Benefits shown are for services received from an in-network provider.
|
Preferred Provider Plan PPO with Prescription Drug |
|---|
| Annual deductible None |
|
Annual Out-of-pocket Maximum |
|
Annual Preventive Health Evaluation: Office Visits: You pay 10% for these services:
You pay 20% for these services:
Emergency Room: |
|
Preferred Provider Plan PPO |
|
CompMED with Prescription Drug |
|---|
| Annual deductible $300 per person $900 (max) per family |
|
Annual Out-of-pocket Maximum |
|
Annual Preventive Health Evaluation: Office Visits: You pay 20% for these services:
Outpatient Laboratory: Emergency Room: |
|
CompMED |
|
Health Plan Hawaii Plus HMO with Prescription Drug |
|---|
| Annual deductible None |
|
Annual Out-of-pocket Maximum |
|
Annual Preventive Health Evaluation: Office Visits: You pay $0 for these services:
You pay 10% for these services:
Emergency Room: Hospital Room and Board: |
|
Health Plan Hawaii Plus HMO
|
with Prescription Drug
Annual deductible$2,500 per person
$7,500 (max) per family
Preferred Provider Plan PPO
Plan documents
with Prescription Drug
Annual deductibleCompMED
Plan documents
with Prescription Drug
Annual deductible
None
Annual Out-of-pocket Maximum
$2,500 per person
$7,500 (max) per family
Health Plan Hawaii Plus HMO
Plan documents