Golden Rule Copay Saver Plan
| Insurance Benefit Highlights | Copay Saver |
| Calender Year Deductible | $1500 $2500 $5000 $7500 or $10,000 |
| Co-Insurance Choices | $3,000.00 |
| Lifetime Maximum Benefit | $3 million |
| Initial Rate Guarantee | 12 months |
| Physical (Illness & Injury) | |
| Office Visit | $35 no deductible |
| Prescription Drugs | $15 Generic |
| Annual Maximum | Not applicable |
| Wellness/Preventive Care Benefits | |
| Doctor Office Visit | $35.00 |
| X-ray and lab | Not Covered |
| Child Immunizations | Not Covered |
| Preventative Mammogram, Pa Smear, PSA screen | 20% after deductible |
| Outpatient Expense Benefits | |
| X-ray and lab | 20% after deductible |
| Facility/Hospital for Outpatient Surgery | 20% after deductible |
| Surgeon, Assistant Surgeon, and Facility Fees | 20% after deductible |
| Hemodialysys, Radiation, Chemotherapy | 20% after deductible |
| Emergency Room Fees – Illness | You Pay: $500 copay if not admitted then 20% |
| Emergency Room Fees – Injury | You Pay: $500 copay if not admitted then 20% |
| Spine and Back Disorders | Not Covered |
| Mental and Nervous Disorders | Not Covered |
| Inpatient Expense Benefits | |
| Room and Board | 20% after deductible |
| Intensive Care Unit | 20% after deductible |
| Operating Room | 20% after deductible |
| Recovery Room | 20% after deductible |
Convenient Doctor Office Copay Benefits
Designed for individuals and families, our copay plans are more like traditional employer plans with a copayment for routine health-care expenses. When you use a network doctor for an office visit, we pay 100% for history and exam. When you use a network doctor for an office visit, we pay 100% of history and exa fees after a $35 copay with Copay Select. Office visit expenses outside your network are not eligible for copay benefits.
Adult And Child Preventive Care Included
After a 3-month waiting period, you pay $35 for the doctor office visit with Copay Select. X-rays and lab tests are covered after you pay your chosen coinsurance ( 20%)
You choose $3 million or $5 million lifetime maximum benefits per covered person.
Copay Saver
The Copay Saver plan provides the convenience of copays for doctor office visits (limited to 2 per person, per calendar year) for a lower monthly premium.
Tags: Family Plan, Golden Rule Copay Saver, health insurance, individual, Michigan, Plans
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