Questions
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Who is the current Prime Minister of Canada?
I can't answer your question as I am trained to answer SBC related information, if you have a question in that direction please feel free to ask your query.
No Label
Are preventive care/ screenings/ and immunizations covered?
Yes/ with no charge
SBC1
What is the cost of diagnostic tests such as X-rays and blood work?
Diagnostic tests such as X-rays and blood work are covered without charge under the plan. This applies to in-network services, while a 20% co-insurance applies for out-of-network services.
SBC1
What is the out-of-pocket limit for this plan?
Individual: $240000/ Family: $50000
SBC2
Are children's eye exams covered?
No
SBC1
Are mental health/ behavioral health/ or substance abuse services covered?
Yes-B
SBC2
How does using a network provider affect costs?
Using a network provider can reduce healthcare costs. The plan operates a provider network, and individuals will pay less if they use a provider within this network. Conversely, using an out-of-network provider will incur higher costs, and individuals might receive a bill from the provider for the difference between the provider’s charge and what the plan pays.
SBC2
How much does the plan cover for diagnostic tests such as X-rays and blood work?
The plan covers the total cost of diagnostic tests such as X-rays and blood work for in-network services. However, a 20% co-insurance applies for out-of-network services.
SBC1
Will you pay less if you use a network provider?
Yes
SBC1
Are children's eye exams covered?
Yes
SBC2
What is not included in the out-of-pocket limit?
Premiums/ balance-billed charges/ any pharmacy penalty/ and health care this plan doesn't cover
SBC1
What are the costs associated with mental health, behavioral health, or substance abuse services?
Mental health, behavioral health, or substance abuse services are covered without charge under the plan for both outpatient and inpatient services in-network. However, a 30% co-insurance applies for out-of-network services.
SBC2
Does the plan cover services before meeting the deductible?
Yes
SBC1
What is the OMB control number and expiration date for DOL?
1210-0147 and 5/31/2022
SBC1
What percentage of the cost does the plan cover for mental health, behavioral health, or substance abuse services?
The plan covers the total cost for both outpatient and inpatient services related to mental health, behavioral health, or substance abuse for in-network services. However, a 30% co-insurance applies for out-of-network services.
SBC2
What services does the plan cover before the deductible is met?
The plan covers certain items and services even before the deductible is met. However, a copayment or coinsurance may apply. For instance, the plan covers specific preventive services without cost-sharing and before the deductible is met. A comprehensive list of covered preventive services is available on the healthcare.gov website.
SBC2
Are there services covered before you meet your deductible?
Yes
SBC1
Does the plan meet the Minimum Value Standards?
No
SBC2
What is the fastest land animal?
I can't answer your question as I am trained to answer SBC related information, if you have a question in that direction please feel free to ask your query.
No Label
What is the cost for diagnostic tests such as x-rays and blood work?
$5000
SBC2
What proportion of the costs for emergency medical attention does the plan cover?
For emergency room care, the plan requires a $250 co-pay, after which it covers the remaining cost. However, the co-pay is waived if the individual is admitted to the hospital following the emergency room visit or for an accidental injury. Emergency medical transportation is covered without charge.
SBC1
Is adult dental care covered?
Yes
SBC2
Is adult dental care covered?
No
SBC1
What is the percentage of cost covered for generic drugs?
The cost for generic drugs is $10 for a 34-day supply or $20 for a 90-day supply. The percentage of the cost covered by the plan would depend on the total cost of the drugs, but the individual's cost would not exceed the stated amounts.
SBC1
Do you need a referral to see a specialist?
No
SBC1
What is the overall deductible for in-network and out-of-network services in this health plan?
The overall deductible for in-network services is $100 for an individual and $200 for a family. For out-of-network services, the deductible is $250 for an individual and $500 for a family. Generally, the individual must pay all of the costs from providers up to the deductible amount before the plan begins to pay.
SBC1
What percentage of the cost does the plan cover for outpatient surgery?
The plan covers the total cost of outpatient surgery, including the facility fee and physician/surgeon fees, for in-network services. However, a 30% co-insurance applies if the services are provided out-of-network.
SBC2
Does the plan cover services before you meet your deductible?
Yes
SBC1
Can individuals see a specialist without a referral?
Yes, individuals can see the specialist of their choice without a referral under this health plan. This offers greater flexibility and convenience, allowing individuals to access specialist services without the need for a referral from another healthcare provider.
SBC1
What is the cost for preferred brand drugs?
20 for 44-day supply/ 40 for 100-day supply
SBC2
Who was the President of the United States in 1980?
I can't answer your question as I am trained to answer SBC related information, if you have a question in that direction please feel free to ask your query.
No Label
What is the cost for childbirth/delivery facility services?
No charge
SBC2
What is the out-of-pocket limit for this plan?
Individual: $2000/ Family: $4000
SBC1
Does the plan meet the Minimum Value Standards?
