Comparison of PPO Plan 1 and 2 for Medical Visits

Comparison – PPO Plan 1 Tier #1 vs. PPO Plan 2 Tier #1 Medical Plans Tom’s 4 annual physicals & 2 additional office visits, 1 X-Ray (Family Coverage/Administrator) PPO Plan 1 Tier #1 PPO Plan 2 Tier #1 • Plan Deductible……………………………………….........…$2,000/$4,000 • Plan Deductible…………………………………...…….$3,000/$6,000 • Coinsurance……………………………………....………….……..………..….20% • Coinsurance…………………………...…………………………………..20% • Copays……………………………………………………………………….………$15 • Copays………………….………………….....………..…..…………….……$15 This example event includes services like: This example event includes services like: • Primary Care physician office visits (including disease • Primary Care physician office visits (including disease education) education) • Diagnostic Tests (blood work) • Diagnostic Tests (blood work) Preventive Wellness Physical • • Preventive Wellness Physical • Durable medical equipment • Durable medical equipment Total Example Cost $4,500 Total Example Cost $4,500 In this example, Tom would pay: In this example, Tom would pay: Cost Sharing Cost Sharing Deductibles $4,500 Deductibles $4,000 Coinsurance $ Coinsurance $100 Copayments $30 Copayments $30 Tom’s Total Cost $4,530 Tom’s Total Cost $4,130