Insurance Contact:
Derek Dick | Main: 785 584-6043
Fusion Health PPO $2000 Rx Benefit Summary Guide:
Benefit | Primary Insurance | Supplemental Coverage | What You Owe? |
Deductible/Benefit Individual/Family | $7,500/$15,000 | $5,500/$11,000 | $2000/$4000 |
Plan Pays | 100% after deductible | 100% after deductible | $0 after deductible |
Max Out-of-Pocket Individual/Family | $7,500/$15,000 (Includes deductible, copays, prescription drug copays, & other qualified expenses) | $2,000/$4,000 (Includes ONLY deductible expenses. Does NOT cover copays, prescriptions, & other qualified expenses) | $7,500/$15,000 (Includes deductible, copays, prescription drug copays, & other qualified expenses) |
Primary Care Office Visits | $10 copay | No Coverage | $10 copay |
Specialist Care Office Visits | $40 copay | No Coverage | $40 copay |
Urgent Care Visit | $50 copay | No Coverage | $50 copay |
Telemedicine | $0 copay | No Coverage | $0 copay |
Emergency Room | $250 copay | No Coverage | $250 copay |
Emergency Transportation | 100% after deductible | 100% after deductible | Up to $2,000 deductible |
Preventive Care / Screening/Immunization | No Charge | No Coverage | $0 |
Diagnostic Test (X-Ray, Blood Work) | $10 Copay | No Coverage | $10 Copay |
Imaging (CT/PET scans/MRI’s) | 100% after deductible | 100% after deductible | Up to $2000 deductible (Can be $0 copay if using Rezilient steerage) |
Outpatient Surgery (Ambulatory Surgery Center) | 100% after deductible | 100% after deductible | Up to $2,000 deductible (Can be $0 copay if using Rezilient steerage) |
Physician/Surgeon Fees | 100% after deductible | 100% after deductible | Up to $2,000 deductible (Can be $0 copay if using Rezilient Steerage) |
Mental Health, Behavioral Health, Substance Abuse Office Visit | $10 copay | No Coverage | $10 copay |
Mental Health, Behavioral Health, Substance Abuse Outpatient Visit | 100% after deductible | 100% after deductible | Up to $2,000 deductible |
Mental Health, Behavioral Health, Substance Abuse Inpatient Visit | 100% after deductible | 100% after deductible | Up to $2,000 deductible |