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CeltiCare "Any Doc" PPO Plan
(Hospital Network Only)
You don't have to change doctors to realize the
advantage of a low office visit copayment. With the
Celtic "Any Doc" PPO you have the flexibility to
choose your own physician while saving money with the
preferred rates of our prominent nationwide hospital network.
In offering this PPO plan, Celtic is in partnership with
Private HealthCare Systems (PHCS), a widely-respected
national network.
Note: The CeltiCare "Any Doc" PPO is
available in areas in which there are Preferred Provider
Hospitals.
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| Features/Benefits |
80/20 |
100% |
| Coinsurance |
80/20 Coverage
after deductible of the next $5,000 |
100% Coverage
after deductible |
| Deductibles |
$250 |
$500 |
$1,000 |
$1,000 |
$2,500 |
$5,000 |
| Out-of-Pocket
Maximum |
$1,250 |
$1,500 |
$2,000 |
$1,000 |
$2,500 |
$5,000 |
| Lifetime Maximum |
$5,000,000 |
$5,000,000 |
| Non-preventive
office visits to any doctor |
$25 copay |
$25 copay |
| Emergency Room
Deductible (in addition to plan deductible) |
$50 deductible
per visit, if not admitted. |
$50 deductible
per visit, if not admitted. |
| Out-of-Network
Services at Hospitals per occurrence |
Eligible charges
reduced additional 20% capped at $5,000 per occurrence. |
Eligible charges
reduced additional 20% capped at $5,000 per occurrence. |
| Supplemental
Accident |
$500 per injury |
$500 per injury |
| FREE RX Discount
Card |
An average
savings of 15% at over 40,000 U.S pharmacies. |
| Psychiatric Care* |
Inpatient annual
maximum of $2,500 per person, per calendar year.
Outpatient annual maximum of $1,000 per person per calendar
year. Lifetime maximum of $10,000 per person per
inpatient and outpatient combined. |
| Manipulative Therapy
(benefits vary by state) |
$500 maximum per
person, per calendar year. |
| Hospital |
Average
semi-private room rate. Intensive care at four times
the average semi-private room rate. |
| Home Health Care |
30 visits per
person, per calendar year, one visit per day. |
| Rehabilitation
Facility |
Inpatient - up
to 30 days confinement per person, per calendar year. |
| Rehabilitation
Therapy |
Outpatient - up
to 30 visits per person, per calendar year. |
| Extended Care
Facility |
Up to 12 days of
confinement, per person, per calendar year. |
| Transplants |
Covered up to
amount negotiated by network if Transplant Network used;
capped at $100,000 per procedure if insured goes out of
network. |
| Optional
Features/Benefits |
CeltiCare Plus
Option |
Term Life
Insurance Option not available in all states
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Important Note: The information
contained on this web page and the other linked pages is not intended
to provide full details of Celtic plans and may change at the
discretion of Celtic Insurance Company. Benefits and Plan
details may vary by state. Complete terms of coverage are
outlined in the individual Certificate Booklets and set forth in the
applicable insurance Policy and Trust agreement. In applying
for coverage, the primary insured agrees to be bound by the
Certificate. The benefits described in these pages and any
accompanying literature are the standard benefits offered by Celtic.
Policy provisions vary in some states.
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