|
Blue Cross
Hospitalization |
Blue Shield
Medical/Surgical |
Supplemental
Major Medical |
| Option 1A |
$350 deductible per benefit period; $50 copay per outpatient service (max of 5 copays per year) |
Plan 100 (paid 100% UCR) |
$100 deductible, then pays 80% of the next $2,000 of eligible expenses (100% thereafter) |
| Option 1B |
$350 deductible per benefit period; $50 copay per outpatient service (max of 5 copays per year) |
Plan 100 (paid 100% UCR) |
$250 deductible, then pays 80% of the next $2,000 of eligible expenses (100% thereafter) |
| Option 1C |
$350 deductible per benefit period; $50 copay per outpatient service (max of 5 copays per year) |
Plan 100 (paid 100% UCR) |
$500 deductible, then pays 80% of the next $2,000 of eligible expenses (100% thereafter) |