General Discussion
In reply to the discussion: If you're not buying Obamacare, stop saying you are. OK? [View all]Kber
(5,043 posts)one HMO and two PPO's which have some "out of network" coverage
For the HMO, the employee only premium is $84.00 per month.
There is no out of network coverage.
In network, there is an individual deductible of $750 that applies to diagnostic tests, out patient surgery and hospital care. Doctor visits are not subject to the deductible.
Co-pay is $30 for primary and $40 for a specialist and $100 for emergency room visits.
As required by law, all preventative care is covered at 100% with no co-pay and no deductible.
The lower priced PPO is $165 / month for employee only.
There is no deductible if you stay in network and a &750 deductible for of network stuff. Out of network is covered at 70%. In network is covered 100% after your copay of $25 for primary and $35 for a specialist. Emergency room visits have a $100 co-pay, waived if you are admitted.
My company picks up 80% of the premiums cost so it's generally a better deal than the ACA and we don't have any employees who would qualify for subsidies based on the research I've done (I'm in HR)