HIRSP Federal Plans
|
HIRSP Federal 500 |
HIRSP Federal 1,000 |
HIRSP Federal 2,500 |
HIRSP Federal 3,500 |
|
|---|---|---|---|---|
| Premiums | ||||
|
Medical deductible (you pay) |
$500 per year | $1,000 per year | $2,500 per year | $3,500 per year |
| Medical Coinsurance | 20% of allowed amount up to $1,000 total per year | 20% of allowed amount up to $1,000 total per year | 20% of allowed amount up to $1,000 total per year | 20% of allowed amount up to $1,000 total per year |
| Medical Out-of-Pocket Maximum | $1,500 | $2,000 | $3,500 | $4,500 |
| Drug Copay (you pay) |
$10 Tier 1 /
$40 Tier 2
|
|||
| Drug Out-of-Pocket Maximum | $2,000 per year | $2,000 per year | $2,000 per year |
$1,450 per year |
| Total Out-of-Pocket | $3,500 | $4,000 | $5,500 | $5,950 |
Higher deductible plans have lower premiums and lower deductible plans have higher premiums.
HIRSP Federal Plan Premium Rates: The premiums for the HIRSP Federal Plan will be based on standard market rates for individual health insurance.
The premium rates for the HIRSP Federal Plan will generally be lower than the full HIRSP premium rates for plans with the same deductible.
However, if your household income is below $33,000, you may be eligible for a premium reduction on the other HIRSP plans. This may make your premium lower than the HIRSP Federal Plan premium.
HIRSP Federal Plan Provider Network: To be covered by the HIRSP Federal Plan, healthcare providers must be Wisconsin Medicaid-certified. HIRSP Federal Plan will pay benefits up to the HIRSP Federal Plan allowed amount. You are responsible for any applicable deductible and coinsurance amounts.
If you receive emergency medical care from a healthcare provider located outside of the state of Wisconsin who is not Medicaid-certified, HIRSP Federal Plan will cover those health care services up to the HIRSP Federal Plan allowed amount. You are responsible for any applicable deductible and coinsurance amounts, and maybe balanced billed for the difference between the provider charges and the HIRSP Federal Plan allowed amount.
The HIRSP Federal Plan will be accepting applications beginning July 15, 2010 for August 1, 2010 effective dates.