Yes
SBC1
What are the cost-sharing amounts for the coverage examples?
Deductibles/ Copayments/ Coinsurance
SBC2
What are the cost-sharing amounts for the coverage examples?
Deductibles/ Copayments/ Coinsurance
SBC1
Are there any services that the plan does not cover?
Yes
SBC1
What is the cost of prescription drug coverage?
20 for 44-day supply/ 40 for 100-day supply
SBC2
What are the costs associated with a hospital stay?
The costs associated with a hospital stay, such as the facility fee for the hospital room and the physician/surgeon fees, are covered by the health plan with no charge. However, it's important to remember that other costs may apply, depending on the specific services received during the hospital stay.
SBC2
What is the total cost Joe would pay for managing Type 2 Diabetes?
340
SBC1
What is the cost for rehabilitation services?
No charge
SBC1
Can individuals see a specialist without a referral?
No
SBC2
What is the role of the Glossary in understanding the health plan?
The Glossary plays a crucial role in helping individuals understand common terms related to health plans. It provides definitions for terms such as allowed amount, balance billing, coinsurance, copayment, deductible, provider, and other underlined terms. This aids in understanding the terms of coverage, cost-sharing, and other aspects of the health plan.
SBC1
What is the cost for generic drugs?
20 for 44-day supply/ 40 for 100-day supply
SBC2
What is the cost for home health care?
No charge
SBC1
What is the average temperature in Miami in February?
I can't answer your question as I am trained to answer SBC related information, if you have a question in that direction please feel free to ask your query.
No Label
What is the cost coverage for a hospital stay under the plan?
The plan covers the total costs associated with a hospital stay, such as the facility fee for the hospital room and the physician/surgeon fees, for in-network services. However, a 30% co-insurance applies for out-of-network services.
SBC2
What is the cost for emergency room care?
250 co-pay
SBC1
How much does outpatient surgery cost?
$9000
SBC2
What is the OMB control number and expiration date for DOL?
2000-0148 and 8/31/2023
SBC2
How much does urgent care cost?
25 co-pay
SBC1
What are some of the services covered before meeting the deductible?
This health plan covers some items and services even if the deductible amount has not been met. However, a copayment or coinsurance may apply. For example, this plan covers certain preventive services without cost-sharing and before you meet your deductible. This includes services like routine check-ups, screenings, and immunizations.
SBC1
What is the cost of emergency medical attention?
Emergency medical attention, including emergency room care, carries a $250 co-pay under the plan. However, the co-pay is waived if the individual is admitted to the hospital following the emergency room visit or for an accidental injury. Emergency medical transportation is covered without charge.
SBC1
What is the OMB control number and expiration date for HHS?
0938-1146 and 10/31/2022
SBC1
What costs are not included in the out-of-pocket limit?
The out-of-pocket limit does not include premiums, balance-billed charges, any pharmacy penalty, and health care that the plan doesn’t cover. While these expenses are paid by the individual, they do not count toward the out-of-pocket limit.
SBC1
What is the cost for rehabilitation services?
No charge
SBC2
What is the percentage of cost covered for preferred brand drugs?
The cost for preferred brand drugs is $20 for a 34-day supply or $40 for a 90-day supply. The percentage of the cost covered by the plan would depend on the total cost of the drugs, but the individual's cost would not exceed the stated amounts
SBC1
Are there services covered before you meet your deductible?
No
SBC2
What is the total cost Mia would pay for a simple fracture?
150
SBC2
How much does outpatient surgery cost?
No charge
SBC1
What is the cost coverage for pregnancy and childbirth services?
The plan covers the total cost of pregnancy and childbirth services, including office visits, professional services for childbirth/delivery, and facility services for childbirth/delivery, for in-network services. However, a 20% co-insurance applies for out-of-network services.
SBC1
Why is it advantageous to use a network provider?
Using a network provider is advantageous as it reduces the cost of healthcare services. The plan uses a provider network and individuals will pay less if they use a provider in the plan’s network. However, using an out-of-network provider might result in higher costs and individuals might receive a bill from a provider for the difference between the provider’s charge and what the plan pays, a practice known as balance billing.
SBC1
How much does urgent care cost?
No charge-B
SBC2
What is the capital of Australia?
I can't answer your question as I am trained to answer SBC related information, if you have a question in that direction please feel free to ask your query.
No Label
What is the cost for rehabilitation services?
No charge
SBC1
What is the distance between the Earth and the Moon?
I can't answer your question as I am trained to answer SBC related information, if you have a question in that direction please feel free to ask your query.
No Label
How much is the co-pay for a specialist visit?
80
SBC2
What is the cost of emergency room care?
The cost of emergency room care under this health plan is a $250 co-pay. However, the co-pay is waived if the individual is admitted to the hospital following the emergency room visit or for an accidental injury.
SBC1
What is the total cost Joe would pay for managing Type 2 Diabetes?
150
SBC2
What is the cost for a hospital stay?
