The PerfectHealth EPO Diamond plan features:

• A high-deductible, in-network-only EPO Plan
• Discounts on in-network care before meeting your deductible
  

About the Plan
The PerfectHealth EPO Diamond plan provides high-deductible coverage in case of serious illness or injury, for a low premium price. With this plan, you pay discounted rates out-of-pocket for all of your in-network medical expenses up to $10,000 per year for an individual ($20,000 for families). Once you have met the $10,000 deductible, all in-network expenses are covered 100% for the remainder of the year. Well Child Care - regular check ups and immunizations for your children - is covered 100% and is not subject to the deductible. Prescription drug expenses will be applied toward your deductible; once your deductible is met, they will be covered at 70%.


VIEW THE SUMMARY OF BENEFITS»

About the Provider Network
PerfectHealth uses the MultiPlan Inc. doctor network and both the MultiPlan and HIP Health Plan of New York hospital networks depending on where you live. You must see a MultiPlan doctor (even in the hospital) for your expenses to count toward your deductible or be covered once you've met your deductible.

Since this is an EPO plan, you do not need to choose a primary care physician, and you do not need referrals to see specialists. In addition, this plan has no lifetime maximum.

Residency restrictions:
Doctor Network: You may only use MultiPlan doctors in your state of residency. Visits to doctors in another state will not be covered or applied towards your deductible.

Hospital Network*: If you reside in New York State, you may only use the HIP hospital network (with MultiPlan doctors). If you reside outside New York State, you may only use MultiPlan hospitals (with MultiPlan doctors) in your state of residency.

*This does not apply to emergency visits. In the event of an emergency, you should visit the closest hospital and follow the procedures listed on your insurance card.

About the Discounts
Before you reach your deductible you are eligible for discounted rates for in-network medical expenses. If you visit a MultiPlan doctor you will be charged a negotiated discount rate. You pay nothing at the time of the visit and shortly after, both you and your doctor will receive an Explanation of Benefits from PerfectHealth. Your doctor will then send you an adjusted bill and you will pay your doctor. After you pay the doctor, you should submit a claim to PerfectHealth so that your medical expenses are applied to your deductible.

For more information about the PerfectHealth EPO Diamond, read the Summary of Benefits.

PerfectHealth EPO Diamond Monthly rates*:

PerfectHealth EPO Diamond Monthly rates*:
Individual	$130.37
Individual & Child(ren)	$247.99
Individual & Spouse	$290.72
Family	$411.85

*These rates are guaranteed until December 31, 2008.