Click to View Benefit Brochure for Details, Limitations and Exclusions
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Individual KeyCare Preferred®?  |
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| The Basics – how your coverage works |
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| In-Network PPO Network of Providers. No gatekeepers or referrals |
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| Deductible | Coinsurance | Expense Limit | |||
| $300 $750 $1,500 $2,500 $5,000 Family deductible/out-of-pocket expense limit = 2x single deductible/out-of-pocket expense limit |
20% 0% |
$1,500 $0 |
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| Out-of-Network Use any provider. You will be responsible for more of the cost with an out-of-network provider. No gatekeepers or referrals. |
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| Deductible | Coinsurance | Expense Limit | |||
| $300 $750 $1,500 $2,500 $5,000 |
30% | $3,000 | |||
| After the Deductible, you pay a Coinsurance amount, with an annual Out-of-Pocket Expense Limit. This Expense Limit helps control your annual out-of-pocket expenses by limiting the amount you pay in Coinsurance. | |||||
| The Details – the benefits and your share of the cost Lifetime Maximum: $5 Million regardless of providers or facilities |
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| Hospital Inpatient & Outpatient Care |
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| In-Network | You pay: 20% or 0% | ||||
| Out-of-Network | You pay: 30% | ||||
| Emergency Care |
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| In-Network | You pay 20% or 0% coinsurance, in or out-of-network 3 | ||||
| Out-of-Network | You pay 20% or 0% coinsurance, in or out-of-network 3 | ||||
| Doctor Visits |
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| In-Network | Covered before deductible |
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| Out-of-Network | You pay 30% |
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| Prescription Drugs |
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| Covered before deductible. You pay $10 or 40%, whichever is greater. Yearly Benefit Maximum: $5,000 per person |
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| Routine Wellness Care |
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| In-Network | Doctor Visits for Routine Wellness Care Covered before deductible. $20 PCP, $30 Specialist. Two yearly visits per person. Routine Screenings Most screenings covered before deductible. You pay 20% or 0%, depending on the deductible you choose and the screening. See your brochure for more details. Provides additional $150 per person per year for routine immunizations, labs & x-rays. |
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| Out-of-Network | You pay: 30% for doctor visit & screenings. Two yearly visits per person (combined with in-network visits). | ||||
| GET INSTANT QUOTES and APPLY ONLINE |
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