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Statewide PPO |
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PPO
PLANS
IN
LOUISIANA. |
| Benefits | Statewide PPO | ||
| Lifetime Maximum |
$5,000,000.00 | ||
| Deductible choice |
$100, $250, $500, $750 | ||
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$1,000,$2,500,even $5,000 | |||
| Maximum Out of Pocket |
$1,000 + deductible | ||
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| Co-Insurance % |
80% InNetWork/60% OutofNetWorkl | ||
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| Doctor Office Visits |
$20 Co-pay In Network | ||
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| State Mandated Benefits |
Routine
Pap
Smear;PSA;Mammogram covered with no Deductible | ||
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| Rx Card |
$10 Gen $20 Brand $40 Brand* | ||
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up through the $750 deductible | |||
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(Discount only @ $1000) | |||
| Maternity |
Optional, Covered as any other illness | ||
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| Request a Quote ! | |||
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