FBHP Gold G02CP

FBHP Gold G02CP

This ACA-compliant Gold plan provides participants with full coverage and protection from the health care tax penalty -- with the lowest deductibles and out of pocket costs available from Farm Bureau Health Plans.

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Provider Network
Prescription Drug List
Summary Of Benefits and Coverage

FBHP Gold G02CP
Effective January 1, 2017 In-Network Out-of-Network
Calendar Year Deductible (Individual) $1,500 $3,000
Calendar Year Deductible (Family) $3,000 $6,000
Out-of-Pocket (Individual) $3,000 $9,000
Out-of-Pocket (Family) $6,000 $18,000

Effective January1, 2017  In-Network Out-of-Network
Coinsurance (except as otherwise listed) 20% (Plan pays 80%) 50% (Plan pays 50%)
Primary Care Visit to treat an injury or illness $25 copay/visit after deductible 50% coinsurance after deductible plus amounts over the allowed amount 
Specialist visit

20% coinsurance after deductible

50% coinsurance after deductible plus amounts over the allowed amount

Other practitioner office visit

 

20% coinsurance after deductible

50% coinsurance after deductible plus amounts over the allowed amount

Preventive care/screening/immunization

No Charge

50% coinsurance after deductible plus amounts over the allowed amount

Preventative Benefits 0% (Plan pays 100%) 50% after deductible (Plan pays 50%)
Inpatient (After Deductible) 20% (Plans pays 80%)  50% after deductible (Plan pays 50%)
Other Covered Services (After Deductible) 20% (Plans pays 80%)  50% after deductible (Plan pays 50%)
Routine Dental Pediatric dental check-up: 
No charge
Pediatric dental check-up: 
50% coinsurance after deductible plus amounts over the allowed amount
Routine Vision Pediatric eye exam:
No charge
Pediatric eye exam:
No charge
Prescription Drug Coverage Generic:
10% coinsurance after deductible

Preferred brand:
20% coinsurance after deductible

Non-preferred brand
30% coinsurance after deductible

Generic and preferred specialty: 
40% coinsurance after deductible

Non-preferred specialty: 
45% coinsurance after decutible
Generic: 
50% coinsurance after deductible, plus amounts over allowed amount

Preferred brand drugs: 
50% coinsurance after deductible, plus amounts over allowed amount

Non-preferred brand drugs: 
50% coinsurance after deductible, plus amounts over allowed amount
Emergency Room Services $75 copay/visit after deductible $75 copay/visit after deductible
 

Ready to Enroll?

Farm Bureau Health Plans is proud to offer quality coverage at an affordable cost.

Medicare Supplements Insured by TRH Health Insurance Company, Columbia, TN.
TRHH-POST-POLA-FL14-174; TRHH-POST-POLB-FL14-175; TRHH-POST-POLC-FL14-176; TRHH-POST-POLD-FL14-177; 
TRHH-POST-POLF-FL14-178; TRHH-POST-POLG-FL14-179; TRHH-POST-POLM-FL14-180; TRHH-POST-POLAN-FL14-181
Not connected with or endorsed by the U.S. or state government. This is a solicitation of insurance. A representative of TRH Health Insurance Company may contact you. Benefits not provided for expenses incurred while coverage under the policy is not in force, expenses payable by Medicare, non- Medicare eligible expenses or any Medicare deductible or copayment/coinsurance or other expenses not covered under the policy.

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