Insurance

Insurance Contact:
Derek Dick | Main: 785 584-6043

Fusion Health PPO $2000 Rx Benefit Summary Guide:
BenefitPrimary InsuranceSupplemental CoverageWhat You Owe?
Deductible/Benefit
Individual/Family
$7,500/$15,000$5,500/$11,000$2000/$4000
Plan Pays100% after deductible100% 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 copayNo Coverage$10 copay
Specialist Care Office Visits$40 copayNo Coverage$40 copay
Urgent Care Visit$50 copayNo Coverage$50 copay
Telemedicine$0 copayNo Coverage$0 copay
Emergency Room$250 copayNo Coverage$250 copay
Emergency Transportation100% after deductible100% after deductibleUp to $2,000 deductible
Preventive Care / Screening/ImmunizationNo ChargeNo Coverage$0
Diagnostic Test (X-Ray, Blood Work)$10 CopayNo Coverage$10 Copay
Imaging (CT/PET scans/MRI’s)100% after deductible100% after deductibleUp to $2000 deductible (Can be $0 copay if using Rezilient steerage)
Outpatient Surgery (Ambulatory Surgery Center)100% after deductible100% after deductibleUp to $2,000 deductible (Can be $0 copay if using Rezilient steerage)
Physician/Surgeon Fees100% after deductible100% after deductibleUp to $2,000 deductible (Can be $0 copay if using Rezilient Steerage)
Mental Health, Behavioral Health, Substance Abuse Office Visit$10 copayNo Coverage$10 copay
Mental Health, Behavioral Health, Substance Abuse Outpatient Visit100% after deductible100% after deductibleUp to $2,000 deductible
Mental Health, Behavioral Health, Substance Abuse Inpatient Visit100% after deductible100% after deductibleUp to $2,000 deductible