Page 11 - Future Steps
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Paying for Services 2017 Beneits Enrollment
In addition to sharing the monthly premium cost with GESM, you share in the cost
of services you receive, as follows.
For the $1,000 Deductible Plan
Annual Deductible
You pay the irst $1,000 of covered expenses for each individual and a maximum of
$2,000 for your family before coinsurance begins.
Three for Free—NEW!
For in-network services, each family member may receive up to a total of three ofice
visits, which include virtuwell, convenience care, and urgent care visits each year
where the physician’s services are covered 100%. All charges for ofice procedures,
laboratory, radiology, day treatment services, group visits, chiropractic care, physical,
occupational, and speech therapy services will be subject to the deductible and
coinsurance.
Coinsurance
Once you meet the annual deductible, you and the plan share costs through
coinsurance until you reach your out-of-pocket maximum. The plan pays 80% of the
cost and you pay 20%.
Out-of-Pocket Maximum
The amount you must pay out of your own pocket for your annual deductible,
copayments, and coinsurance is limited each plan year. This limit is called the out-
of-pocket maximum. The out-of-pocket maximum is $3,000 for each individual and
$6,500 per family.
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In addition to sharing the monthly premium cost with GESM, you share in the cost
of services you receive, as follows.
For the $1,000 Deductible Plan
Annual Deductible
You pay the irst $1,000 of covered expenses for each individual and a maximum of
$2,000 for your family before coinsurance begins.
Three for Free—NEW!
For in-network services, each family member may receive up to a total of three ofice
visits, which include virtuwell, convenience care, and urgent care visits each year
where the physician’s services are covered 100%. All charges for ofice procedures,
laboratory, radiology, day treatment services, group visits, chiropractic care, physical,
occupational, and speech therapy services will be subject to the deductible and
coinsurance.
Coinsurance
Once you meet the annual deductible, you and the plan share costs through
coinsurance until you reach your out-of-pocket maximum. The plan pays 80% of the
cost and you pay 20%.
Out-of-Pocket Maximum
The amount you must pay out of your own pocket for your annual deductible,
copayments, and coinsurance is limited each plan year. This limit is called the out-
of-pocket maximum. The out-of-pocket maximum is $3,000 for each individual and
$6,500 per family.
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