Celtic Insurance has put together the type of plan that 90% of the paying public wants. From personal experience the cost is one of the most competitive. Despite being very competitive price wise it is very benefit rich. First of all the lifetime maximum is $7,000,000 as compared to the usual $5,000,000 for most other companies. Office calls are just a $15 copay for the first 6 visits per year in the ppo plan. Most companies are putting a limit to the number of visits under the copay, but I think 6 visits per year is a reasonable allowance. The trend for most health plans is not to include Lab and X-ray under the copay. This plan covers the first $200 for lab and X-ray for non-preventive office visits plus when the Plus Option is selected, $300 per year for preventive care, which includes $50 for an eye exam. Also included in the Plus Option is the prescription copay option which can also be purchased as an option all by itself. The copay is $20 for Generic and $40 for preferred brand drugs after a $100 annual deductible on brand only. Also included in the Plus Option is Supplemental Accident coverage. This covers accidents and injuries 100% up to $500 per person per occurrence. The one benefit that sets this plan apart from all the rest is the Healthy Lifestyle Program. This is not an option. It is included with the base plan. This benefit encourages healthy lifestyles as the name implies. The insurance company will pay 25% of eligible programs that improve physical health up to $300 per person per year. This could be a program at a health club or a program to stop smoking. Another unique standard benefit is $3000 for ambulance including Air Ambulance. Most health plans do not include Air Ambulance.
For those not wishing to say within a PPO network, there is also an “Any Doc” plan with a $35 copay for office calls to any doctor, regardless of any network affiliation.
This is also an excellent plan for a child only plan because the Plus Option with the preventive care also includes immunizations. There are a few drawbacks however. First of all, on a child only plan the child must be at least 6 months old and there can be only one child per policy. This can make the plan more expensive than plans with other companies that allow more than one child per policy. Note, if a parent is on the plan with the child, the age requirement is reduced to 6 weeks.