MPIPHP Insurance Company Summaries!
For your convenience here are the insurance company summaries for the two options (Anthem vs Oxford) provided from MPIPHP.
Please note we don't endorse one over the other, this is a personal choice and one which is best made after reviewing the In-network doctors and hospitals.
Oxford SBC-2023 Summary:
Deductibles:
In-network: $0
Out-of-network: $500 Individual / $1,000 Family
Out-of-pocket limits:
In-network: None
Out-of-network: $8,000 Individual / $16,000 Family
Co-payments:
Primary care: $15 per visit
Specialist: $15 per visit
Preventive care:
In-network: No charge
Out-of-network: 30% coinsurance after deductible
Prescription drug coverage:
Generic: $10 copay
Preferred brand: $25 copay
Non-preferred brand: $40 copay
Emergency services:
Emergency room: $25 copay, waived if admitted
Emergency medical transportation: No charge
Hospitalization coverage:
Facility fee: No charge
Physician/surgeon fees: No charge
Mental health services:
Outpatient: $15 copay per visit
Inpatient: No charge
Rehabilitation services:
$15 copay per visit
Maternity care:
Office visits: No charge
Childbirth/delivery: No charge
Anthem SBC-2023 Summary:
Deductibles:
In-network: $0
Out-of-network: $1,000 Individual / $2,000 Family
Out-of-pocket limits:
In-network: $4,000 Individual / $8,000 Family
Out-of-network: $8,000 Individual / $16,000 Family
Co-payments:
Primary care: $20 per visit
Specialist: $40 per visit
Preventive care:
In-network: No charge
Out-of-network: 40% coinsurance after deductible
Prescription drug coverage:
Generic: $10 copay
Preferred brand: $30 copay
Non-preferred brand: $50 copay
Emergency services:
Emergency room: $150 copay
Emergency medical transportation: 20% coinsurance
Hospitalization coverage:
Facility fee: $250 copay per admission
Physician/surgeon fees: 20% coinsurance
Mental health services:
Outpatient: $20 copay per visit
Inpatient: $250 copay per admission
Rehabilitation services:
$20 copay per visit
Maternity care:
Office visits: No charge
Childbirth/delivery: $250 copay per admission