Out of Pocket Calculator Help

Point of Service

Point of Service is one of the models to select from in the Select a Plan Model portion of the Plan Information section in the General Plan Information Sheet. Point of Service plans are HMO type health plans that include a benefit for non participating providers. Thus Point of Service plans function similarly to PPOs. The Point of Service Benefit model assumes the following default benefit features:

General Individual Deductible: $200
General Family Deductible: $550
Inpatient Deductible Per Admission- Participating Hospitals: $250
Inpatient Deductible Per Admission- Non-Participating Hospitals: $250
Coinsurance- Participating Hospitals: None
Coinsurance- Non-Participating Hospitals: 30%
Maximum Allowable Per Day- Non Participating Hospitals: NA
Maximum Individual Annual Out of Pocket – Participating Providers: $2,500
Maximum Individual Annual Out of Pocket – Non Participating: $3,000
Maximum Family Annual Out of Pocket – Participating Providers: $4,000
Maximum Family Annual Out of Pocket – Non Participating: $6,000