Passage Bronze Alternative PCP POS
What is the individual deductible?
$6,500
Tier One Drug Cost
$10 Copay per prescription
MOOP for out of network families
$17,200
Cost of out of network Speech Therapy?
30% coinsurance after OON Plan Deductible met.
How much is a home health care visit?
$25 copay per visit
What's the MOOP for family?
$16,300 is the maximum out of pocket for a family.
Cost of urgent care visit?
$75 copay per visit
How much is a mammography ultrasound?
$20 Copay per visit
How much is a PET Scan?
$65 copay per visit
How much is a routine eye exam for Pediatrics?
$40 Copay per visit
Patient 0 has a major rash and needs lab work done, which totaled $12,750. This is the first time patient 0 is using the plan and hasn't paid the deductible yet. How much will they pay?
They'd pay $8,150 as they're meeting both the MOOP and deductible
Malory Duck has already met her deductible, but needs to buy some T3 bread drugs totaling $300. How much can Ms. Duck expect to pay?
$150
Teddaline Bearastine needs to go see a chiropractor as they keep bending their back instead of standing upright. How much is their first ever visit going to cost them at $4000 in network
$50 copay
Romeo's mother is ill and needs to run to urgent care. How much will the bill be?
$50 copay
Someone couldn't pull the turkey out in time and started a thanksgiving fire! They had to be rushed to the ER totalling an ambulance bill of $2000. How much will they owe with having met their deductible?
$400
A Patient is billed $500 on their new plan for their T4 drugs. How much would Connecticare pay for this drug?
$0. The patient has to meet the deductible before insurance will pay.
Ms. Duck is out of town on a flight and needs some quack (speech) therapy. it totaled $500 and hasn't met her out of network deductible. How much does she owe?
They'd pay $500
Bearastine needs to get fish pills from their T1 pharmacy. They normally cost $40, how much does it cost them?
$10 Copay per prescription
Romeo and Juliet's toddler Romiet needs braces as they're medically necessary and cost $7,000! How much do they pay?
They would pay $3,500 as it's 50% coinsurance.
Sally has to take her kid Sue in for his allergy test. How much will they pay?
$40 Copay as it's the same cost as Specialist or PCP.
If a football player had a major leg injury and needs to seek someone for help to be able to walk. How much should they expect to pay?
$50 copay after deductible is met
On Ms. Duck's visit back she lost her oxygen tank at max altitude. She had to stop for a new one in a random town costing $25,000 as she needs her DME. How much will they owe?
$16,300 as that is the MOOP for out of network
Bearastine Has taken a spill and is in the ER! they have yet to meet their deductible, but the ER was $450 and their new paw with claws included was $5000.
How much do they owe in the end?
$1,450
Romeo was without his juliet and went down the drinking hole. He needs to go to rehab. He already met his deductible, but he was given a bill for $3000. What's the portion Romeo pays?
$1000 as the deductible was met meaning it's capped at $1000 per admission.
Sue (11 years old) needs new lenses totaling her mom a sweet penny of $3000. How much is that pair of glasses?
$1,500 as the cost is %50 off.