Medows Insurance Company
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Medical and Voluntary products: Dental, Life, and Short Term & Long Term Disabilities
• Individual Insurance
• Small, Medium and Large groups Insurance
• Medicare Supplement Insurance
• Short Term (Temporary) Insurance


Blue Cross - Blue Shield
PPO Select Choice Provides:
  Affordable, cost effective health coverage.
  Freedom to choose doctors and hospitals.
  Choice of deductibles
  Choice of out of pocket security provisions
  Three-tier prescription drug program
  Individual, spouse and child coverage's.
Prescription Drug Card Program
Options
 
Separate
Deductibles
Prescription Drug Card Program
Individual
(per year)
Copayment Amounts
Max Benefits
(per year) 
Gener Preferd Nonpref
Plan I
Plan II
$100
$15
$25
$40
$1,500
Plan III
Plan IV
$200
$15
$25
$40
$1,500
Plan V
Plan VI
$300
$15
$25
$40
$1,500
Value  
Feature for feature, PPO Select Choice offers comprehensive major medical insurance for individuals and their families.
$5,000,000 lifetime maximum benefit.
Inpatient hospital benefits and professional care (Preventative care)
Outpatient professional care (including office visits, X-rays, lab and diagnostic services
24-hour, worldwide emergency care
Well-child care (routine physical exams and developmental assessment through age 7)
Immunization benefits (thought age 7)
Human organ and tissue transplant benefits ($300,000 lifetime maximum) 
Home health care, hospice and skilled nursing facility benefits (subject to limitations)
Age banded rates for child only coverage
Access to one of the largest provider networks in the state, Blue Choice
Security of one of the most widely recognized insurance cards - Blue Cross and Blue Shield of Texas
Three tier pricing prescription drug plan
BlueCard program
Optional Dental
 
Options at a Glance
Options
Calendar Year Deductibles
Copayment
Amounts 
Calendar Year out of Pocket
Maximum / Security Provisions
Coinsurance**
Individual
InNetwork
Individual
OutNetwork
Family
InNetwork
Family
OutNetwork 
Office Visit*
Emergency
Care 
Individual
InNetwork
Individual
OutNetwork
Family
InNetwork
Family
OutNetwork 
InNetwork
OutNetwork
Plan
Pays 
You
Pay 
Plan
Pays 
You
Pay 
Plan I
$250
$500
$750
$1500
$25
80%
$3000
$5000
$6000
$10000
80%
20%
75%
25%
Plan II
$500
$1000
$1500
$3000
Plan III
$1000
$2000
$3000
$6000
Plan IV
$1500
$3000
$4500
$9000
Plan V
$2500
$5000
$7500
$15000
Plan VI
$5000
$10000
$15000
$30000
* Physician consultation only. All other Medical-sugical expense (lab & x-ray) will be subject to deductible & coinsurance amounts. 80% subject to the deductible
** Percentages apply to covered expenses after calander-year deductibles are met. Lifetime maximum is $2 million per person.

 

 

 

 

 

 

 

 

 

 

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