maximum of $2 million applies to all plans. All plans cover on-the-job-injury-related health care costs for partners, proprietors, or corporate officers who are not covered by a workers' compensation act, subject to the plan's cost shares and benefit limitations.
Coverage provided by Group Health Options, Inc.
|
|
E-mail us for more information and a free quote or CALL TOLL FREE
1-800-875-4490 (in the U.S.)
or 1-253-854-0199 (outside the U.S.)
Fax: 1-253-896-9411
Mailing address: Maddock & Associates, 1407 Willow Road E, Suite C, Tacoma, WA 98424
Serving all of Washington at 800-875-4490, Seattle at 206-682-1628,
Bellevue at 425-454-6834, Kent at 253-854-0199 and Tacoma at 253-572-3291.
Copyright© 1998-2010, Maddock & Associates | Privacy Statement
Problems viewing this page? Contact the webmaster.
|
|
