{"id":74,"date":"2014-10-06T12:50:45","date_gmt":"2014-10-06T16:50:45","guid":{"rendered":"https:\/\/www.bu.edu\/hr\/?page_id=74"},"modified":"2024-03-12T20:40:07","modified_gmt":"2024-03-13T00:40:07","slug":"health-plan-comparison","status":"publish","type":"page","link":"https:\/\/www.bu.edu\/hr\/health-wellness\/health\/health-plan-comparison\/","title":{"rendered":"Health Plan Comparison"},"content":{"rendered":"
\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
\n

BCBS PPO Plan<\/h1>\n<\/th>\n

<\/th>\n\n

BU Health Savings Plan<\/h1>\n<\/th>\n<\/tr>\n

\n

BCBS National PPO Network<\/h2>\n<\/th>\n

\n

Out-of-Network Providers<\/h2>\n<\/th>\n

<\/th>\n\n

In-Network<\/h2>\n<\/th>\n

\n

Out-of-Network<\/h2>\n<\/th>\n<\/tr>\n

\n

BMC Providers<\/h3>\n<\/th>\n

\n

All Other Network Providers<\/h3>\n<\/th>\n

<\/th>\n<\/th>\n<\/th>\n<\/th>\n<\/th>\n<\/tr>\n<\/thead>\n
\n

Applied Behavior Analysis<\/h2>\n<\/td>\n

<\/td>\n\n

Applied Behavior Analysis<\/h2>\n<\/td>\n<\/tr>\n

$15 copayment per visit (deductible does not apply)<\/td>\n$35 copayment per visit (deductible does not apply)<\/td>\n30% coinsurance after deductible<\/td>\n<\/td>\nNot Covered<\/td>\nNot Covered<\/td>\n<\/tr>\n
\n

Chiropractic Care<\/h2>\n<\/td>\n

<\/td>\n\n

Chiropractic Care<\/h2>\n<\/td>\n<\/tr>\n

$35 copayment per visit (deductible does not apply);
\n20 visits per calendar year<\/td>\n		$35 copayment per visit (deductible does not apply);
\n20 visits per calendar year<\/td>\n		30% coinsurance after deductible;
\n20 visits per calendar year<\/td>\n		<\/td>\n12% coinsurance after deductible;
\n20 visits per calendar year<\/td>\n		30% coinsurance after deductible;
\n20 visits per calendar year<\/td>\n<\/tr>\n
\n

Drug and Alcohol Treatment<\/h2>\n<\/td>\n

<\/td>\n\n

Drug and Alcohol Treatment<\/h2>\n<\/td>\n<\/tr>\n

Inpatient<\/strong> No charge after deductible<\/td>\nInpatient<\/strong> Low Cost Provider: No Charge after deductible
\nHigh Cost Provider: 20% after deductible<\/td>\n		Inpatient<\/strong> 30% coinsurance after deductible<\/td>\n<\/td>\nInpatient<\/strong> 12% coinsurance after deductible<\/td>\nInpatient<\/strong> 30% coinsurance after deductible<\/td>\n<\/tr>\n
Outpatient<\/strong> No charge after deductible<\/td>\nOutpatient<\/strong> Low Cost Provider: No Charge after deductible
\nHigh Cost Provider: 20% after deductible<\/td>\n		Outpatient<\/strong> 30% coinsurance after deductible<\/td>\n<\/td>\nOutpatient<\/strong> 12% coinsurance after deductible<\/td>\nOutpatient<\/strong> 30% coinsurance after deductible<\/td>\n<\/tr>\n
Office Visits<\/strong> $15 copayment per visit (deductible does not apply)<\/td>\nOffice Visits<\/strong> $35 copayment per visit (deductible does not apply)<\/td>\nOffice Visits<\/strong> 30% coinsurance after deductible<\/td>\n<\/td>\nOffice Visits<\/strong> 12% coinsurance after deductible<\/td>\nOffice Visits<\/strong> 30% coinsurance after deductible<\/td>\n<\/tr>\n
\n

Durable Medical Equipment<\/h2>\n<\/td>\n

<\/td>\n\n

Durable Medical Equipment<\/h2>\n<\/td>\n<\/tr>\n

10% coinsurance after deductible<\/td>\n12% coinsurance after deductible<\/td>\n30% coinsurance after deductible<\/td>\n<\/td>\n12% coinsurance after deductible<\/td>\n30% coinsurance after deductible<\/td>\n<\/tr>\n
\n

