Select-Med=1,900 Physicians
Select-Care=2,800 Physicians
You have indicated (Two Party)
coverage.
There are many plan options.
Our experience has shown these designs have the best value:
|
|
250 deductible options | 500 deductible options | 1000 deductible options | 2500 deductible options |
|
Select-Value=800
Physicians Select-Med=1,900 Physicians Select-Care=2,800 Physicians |
|
Rate
Example
|
|
To Calculate Locate the age of the oldest family member enrolling. Then follow grid to the right to get price. |
Base-Level Clarification> Office & Rx copays apply AFTER the deductible is met.  |
Mid-Level Clarification> Office copays apply immediately. Rx copays apply after deductible is met.
|
High-Level Clarification> Office & Rx copays apply immediately. Deductible applies to hospital billed charges.
|
| AGE 0-19 --> 20-24 -> 25-29 -> 30-34 -> 35-39 -> 40-44 -> 45-49 -> 50-54 -> 55-59 -> 60-64 -> |
SelectValue |
Select Med |
SelectCare |
SelectValue |
Select Med |
SelectCare |
SelectValue |
Select Med |
SelectCare |
|
Rate
Example
|
|
To Calculate Locate the age of the oldest family member enrolling. Then follow grid to the right to get price. |
Base-Level Clarification> Office & Rx copays apply AFTER the deductible is met. |
Mid-Level Clarification> Office copays apply immediately. Rx copays apply after deductible is met. |
High-Level Clarification> Office & Rx copays apply immediately. Deductible applies to hospital billed charges. |
|
AGE 0-19 --> 20-24 -> 25-29 -> 30-34 -> 35-39 -> 40-44 -> 45-49 -> 50-54 -> 55-59 -> 60-64 -> |
SelectValue |
Select Med |
SelectCare |
SelectValue |
Select
Med |
SelectCare |
SelectValue |
Select
Med |
SelectCare |
|
Rate
Example
|
|
To Calculate Locate the age of the oldest family member enrolling. Then follow grid to the right to get price. |
Base-Level Clarification> Office & Rx copays apply AFTER the deductible is met. |
Mid-Level Clarification> Office copays apply immediately. Rx copays apply after deductible is met. |
High-Level Clarification> Office & Rx copays apply immediately. Deductible applies to hospital billed charges. |
| AGE 0-19 --> 20-24 -> 25-29 -> 30-34 -> 35-39 -> 40-44 -> 45-49 -> 50-54 -> 55-59 -> 60-64 -> |
SelectValue |
Select Med |
SelectCare |
SelectValue |
Select Med |
SelectCare |
SelectValue |
Select Med |
SelectCare |
|
Rate
Example
|
|
To Calculate Locate the age of the oldest family member enrolling. Then follow grid to the right to get price. |
Base-Level Clarification> Office & Rx copays apply AFTER the deductible is met. |
Mid-Level Clarification> Office copays apply immediately. Rx copays apply after deductible is met. |
High-Level Clarification> Office & Rx copays apply immediately. Deductible applies to hospital billed charges. |
|
AGE 0-19 --> 20-24 -> 25-29 -> 30-34 -> 35-39 -> 40-44 -> 45-49 -> 50-54 -> 55-59 -> 60-64 -> |
SelectValue |
Select Med |
SelectCare |
SelectValue |
Select
Med |
SelectCare |
SelectValue |
Select
Med |
SelectCare |
|
Rate
Example
|
|
To Calculate Locate the age of the oldest family member enrolling. Then follow grid to the right to get price. |
Base-Level Clarification> Office & Rx copays apply AFTER the deductible is met. |
Mid-Level Clarification> Office copays apply immediately. Rx copays apply after deductible is met. |
High-Level Clarification> Office & Rx copays apply immediately. Deductible applies to hospital billed charges. |
| AGE 0-19 --> 20-24 -> 25-29 -> 30-34 -> 35-39 -> 40-44 -> 45-49 -> 50-54 -> 55-59 -> 60-64 -> |
SelectValue |
SelectMed |
SelectCare |
Not Available |
SelectValue |
SelectMed |
SelectCare |
|
Rate
Example
|
|
To Calculate Locate the age of the oldest family member enrolling. Then follow grid to the right to get price. |
Base-Level Clarification> Office & Rx copays apply AFTER the deductible is met. |
Mid-Level Clarification> Office copays apply immediately. Rx copays apply after deductible is met. |
High-Level Clarification> Office & Rx copays apply immediately. Deductible applies to hospital billed charges. |
|
AGE 0-19 --> 20-24 -> 25-29 -> 30-34 -> 35-39 -> 40-44 -> 45-49 -> 50-54 -> 55-59 -> 60-64 -> |
SelectValue |
SelectMed |
SelectCare |
Not Available |
SelectValue |
SelectMed |
SelectCare |
|
Rate
Example
|
|
To Calculate Locate the age of the oldest family member enrolling. Then follow grid to the right to get price. |
Base-Level Clarification> Office & Rx copays apply AFTER the deductible is met. |
Mid-Level Clarification> Office copays apply immediately. Rx copays apply after deductible is met. |
High-Level Clarification> Office & Rx copays apply immediately. Deductible applies to hospital billed charges. |
| AGE 0-19 --> 20-24 -> 25-29 -> 30-34 -> 35-39 -> 40-44 -> 45-49 -> 50-54 -> 55-59 -> 60-64 -> |
SelectValue |
SelectMed |
SelectCare |
Not Available |
Not Available |
|
Rate
Example
|
|
To Calculate Locate the age of the oldest family member enrolling. Then follow grid to the right to get price. |
Base-Level Clarification> Office & Rx copays apply AFTER the deductible is met. |
Mid-Level Clarification> Office copays apply immediately. Rx copays apply after deductible is met. |
High-Level Clarification> Office & Rx copays apply immediately. Deductible applies to hospital billed charges. |
|
AGE 0-19 --> 20-24 -> 25-29 -> 30-34 -> 35-39 -> 40-44 -> 45-49 -> 50-54 -> 55-59 -> 60-64 -> |
SelectValue |
SelectMed |
SelectCare |
Not Available |
Not Available |
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.
