|
Back to main intersection
You have indicated you are (Two Party)
for HSA coverage.
There are many plan options.
Our experience has shown these designs have the best value:
Apply Now!
|
Preventative Care |
-> |
$15 for
primary Doctors
$25 for specialist Doctors |
|
Doctor Office Visits |
-> |
$15 after deductible for primary doctors
$25 after deductible for specialist doctors |
| Deductible |
-> |
1500
(Single)
3000 (Family) |
| Rx Copays |
-> |
AFTER YOUR DEDUCTIBLE IS MET:
$10 for generic Rx
25% for name brand Rx
50% for Non Formulary Rx |
|
Sample
Age
38 Male
w/
Spouse Age 37
 |
Select Med
IHC-Med
- $151
Select-Med
-
$163
IHC-Care
-
$1179 |
|
|
To Calculate
Locate the age
of the oldest
family member
enrolling. Then
follow grid to the right to get price. |
IHC-Med |
Select-Med |
IHC-Care |
AGE
0-19 -->
20-24 ->
25-29 ->
30-34 ->
35-39 ->
40-44 ->
45-49 ->
50-54 ->
55-59 ->
60-64 -> |
Two Party
102
115
130
148
151
176
209
247
302
372 |
Two Party
111
125
141
161
163
191
227
268
328
404 |
Two Party
121
137
155
176
179
210
249
295
360
444 |
|
Preventative Care |
-> |
$15 for
primary Doctors
$25 for specialist Doctors |
|
Doctor Office Visits |
-> |
$15 after deductible for primary doctors
$25 after deductible for specialist doctors |
| Deductible |
-> |
2700
(Single)
5400 (Family) |
| Rx Copays |
-> |
AFTER YOUR DEDUCTIBLE IS MET:
$10 for generic Rx
25% for name brand Rx
50% for Non Formulary Rx |
|
Sample
Age
38 Male
w/
Spouse Age 37
 |
Select Med
IHC-Med
- $131
Select-Med
-
$142
IHC-Care
-
$156 |
|
|
To Calculate
Locate the age
of the oldest
family member
enrolling. Then
follow grid to the right to get price. |
IHC-Med |
Select-Med |
IHC-Care |
AGE
0-19 -->
20-24 ->
25-29 ->
30-34 ->
35-39 ->
40-44 ->
45-49 ->
50-54 ->
55-59 ->
60-64 -> |
Two Party
89
100
113
129
131
153
182
215
262
323 |
Two Party
96
109
123
140
142
166
197
233
285
351 |
Two Party
106
119
135
153
156
182
216
256
313
385 |
|
Preventative Care |
-> |
$15 for
primary Doctors
$25 for specialist Doctors |
|
Doctor Office Visits |
-> |
Covered 100% after deductible |
| Deductible |
-> |
5000
(Single)
10000 (Family) |
| Rx Copays |
-> |
Covered 100% after deductible |
|
Sample
Age
38 Male
w/
Spouse Age 37
 |
Select Med
IHC-Med
- $102
Select-Med
-
$110
IHC-Care
-
$121 |
|
|
To Calculate
Locate the age
of the oldest
family member
enrolling. Then
follow grid to the right to get price. |
IHC-Med |
Select-Med |
IHC-Care |
AGE
0-19 -->
20-24 ->
25-29 ->
30-34 ->
35-39 ->
40-44 ->
45-49 ->
50-54 ->
55-59 ->
60-64 -> |
Two Party
69
78
88
100
102
119
140
166
202
249 |
Two Party
75
84
95
108
110
129
152
180
219
270 |
Two Party
82
92
104
119
121
141
167
197
241
296 |
A. These are only estimated monthly
premiums and are subject to change based on underwriting review
B. Premium rates are based on the age
of the oldest family member. The enrollment application must be written with the
oldest family member as the applicant.
C. Premiums under these plans are
subject to adjustment each January 1, if your original effective date is
January 1 through June 30, or each July 1, if your original effective date is
July 1 through December 31.
D. Premiums will increase on the first
of the month following the birthday on which the subscriber (policyholder) moves
from one age category to another.
E. Approval of your application
is subject to IHC Health Plans underwriting requirements and is not guaranteed.
|