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Comparison of CeltiCare
II In order to make it easy for you to understand your options when you apply for CeltiCare II Health Plans, this chart outlines and compares the features and benefits of each plan.
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| Features/Benefits | CeltiCare II Select PPO | CeltiCare II "Any Doc" PPO | CeltiCare II Managed Indemnity Plan |
| Annual Deductibles | $500, $1,000, $1,500, $2,500, $5,000 | $500, $1,000, $1,500, $2,500, $5,000 | $500, $1,000, $1,500, $2,500, $5,000 |
| Choices of Coinsurance after the deductible |
80/20 of the next $10,000 & 100%
thereafter; or 100%
(100% only available w/$2,500 & $5,000 deductibles) |
80/20 of the next $10,000 & 100%
thereafter; or 100%
(100% only available w/$2,500 & $5,000 deductibles) |
80/20 of the next $10,000 & 100%
thereafter; or 100%
(100% only available w/$2,500 & $5,000 deductibles) |
| Lifetime Maximum | $7,000,000 | $7,000,000 | $7,000,00 |
| Physician Copay Services | $15 copay/6visits per person, per calendar year | $35 copay/6visits per person, per calendar year | Subject to deductible and coinsurance |
| Physician & Hospital Services | Benefits at PHCS network physicians and hospitals | Benefits at any physician and PHCS network hospitals | Benefits at any physician and hospital |
| Emergency Room Deductible (in addition to annual deductible) | $250 per visit, if not admitted. | $250 per visit, if not admitted. | $250 per visit, if not admitted. |
| Out-of-Network Services (in addition to annual plan deductible) | Doctor & Hospital
$1,500 annual ded. Eligible charges reduced additional 20% per occurrence. |
Hospital (only)
$1,500 annual ded. Eligible charges reduced additional 20% per occurrence. |
Not applicable |
| Healthy Lifestyle Program | Pays 25% of fees for eligible physical health programs up to $300 max. per person, per year. | Pays 25% of fees for eligible physical health programs up to $300 max. per person, per year. | Pays 25% of fees for eligible physical health programs up to $300 max. per person, per year. |
| Billing Options | Monthly, Quarterly, EFT | Monthly, Quarterly, EFT | Monthly, Quarterly, EFT |
| Eligibility | 6 mos. - 64 ½ yrs | 6 mos. - 64 ½ yrs | 6 mos.- 64 ½ yrs |
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Optional Benefits | |||
| Preventive Care | CeltiCare II Plus Option | CeltiCare II Plus Option | CeltiCare II Plus Option |
| Prescription Drug option | Stand-alone Option or part of CeltiCare II Plus Option | Stand-alone Option or part of CeltiCareII Plus Option | Stand-along Option or part of CeltiCare II Plus Option |
| Supplemental Accident | CeltiCare II Plus Option | CeltiCare II Plus Option | CeltiCare II Plus Option |
| Term Life
Insurance (not available in all states) |
$25,000 | $25,000 | $25,000 |