Emergency Room<\/h2>\n<\/td>\n

<\/td>\n\n

Emergency Room<\/h2>\n<\/td>\n<\/tr>\n

$150 copayment per visit(deductible does not apply); copayment waived if held for observation or admitted within 24 hours<\/td>\n<\/td>\n12% coinsurance after deductible<\/td>\n12% coinsurance after deductible<\/td>\n<\/tr>\n
\n

Family Planning<\/h2>\n<\/td>\n

<\/td>\n\n

Family Planning<\/h2>\n<\/td>\n<\/tr>\n

$15 copayment per visit (deductible does not apply)<\/td>\n$35 copayment per visit (deductible does not apply)<\/td>\n30% coinsurance after deductible<\/td>\n<\/td>\n12% coinsurance after deductible<\/td>\n30% coinsurance after deductible<\/td>\n<\/tr>\n
\n

Hospital Benefits<\/h2>\n<\/td>\n

<\/td>\n\n

Hospital Benefits<\/h2>\n<\/td>\n<\/tr>\n

General Hospital<\/strong> No charge after deductible<\/td>\nGeneral Hospital<\/strong> Low Cost Provider: 12% after deductible;
\nHigh Cost Provider: 20% after deductible<\/td>\n		General Hospital<\/strong> 30% coinsurance after deductible<\/td>\n<\/td>\nGeneral Hospital<\/strong> 12% coinsurance after deductible<\/td>\nGeneral Hospital<\/strong> 30% coinsurance after deductible<\/td>\n<\/tr>\n
Skilled Nursing Facility<\/strong> 10% after deductible;
\n100-day benefit limit per member per calendar year<\/td>\n		Skilled Nursing Facility<\/strong> 12% after deductible;
\n100-day benefit limit per member per calendar year<\/td>\n		Skilled Nursing Facility<\/strong> 30% after deductible;
\n100-day benefit limit per member per calendar year<\/td>\n		<\/td>\nSkilled Nursing Facility<\/strong> 12% after deductible;
\n100-day benefit limit per member per calendar year<\/td>\n		Skilled Nursing Facility<\/strong> 30% after deductible;
\n100-day benefit limit per member per calendar year<\/td>\n<\/tr>\n
\n

Mental Health Benefits<\/h2>\n<\/td>\n

<\/td>\n\n

Mental Health Benefits<\/h2>\n<\/td>\n<\/tr>\n

Inpatient<\/strong> No Charge after deductible<\/td>\nInpatient<\/strong> Low Cost Provider: No Charge after deductible
\nHigh Cost Provider: 20% after deductible<\/td>\n		Inpatient<\/strong> 30% after deductible<\/td>\n<\/td>\nInpatient<\/strong> 12% after deductible<\/td>\nInpatient<\/strong> 30% after deductible<\/td>\n<\/tr>\n
Outpatient<\/strong> No Charge after deductible<\/td>\nOutpatient<\/strong> Low Cost Provider: No Charge after deductible
\nHigh Cost Provider: 20% after deductible<\/td>\n		Outpatient<\/strong> 30% after deductible<\/td>\n<\/td>\nOutpatient<\/strong> 12% after deductible<\/td>\nOutpatient<\/strong> 30% after deductible<\/td>\n<\/tr>\n
Office Visits<\/strong> $15 copayment per visit (deductible does not apply)<\/td>\nOffice Visits<\/strong> $35 copayment per visit (deductible does not apply)<\/td>\nOffice Visits<\/strong> 30% coinsurance after deductible<\/td>\n<\/td>\nOffice Visits<\/strong> 12% coinsurance after deductible<\/td>\nOffice Visits<\/strong> 30% coinsurance after deductible<\/td>\n<\/tr>\n
\n

MRIs, CT scans, Nuclear Cardiac Imaging & Lab Tests<\/h2>\n<\/td>\n

<\/td>\n\n

MRIs, CT scans, Nuclear Cardiac Imaging & Lab Tests<\/h2>\n<\/td>\n<\/tr>\n

No Charge after deductible<\/td>\nLow Cost Provider: 12% after deductible;
\nHigh Cost Provider: 20% after deductible<\/td>\n		30% coinsurance after deductible<\/td>\n<\/td>\n12% coinsurance after deductible<\/td>\n30% coinsurance after deductible<\/td>\n<\/tr>\n
\n

