Assurant OneDeductible PPO 1,600 - 100% after deductible Single

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ASSURANT Health Time Insurance Company

OneDeductible PPO $1,600 100% after deductible Single California Health Insurance Plan

A plan summary of the Assurant California OneDeductible 1,600 100% after deductible Single Plan is detailed out below for both In Network and Out of Network coverage.

In Network		Out of Network
Copay	No Charge after Deductible	N/A
Office Visits	No Charge after Deductible	N/A
Annual Deductible	Individual: $1,600	Individual: $3,200
Annual Out-Of-Pocket Limit	Individual: $1,600	Individual: $6,000 (Deductible not included)
Lifetime Maximum	Not Applicable	Not Applicable
Prescription Drugs	Subject to integrated deductible and coinsurance	See brochure for more details
Laboratory & X-Ray	No Charge after Deductible	See brochure for more details
Annual Physical Exam	No Charge. See brochure for more details.	See brochure for more details
Annual OB-GYN Exam	No Charge. See brochure for more details.	See brochure for more details
Well Baby Care	No Charge. See brochure for more details.	See brochure for more details
Outpatient Surgery	Subject to integrated deductible and coinsurance	See brochure for more details
Emergency Room	$75 access fee (waived if admitted) Covered charges are subject to the integrated deductible and coinsurance	$75 access fee (waived if admitted) Covered charges are subject to the integrated deductible and coinsurance
Ambulance	See brochure for more details	See brochure for more details
Home Health Care	See brochure for more details	See brochure for more details
Mental Health - Outpatient	See brochure for more details	See brochure for more details
Chiropractic Care	Subject to integrated deductible and coinsurance (Covered under the Outpatient Physical Medicine provision with a combined Maximum Calendar Year Benefit of $3000 per Covered Person)	See brochure for more details
Acupuncture	See brochure for more details	See brochure for more details
Inpatient Hospital	Subject to the integrated deductible and coinsurance	See brochure for more details
Maternity Care	Complications of pregnancy only, subject to state: Subject to integrated deductible and coinsurance	See brochure for more details
Mental Health - Inpatient	See brochure for more details	See brochure for more details
Chemical Dependency - Inpatient	See brochure for more details	See brochure for more details

To learn more about your individual and family California health insurance options, the price of each plan and/or a detailed benefit summary of the plans, visit us here.

NOTICE! Final rates and benefits are based on actual plan selection (including plan riders you may request) and the assignment of any rate adjustment factors due to the health plan's underwriting guidelines.

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