I am considering a job offer and have never seen a medical plan like this. Hoping someone can interpret some things for me. This is a “minimum value limited day” plan. This seems like a weird type of plan, so I want to make sure I know what I’m potentially getting myself into. I’m relatively healthy, but you never know what could happen.
It says “PHCS (Physician only network).” What does “phyisican only network” mean? I looked up PHCS and it looks like a network of providers, but “physician only” makes me think something is being excluded and I’m not sure what.
It says there is a daily in-hospital rate of $350 per admission. Does that mean it’s a $350 co-pay? It’s limited to 5 days per calendar year. The out of pocket maximum is $7,360 / $14,700. (I assume that second number is for out-of-network care.) It says the deductible is $0.
Surgery is limited to 2 days per calendar year. So if I exceed my two days of surgery, are any additional days just not covered at all?
Maternity is not covered. (Is that even legal?)
Looks like generic drugs are all that’s covered for pharmacy, and there’s a co-pay.
I was looking through the exclusions and there are a lot. Namely, chemotherapy/radiation, fertility treatments, NICU care, durable medical equipment…
I would appreciate anyone’s thoughts on this plan. Is this a fairly common offering among employers these days?
submitted by /u/candycane_
[link] [comments]
I am considering a job offer and have never seen a medical plan like this. Hoping someone can interpret some things for me. This is a “minimum value limited day” plan. This seems like a weird type of plan, so I want to make sure I know what I’m potentially getting myself into. I’m relatively healthy, but you never know what could happen. It says “PHCS (Physician only network).” What does “phyisican only network” mean? I looked up PHCS and it looks like a network of providers, but “physician only” makes me think something is being excluded and I’m not sure what. It says there is a daily in-hospital rate of $350 per admission. Does that mean it’s a $350 co-pay? It’s limited to 5 days per calendar year. The out of pocket maximum is $7,360 / $14,700. (I assume that second number is for out-of-network care.) It says the deductible is $0. Surgery is limited to 2 days per calendar year. So if I exceed my two days of surgery, are any additional days just not covered at all? Maternity is not covered. (Is that even legal?) Looks like generic drugs are all that’s covered for pharmacy, and there’s a co-pay. I was looking through the exclusions and there are a lot. Namely, chemotherapy/radiation, fertility treatments, NICU care, durable medical equipment… I would appreciate anyone’s thoughts on this plan. Is this a fairly common offering among employers these days?
submitted by /u/candycane_ [link] [comments]Read Morer/HealthInsurance