Physical Therapy<\/h2>\n<\/td>\n

<\/td>\n\n

Physical Therapy<\/h2>\n<\/td>\n<\/tr>\n

$15 copayment per visit (deductible does not apply); copayment waived for physical therapy furnished by BU Physical Therapy Center;
\nup to 60 visits per calendar year<\/td>\n		$35 copayment per visit (deductible does not apply);
\ncopayment waived for physical therapy furnished by BU Physical Therapy Center;
\nup to 60 visits per calendar year<\/td>\n		30% after deductible;
\nup to 60 visits per calendar year<\/td>\n		<\/td>\n12% after deductible;
\nup to 60 visits per calendar year<\/td>\n		30% after deductible;
\nup to 60 visits per calendar year<\/td>\n<\/tr>\n
\n

Physicians\u2019 Services<\/h2>\n<\/td>\n

<\/td>\n\n

Physicians\u2019 Services<\/h2>\n<\/td>\n<\/tr>\n

$15 copayment per visit (deductible does not apply)<\/td>\n$35 copayment per visit(deductible does not apply)<\/td>\n30% after deductible<\/td>\n<\/td>\n12% after deductible<\/td>\n30% after deductible<\/td>\n<\/tr>\n
\n

Preventive Care<\/h2>\n<\/td>\n

<\/td>\n\n

Preventive Care<\/h2>\n<\/td>\n<\/tr>\n

You pay nothing<\/td>\n30% after deductible<\/td>\n<\/td>\nYou pay nothing<\/td>\n30% after deductible<\/td>\n<\/tr>\n
\n

Preventive Eye Exams<\/h2>\n<\/td>\n

<\/td>\n\n

Preventive Eye Exams<\/h2>\n<\/td>\n<\/tr>\n

You pay nothing<\/td>\n30% after deductible<\/td>\n<\/td>\nYou pay nothing<\/td>\n30% after deductible<\/td>\n<\/tr>\n
\n

Preventive Mental Health Exams<\/h2>\n<\/td>\n

<\/td>\n\n

Preventive Mental Health Exams<\/h2>\n<\/td>\n<\/tr>\n

You pay nothing<\/td>\n30% after deductible<\/td>\n<\/td>\nYou pay nothing<\/td>\n30% after deductible<\/td>\n<\/tr>\n
\n

Deductible Per Calendar Year (single\/family)<\/h2>\n<\/td>\n

<\/td>\n\n

Deductible Per Calendar Year (single\/family)<\/h2>\n<\/td>\n<\/tr>\n

$500 per member \/$1,000 per family<\/td>\n$1,000 per member $2,000 per family<\/td>\n<\/td>\n$2,000 employee only $4,000 per family<\/td>\n$4,000 employee only $8,000 per family<\/td>\n<\/tr>\n
\n

Out-of-Pocket Maximum<\/h2>\n<\/td>\n

<\/td>\n\n

Out-of-Pocket Maximum<\/h2>\n<\/td>\n<\/tr>\n

$3,000 per member \/$6,000 per family<\/td>\n$6,000 per member \/$12,000 per family<\/td>\n<\/td>\n$4,000 employee only $8,000 per family<\/td>\n$8,000 employee only $16,000 per family<\/td>\n<\/tr>\n
\n

Lifetime Maximum<\/h2>\n<\/td>\n

<\/td>\n\n

Lifetime Maximum<\/h2>\n<\/td>\n<\/tr>\n

None<\/td>\n<\/td>\nNone<\/td>\n<\/tr>\n
\n

Provider Choice<\/h2>\n<\/td>\n

<\/td>\n\n

Provider Choice<\/h2>\n<\/td>\n<\/tr>\n

You must use a BMC network participating provider.<\/td>\nYou must use a BCBS National PPO network participating provider.<\/td>\nYou may use the provider of your choice.<\/td>\n<\/td>\nYou must use a BCBS National PPO network participating provider.<\/td>\nYou may use the provider of your choice.<\/td>\n<\/tr>\n
\n

