What are Metros Waiver Standards for Proof of Outside Insurance Coverage?
Prior to submitting your waiver, you must confirm that your health insurance plan meets each of the minimum standards outlined below. Plans that do not meet each of these standards will not be approved for waiver purposes. Your health insurance plan must be in the form of individual or group health coverage that includes ALL of the following minimum requirements: Have an annual deductible of $5,000 or less; Benefits must include a minimum of $250,000 per occurrence, with no less than a 50% co-insurance for major medical coverage, which includes in-patient hospitalization and associated services, and episodic care coverage for lab work, x-rays, prescription medications, outpatient procedures and acute illnesses/injuries; Plan is required to include mental/nervous benefits and must be paid at the following minimum levels: outpatient – 50% coinsurance or a co pay, with no less than a $1000 per year cap and/or 20 visits per year; inpatient – 50% coinsurance or a co pay, with no less than $
