Plan Examples:
Example 1
You receive treatment early in the year for a gallbladder problem. Your bills for a doctors visit, sonogram, surgery, lab work, medications and follow up with the doctor totals to be $9,000. Because you are self pay the medical providers have given you a total of $3,000 self-pay discounts.
Gold plan coverage:
CHM pays $6,000 ($9,000 - $3,000), which is 100 percent of the cost after discounts. The Gold plan covers doctor visits (including follow up), surgery, lab work and medication during a covered medical incident.
CHM pays 100% of the cost
(after discounts) with the
Gold plan, in this example
Silver Plan coverage:
With the Silver plan, you have a personal responsibility of $1,000 (see it as a 'deductible'. Also the Silver plan does not cover doctor visits and medication. So your reimbursement won't be $5,000!
The total reimbursement will be $6,000 - $1,000 - doctors visit cost - medication cost.
Bronze Plan coverage:
With the Bronze plan, you have a personal responsibility of $5,000 ('deductible'). Make sure that if you consider the Bronze plan, that you have $5,000 or more available because in case of a medical event, the first $5,000 would be your responsibility!
In this example CHM would pay less than $1,000 to you as there is no coverage for your doctor visit and medication bill. I highly recommend you choose the Gold plan, or the Silver plan.
Example 2
In the middle of the same year you have some blood tests done for an unrelated illness. The total cost was $450. CHM does not share any of these bills because the total cost of the incident is less than $500.
The gold plan pays if your bill is over $500. The Silver plan pays if your bill is over $1,000 and the Bronze plan pays if your bills are over $5,000.
Here is a great way to pay for the $450 (click)
Example 3
At the end of the year you break your arm and the treatment amounts to $2,000.
Gold plan coverage:
CHM pays $2,000 which is 100 percent of the cost after discounts. The Gold plan covers doctor visits (including follow up), surgery, x-rays, lab work and medication during a covered medical incident.
Silver Plan coverage:
With the Silver plan, you have a personal responsibility of $1,000 (see it as a 'deductible'. The Silver plan does not cover doctor visits and medication. So your reimbursement won't be $1,000, it will be less due to the restrictions of the Silver plan.
Bronze Plan coverage:
With the Bronze plan, you have a personal responsibility of $5,000 ('deductible'). Make sure if you consider the Bronze plan, that you have $5,000 or more available because in case of a medical event, the first $5,000 would be your responsibility!
In this example CHM would pay nothing, as the first $5,000 would be your responsibility before any bills get shared.
Again, I highly recommend you choose the Gold plan, or the Silver plan.