$600
SBC2
What is the record for the most home runs in a single season?
I can't answer your question as I am trained to answer SBC related information, if you have a question in that direction please feel free to ask your query.
No Label
What is the cost of diagnostic tests such as X-rays and blood work?
Diagnostic tests such as X-rays and blood work are covered without charge under the plan. This applies to in-network services, while a 30% co-insurance applies for out-of-network services.
SBC2
Can you see a specialist without a referral?
,Yes, this health plan does not require a referral to see a specialist. This means that individuals have the freedom to choose their specialist and access their services without the need for a referral from another healthcare provider.
SBC1
What is the cost for childbirth/delivery professional services?
No charge
SBC2
What is the purpose of the Summary of Benefits and Coverage (SBC) document?
The Summary of Benefits and Coverage (SBC) document is designed to help individuals choose a health plan. It provides an overview of how the cost for covered health care services would be shared between the individual and the plan. However, it does not include information about the cost of the plan (known as the premium), which is provided separately. For more detailed information about the coverage, individuals can visit the specified website or make a phone call to the provided number.
SBC1
Who won the Best Actor Oscar in 2001?
I can't answer your question as I am trained to answer SBC related information, if you have a question in that direction please feel free to ask your query.
No Label
Are children's dental check-ups covered?
Yes
SBC2
What is the cost for emergency room care?
No charge-B
SBC2
Does the plan provide Minimum Essential Coverage?
No
SBC2
Are children's dental check-ups covered?
No
SBC1
Are mental health/ behavioral health/ or substance abuse services covered?
Yes
SBC1
What is the cost of emergency medical attention?
Emergency medical attention, including emergency room care, carries a $255 co-pay under the plan. However, the co-pay is waived if the individual is admitted to the hospital following the emergency room visit or for an accidental injury. Emergency medical transportation is covered without charge.
SBC2
What does the out-of-pocket limit refer to and what does it include?
The out-of-pocket limit is the maximum amount an individual could pay in a year for covered services. If there are other family members in the plan, they have to meet their own out-of-pocket limits until the overall family out-of-pocket limit has been met. It is important to note that the out-of-pocket limit does not include premiums, balance-billed charges, any pharmacy penalty, and health care that the plan doesn’t cover.
SBC1
What proportion of the costs for emergency medical attention does the plan cover?
For emergency room care, the plan requires a $140 co-pay, after which it covers the remaining cost. However, the co-pay is waived if the individual is admitted to the hospital following the emergency room visit or for an accidental injury. Emergency medical transportation is covered without charge.-B
SBC2
What is the cost for a physician's visit during a hospital stay?
No charge
SBC2
Is cosmetic surgery covered?
Yes
SBC2
Is acupuncture covered?
No
SBC1
Who is the current CEO of Apple?
I can't answer your question as I am trained to answer SBC related information, if you have a question in that direction please feel free to ask your query.
No Label
What is the cost for generic drugs?
10 for 34-day supply/ 20 for 90-day supply
SBC1
What is the overall deductible for in-network and out-of-network services in this health plan?
The overall deductible for in-network services is $300 for an individual and $205 for a family. For out-of-network services, the deductible is $400 for an individual and $505 for a family. Generally, the individual must pay all of the costs from providers up to the deductible amount before the plan begins to pay.
SBC2
Does the plan provide Minimum Essential Coverage?
Yes
SBC1
How much is the co-pay for a specialist visit?
20
SBC1
Why is it advantageous to use a network provider?
Using a network provider is advantageous as it reduces the cost of healthcare services. The plan uses a provider network and individuals will pay less if they use a provider in the plan’s network. However, using an out-of-network provider might result in higher costs and individuals might receive a bill from a provider for the difference between the provider’s charge and what the plan pays, a practice known as balance billing.
SBC2
What percentage of the cost does the plan cover for outpatient surgery?
The plan covers the total cost of outpatient surgery, including the facility fee and physician/surgeon fees, for in-network services. However, a 20% co-insurance applies if the services are provided out-of-network.
SBC1
Who can be contacted for grievances and appeals?
Blue Cross and Blue Shield of Michigan/ Michigan Office of Financial and Insurance Regulation/ Employee Benefits Security Administration
SBC1
What is the cost of outpatient surgery?
$400
SBC2
What is the tallest mountain in the world?
I can't answer your question as I am trained to answer SBC related information, if you have a question in that direction please feel free to ask your query.
No Label
What percentage of the cost is covered for in-network primary care visits?
In-network primary care visits require a $30 co-pay, after which the plan covers the remaining cost. The exact percentage covered by the plan would depend on the total cost of the visit, but the individual's cost would not exceed the $30 co-pay.
SBC2
Are children's glasses covered?
No
SBC1
What is the overall deductible for this plan?
The overall deductible for in-network services is $200 for an individual and $205 for a family. For out-of-network services, the deductible is $400 for an individual and $505 for a family.
SBC2

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