HealthMate Coast-to-Coast Direct 2500 *

Nancy, a 59-year-old hair stylist

Nancy is self-employed and her husband is covered by Medicare, so she is not eligible for an employer health plan.

Health status:
Some health risks – overweight; high blood pressure.

Exercise:
Walks three days per week.

Healthcare utilization:
Annual well visit; Routine lab work; Annual mammogram; Annual gynecological exam;Two sick visits; One monthly generic blood pressure medication; One generic antibiotic prescription.

Costs &
Incentives
HealthMate Coast-
to-Coast Direct
2500/5000
Medical Costs
Annual Well Visit with lab work,
mammogram,and gyn exam
No cost
2-sick visits $40
$20/visit
Pharmacy Costs  
Monthly Blood pressure medication $120 annually
$10 copay/month
Antibiotic $10 copay
Monthly Premium $466.29 (Preferred)
$588.60 (Basic)
Annual Premium $5,595.48(Preferred)
$7,063.20 (Basic)
Wellness Reward – 10% $559.55 (Preferred)
$706.32 (Basic
Wellness Incentive Wellness reward
(10% of premium)
TOTAL Estimated Annual Cost with
Insurance
$5,765.48(Preferred)
$7,233.20 (Basic)

* The example provided above is only a summary of benefits provided by the plan based on the hypothetical circumstances of the participant. Other exceptions, reductions, and limitations may also apply to your benefits. The preferred premium described above is for individuals or families who satisfy certain plan requirements, and the basic premium is for participants who do not satisfy those requirements. Your actual premium will be determined based on your application answers and the results of our medical underwriting. For complete benefit details, please see the subscriber agreement for the plan.

**As a BCBSRI member, you benefit from discounts we negotiate with our in-network providers. This means that when you need care, providers charge you less than what they would charge you if you did not have health insurance with BCBSRI. These payments are your anticipated copayment as a percent of the provider’s negotiated charge.

 

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