Well, after years of not having any health care insurance, I finally did it.

I can't say I'm happy about it as it really is nothing short of a rip off... but me *****ing is NOT why I'm posting.

I just would like to hear what folks think. I'm 34 (almost 35), work out 4-5 days a week and VERY VERY active. Don't smoke, and drink only occasionally. No drugs, etc. (Male)

I got this:

Horizon Basic and Essential EPO Plan

Here are the details about it.

Plan Name
Horizon Basic and Essential EPO Plan
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Plan Type
EPO

Estimated Monthly Cost
$164.46

Primary Care Physician Required
No

Specialist Referrals Required
No

HSA Eligible
No

Out-of-Network Coverage
No

In-Network Coverage
Deductible
None

Coinsurance
None

Out-of-Pocket Limit
None

Office Visit
Primary Doctor
Illness and Injury office visits covered to $700 per covered person per calendar year

Specialist
Illness and Injury office visits covered to $700 per covered person per calendar year

Periodic Health Exam
$50 deductible, 20% coinsurance up to $600 wellness benefit per person per calendar year.

Periodic OB-GYN Exam
$50 deductible, 20% coinsurance up to $600 wellness benefit per person per calendar year.

Well Baby Care
$50 deductible, 20% coinsurance up to $600 wellness benefit per person per calendar year.

Chiropractic
Not Covered

Mental Health
Biologially based mental illness only - 30% Coinsurance, 30 visits per year

Prescription Drugs
Generic
Not Covered
Brand
Not Covered
Non-Formulary
Not Covered
Rx Deductible
None
Mail Order
Not Available

Lab/X-Ray
$500 maximum per covered person per calendar year.

Emergency Room
$100 Copay (waived if admitted)

Outpatient Surgery
$250 Copay

Hospitalization
$500 Copayment per period of confinement (90 days per covered person per calendar year)

Maternity
Pre & Postnatal Office Visit
Pre- and post-natal charges are covered when included in the delivery charge
Labor & Delivery Hospital Stay
$500 Copayment per period of confinement (90 days per covered person per calendar year)

Lifetime Maximum
Unlimited

Additional Information
Will insurance company obtain and pay for medical records?
N/A
eSign
(electronic signature)
Yes

A.M. Best Rating
A-pd
as of 10/08/2004
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