Collective Health PPO Plan

PARTNER | COLLECTIVE HEALTH

PPO Preferred Provider Organization

Collective Health will be your medical plan partner, providing concierge-level service for you and your dependents.

The "PPO" (preferred provider organization) plan is designed with a preferred network that includes most, but not all, doctors and hospitals. You do not need to designate a primary care physician or a get a referral to see specialists; you can see doctors you choose for your medical needs. If you see in-network doctors, you will generally pay less than if you see doctors out-of-network.

COLLECTIVE HEALTH PPO Network: ANTHEM NETWORK
Group/Policy #: 282016

*Plan Design Subject to the Deductible

  • Deductible | $1,000 Individual ($2,000 Family) The amount you owe for health care services before your health insurance or plan begins to pay.
  • Maximum Out of Pocket | $3,000 Individual ($6,000 Family) The money you pay for covered medical and pharmacy services counts toward your out of pocket maximum. Once you meet your designated out of pocket maximum, the plan will pay for all of your covered healthcare costs for the rest of the plan year.
  • Primary Care Doctor | $25 copay per visit A PCP is the person your child should see for a routine checkup or non-emergency medical care
  • Specialist | $40 copay per visit A physician specialist focuses on a specific area of medicine or a group of patients to diagnose, manage, prevent or treat a certain types of symptoms and conditions
  • Telemedicine | $10 copay Telemedicine refers to the practice of caring for patients remotely when the provider and patient are not physically present with each other. Modern technology has enabled doctors to consult patients by using HIPAA compliant video-conferencing tools.
  • Urgent Care | 20% coinsurance Care for an illness, injury or condition serious enough that a reasonable person would seek care right away, but not so severe as to require emergency room care.
  • Hospital | 20% coinsurance* The portion of eligible expenses that plan members are responsible paying, most often after the deductible is met. It's usually determined as a percentage of the total cost.
  • X-Ray and Labs | 20% coinsurance* The portion of eligible expenses that plan members are responsible paying, most often after the deductible is met. It's usually determined as a percentage of the total cost.
  • Emergency Room | $150 copay The Emergency Room (ER) provides care for these critical or life-threatening conditions and not for routine health care.

Plan Design Shown Above represent In-Network Benefits

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