ABEL BUSINESS SERVICES, INC.
Health Plan: Rates and Services Chart
FOR WASHINGTON, DC
(Employee's primary doctor is in Washington, DC)CareFirst BlueChoice HMO
| Coverage Details | BlueChoice HMO Plan | ||||||||
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Plan Year:
April 1, 2005 - March 31, 2006 |
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| Primary Doctor Office Visit | $30 | ||||||||
| Specialist Office Visit | $40 | ||||||||
| Hospitilization (per admission) | $0 | ||||||||
| Emergency Room | $50 | ||||||||
| Prescription: generic/formulary*/
non-formulary* Non-Maintenance |
$10 / $25 / $45
$100 deductible per person (family member) $4,000 maximum |
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| Prescription: generic/formulary*/
non-formulary* Maintenance |
90 day supply
$20 / $50 / $90 |
* formulary = list of prescription drugs approved for preferred rates.
See the website:
http://www.carefirst.com
Check for a list of Doctors at http://www.carefirst.com
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The Dental Network Enrollment Form (PDF) Plan Details (PDF)
| Provider Choice II Plan | |
| Plan Prices | Individual $22.00
Parent/Child $36.00 Husband/Wife $41.00 Family $55.00 |
| Dental Visit Copay | $5 |
| Specialist Visit copay | $5 |
| No deductibles
No Benefit Maximums No Pre-existing condition limitations No Waiting periods No claim forms |
View Acrobat Reader File
of plan details: (click here) |
| Website: www.thedentalnet.org | Search for a dentist: Provider Choice |