Agenda - Council - 11/22/1983 - Laserfiche WebLink

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~ ~ NOT A COMPLirI~ Dl//~--TRIPIION Ol~ BRRRlelTSo THE MAI~TER CONTRACT ~ OO'/~]t~I THE ADSfll~ISTRATION O1~ AIL ~ COMPARISON OF BENEFITS IN GROUP HEALTH, pHYSIcIANS HEALTH AND MEDCENTERS HEALTH PLANS (F.~eetive January I, 1984) GROUP HEALTH PHYSICIANS HEALTH MEDCENTER$ HEAI~TH PLAN PLAN PLAN il. I I I I I I I I ~urgery for congenital defects Obst err ie al procedure Anesthesia In-hospital physician's fees. Surgery out of area OUTPATIENT Drugs under outpatient services Office and clinic visits. Eye exams including refractions Routine immunizations B. Covered in full if provided by GHP physician or non- GHP physician upon referral. C. Same as #3A above. D. Same as {~3A above. E. Same as #3A above. F. Same as #3A above. Drugs prescribed by GHP physicians may be pur- chased at Group Health pharmacies. You pay no more than $2.00 per pre- scription for a 34-day supply or term of therapy, whichever is less. No coverage for drugs purchased else- where. B. Covered if provi- ded or ordered by GHP physician. C. Covered if provided or ordered by GHP physician. D. Covered if provided or ordered by GHP physician. If congenital anomaly was not known, diagnosed, and/ or treated prior to member~ effective date of coverage, covered in full if services provided by PHP physician. You pay 25~ of eligible expenses (not applicable to physician office services), up to a maximum co-payment of $1500 per hospital 'eon- fin,merit if congenital anomaly was known, diagnosed, and/or treated prior to dependent~ effective data of coverage. C. Same as #3A above. D. Same as ~3A above. E. Same as ~3A above. F. Same as #3A above. Drugs prescribed by PHP physicians may be pur- chased at PHP pharmacies. You pay no more than $3.50 per prescription or refill for each 34-day supply (3 month supply for birth control pills). Emergency prescriptions through non- PHP pharmacies subject to . co-payment schedule. Be De Covered if provided by PHP physician. You pay $3.00 per office visit for phy- sician services except for well-baby care, immuniza- tions, and routine periodic health evaluations. PHP pays balance. Covered if provided or ordered by PHP physician. You pay $15.00 when a fraction is involved and $3.00 for all other eye exams; PHP pays balance. Covered if ordered or pro- vided by PHP physician. B. Covered in full if provided by MCHP physician or non- MCHP physician upon referral. C. Same as #3A above. D. Same as #3A above. E. Same as #3A above. F. Same as 13A above. QpDrugs prescribed by MCHP hysieians may be pur- chased at MCHP pharma- cies. You pay no more than $3.00 per prescrip- tion or refill for each 30-day supply (3 month supply for birth control phis) or 100 units, whichever is greater, emergency prescriptions through non-MCHP phar- macies are subject to co-payment schedule. Covered if provided or ordered by MCHP physician. C. Covered if provided or ordered by MCHP physician. D. Covered if provided or ordered by 51CHP physician.