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Benefit Designs & Descriptions - Small Groups

 

AvMed Open Access HMO
No referrals, no Primary Care Physician (PCP) designation required, members agree to use AvMed's broad network of providers, emergency care is always covered.

 


Plan Name
(Click on link to view full benefit summary)
 
 

Deductible

 

Description

 

Summary of Benefit Design

HM-OA-3795 0 No Deductible, Co-pay Only Basic Option $45/$500Day; $10/30/50/75 OC
HM-OA-3796 0 No Deductible, Co-pay Only Basic Option $45/$250Day; $10/30/50/75 OC
HM-OA-3797 0 No Deductible, Co-pay Only Basic Option $45/$500Admit; $10/30/50/75 OC
HM-OA-3278 250 Deductible, Co-pay and Coinsurance Open Access HMO $20 / $250 / 10%; Rx $10/25/40/75 OC
HM-OA-3794 500 Deductible, Co-pay, Coinsurance applies to DME and Diagnostic Tests HM-OA-3794 - Open Access HMO $25/$500/$$2,500/20%; RX$10/$30/$50/$75 w/OC
HM-OA-3798 500 Deductible, Co-pay, Coinsurance applies to DME and Diagnostic Tests HM-OA-3798 - Open Access HMO $15/$500/$1500/20%; RX$10/$30/$50/$75 w/OC
HM-OA-4078 500 Deductible, Co-pay, Coinsurance applies to DME and Diagnostic Tests HM-OA-4078 - Open Access HMO $25/$500; RX$20/$40/$60/$75 w/ OC
HM-OA-5054 500 Deductible, Co-pay, Coinsurance applies to DME and Diagnostic Tests HM-OA-5054 - Open Access HMO 15/500/1500/20%; RX$20/$40/$60/$75 w/ OC
HM-OA-5055 500 Deductible, Co-pay, Coinsurance applies to DME and Diagnostic Tests HM-OA-5055 - Open Access HMO 20/500/1500/20%; RX$20/$40/$60/$75 w/ OC
HM-OA-5056 500 Deductible, Co-pay, Coinsurance applies to DME and Diagnostic Tests HM-OA-5056 - Open Access HMO 30/500/1500/20%; RX$10/$30/$50/$75 w/OC
HM-OA-5057 500 Deductible, Co-pay, Coinsurance applies to DME and Diagnostic Tests HM-OA-5057 - Open Access HMO 50/500/1500/20%; RX$10/$30/$50/$75 w/OC
HM-OA-5057B 500 Deductible, Co-pay, Coinsurance applies to DME and Diagnostic Tests HM-OA-5057B - Open Access HMO 50/500/1500/20%; RX$20/$40/$60/$75 w/ OC
HM-OA-5058 500 Deductible, Co-pay, Coinsurance applies to DME and Diagnostic Tests HM-OA-5058 - Open Access HMO 25/500/2500/20%; RX$20/$40/$60/$75 w/ OC
HM-OA-3279 750 Deductible, Co-pay and Coinsurance Open Access HMO $25 / $750 / 20%; Rx $20/35/50/75 OC
HM-OA-3280 1000 Deductible, Co-pay and Coinsurance Open Access HMO $30 / $1,000 / 20%; Rx $20/35/50/75 OC
HM-OA-5062 1000 First dollar coverage for office visits, Co-pay only plan after meeting the Deductible HM-OA-5062 - Open Access HMO 25/1000/1500; RX$20/$40/$60/$75 w/ OC
HD-OA-3688 1500 Copay only after deductible is met, HSA-qualified HDHP 1A; Rx $10/20/30/75 OC
HD-OA-3689 1500 100% after deductible is met, HSA-qualified HDHP 1B; Rx - No Charge after Ded
HM-OA-5063 1500 First dollar coverage for office visits, Co-pay only plan after meeting the Deductible HM-OA-5063 - Open Access HMO 25/1500/1500; RX$20/$40/$60/$75 w/ OC
CD-OA-3701 2000 10% Coinsurance after deductible is met CDHP 1C; Rx $15/30/50/75 OC
HD-OA-3691 2000 20% Coinsurance after Deductible is met, HSA-qualified HDHP 1D; Rx $10/20/30/75 OC
HM-OA-5059 2500 First dollar coverage for office visits and urgent care, 100% after deductible all other services HM-OA-5059 -Open Access HMO 25/2500; RX$20/$50/$75/$100 w/ OC
HM-OA-5064 2500 First dollar coverage for office visits, Co-pay only plan after meeting the Deductible HM-OA-5064 - Open Access HMO 25/2500/1500; RX$20/$40/$60/$75 w/ OC
HD-OA-3690 3000 100% after deductible is met, HSA-qualified HDHP 1C; Rx - No Charge after Ded
HM-OA-5060 5000 First dollar coverage for office visits and urgent care, 100% after deductible all other services HM-OA-5060 - Open Access HMO 25/5000; RX$20/$50/$75/$100 w/ OC
HM-OA-5065 5000 First dollar coverage for office visits, Co-pay only plan after meeting the Deductible HM-OA-5065 - Open Access HMO 25/5000/1500; RX$20/$40/$60/$75 w/ OC
HM-OA-5061 10000 First dollar coverage for office visits and urgent care, 100% after deductible all other services HM-OA-5061 - Open Access HMO 25/10000;RX $15 Generic Only
HM-OA-5066 10000 First dollar coverage for office visits, Co-pay only plan after meeting the Deductible HM-OA-5066 - Open Access HMO 25/10000/1500; RX$20/$40/$60/$75 w/ OC

 

Last modified January 03, 2008
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