What is the coverage by PSIP?
• Hospitalization • Outpatient office visits • Primary and specialty care office visits/referrals • Mental health benefits • Diagnostic studies • Outpatient therapy/treatments • Prescription medications Three tiers of coverage: Care at SHS: • All office visits covered in full, no deductible or co-pays • Most other charges are also covered in full In-network care (preferred provider): • You are responsible for payment of allowable charges up to $250 (deductible) • Once you have met deductible for the year, you are responsible only for the relevant co-pay • The deductible may be waived for certain services or care Out-of-network care (non-preferred care): • You are responsible for payment of charges up to $1500 (deductible) • Provider balance may bill you for difference between actual charge and any PSIP payment • After the deductible is met, the plan pays a percentage of reasonable and customary charges Key features of PSIP • $2,000,000 lifetime maximum benefit • Annual deductible of $2
• Hospitalization • Outpatient office visits • Primary and specialty care office visits/referrals • Mental health benefits • Diagnostic studies • Outpatient therapy/treatments • Prescription medications Three tiers of coverage: Care at SHS: • All office visits covered in full, no deductible or co-pays • Most other charges are also covered in full In-network care (preferred provider): • You are responsible for payment of allowable charges up to $250 (deductible) • Once you have met deductible for the year, you are responsible only for the relevant co-pay • The deductible may be waived for certain services or care Out-of-network care (non-preferred care): • You are responsible for payment of charges up to $1500 (deductible) • Provider balance may bill you for difference between actual charge and any PSIP payment • After the deductible is met, the plan pays a percentage of reasonable and customary charges Key features of PSIP • $2,000,000 lifetime maximum benefit • Annual deductible of $2