Copayment<\/h2>\n<\/td>\n

<\/td>\n\n

Copayment<\/h2>\n<\/td>\n<\/tr>\n

$15 per visit for most covered services<\/td>\n$35 per visit for most covered services<\/td>\nDepending on the service, generally 30% coinsurance after deductible<\/td>\n<\/td>\nDepending on the service, generally 12% coinsurance after deductible<\/td>\nDepending on the service, generally 30% coinsurance after deductible<\/td>\n<\/tr>\n
\n

Benefit Level<\/h2>\n<\/td>\n

<\/td>\n\n

Benefit Level<\/h2>\n<\/td>\n<\/tr>\n

You pay nothing for inpatient services after deductible is met; $35 copayment per visit for some services<\/td>\nYou pay 12% for inpatient services at a low cost provider and 20% at a high cost provider after deductible is met; $35 copayment per visit for some services<\/td>\n30% coinsurance for most covered inpatient and outpatient services after deductible is met<\/td>\n<\/td>\n12% coinsurance for most covered inpatient and outpatient services after deductible is met<\/td>\n30% coinsurance for most covered inpatient and outpatient services after deductible is met<\/td>\n<\/tr>\n
\n

Claim Forms<\/h2>\n<\/td>\n

<\/td>\n\n

Claim Forms<\/h2>\n<\/td>\n<\/tr>\n

Not Required<\/td>\nRequired<\/td>\n<\/td>\nNot Required<\/td>\nRequired<\/td>\n<\/tr>\n
\n

Prescription Drugs<\/h2>\n<\/td>\n

<\/td>\n\n

Prescription Drugs<\/h2>\n<\/td>\n<\/tr>\n

Out of Pocket Maximum<\/strong>
\n$2,500 per member \/ $5,000 per family Retail Pharmacy for up to 30 day supply:
\n<\/strong>Generic Medications
\n<\/strong>$10 copaymentPreferred Brand Name
\n<\/strong>20% coinsurance(minimum cost $45; maximum cost $65\/prescription)Non-preferred Brand Name<\/strong><\/strong>30% coinsurance(minimum cost $65; maximum cost $85\/prescription)Home Delivery for up to 90 day supply:30 day supply limit at retail; 90 day supply limit at mail-order or CVS retail <\/span>Generic Medications
\n<\/strong>$20 copayment<\/p>\n

Preferred Brand Name
\n<\/strong>20% coinsurance(minimum cost $90; maximum cost $130\/prescription)<\/p>\n

Non-preferred Brand Name
\n<\/strong>30% coinsurance(minimum cost $130; maximum cost $170\/prescription)<\/td>\n

Not Covered<\/td>\n<\/td>\n12% after deductible<\/td>\nNot Covered<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n

<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

BCBS PPO Plan BU Health Savings Plan BCBS National PPO Network Out-of-Network Providers In-Network Out-of-Network BMC Providers All Other Network Providers Applied Behavior Analysis Applied Behavior Analysis $15 copayment per visit (deductible does not apply) $35 copayment per visit (deductible does not apply) 30% coinsurance after deductible Not Covered Not Covered Chiropractic Care Chiropractic Care […]<\/p>\n","protected":false},"author":8774,"featured_media":0,"parent":15,"menu_order":14,"comment_status":"closed","ping_status":"closed","template":"page-templates\/comparison.php","meta":[],"_links":{"self":[{"href":"https:\/\/www.bu.edu\/hr\/wp-json\/wp\/v2\/pages\/74"}],"collection":[{"href":"https:\/\/www.bu.edu\/hr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.bu.edu\/hr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/hr\/wp-json\/wp\/v2\/users\/8774"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/hr\/wp-json\/wp\/v2\/comments?post=74"}],"version-history":[{"count":52,"href":"https:\/\/www.bu.edu\/hr\/wp-json\/wp\/v2\/pages\/74\/revisions"}],"predecessor-version":[{"id":21398,"href":"https:\/\/www.bu.edu\/hr\/wp-json\/wp\/v2\/pages\/74\/revisions\/21398"}],"up":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/hr\/wp-json\/wp\/v2\/pages\/15"}],"wp:attachment":[{"href":"https:\/\/www.bu.edu\/hr\/wp-json\/wp\/v2\/media?parent=74"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}