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Essential StaffCARE (FSLIC) MVP 60% Plan  + MEC Logo

MVP 60% Plan Benefits at a Glance

ANNUAL MAXIMUM Unlimited
Member Benefits In-Network Out-of-Network
  Individual Deductible $6,000 $10,000
  Family Deductible $12,000 $20,000
  Coinsurance 0% 40%
OUT-OF-POCKET MAXIMUM PER CALENDAR YEAR
Per Covered Person $6,000 $11,000
Family Deductible $12,000 $22,000
ESSENTIAL HEALTH BENEFITS (coinsurance payable by employee after deductible)
Preventive Care/Screening/Immunization 100% after deductible Not Covered
Physician Office Visits 100% after deductible 60% after deductible
Ambulatory Patient Services 100% after deductible 60% after deductible
Hospitalization (inpatient and outpatient) 100% after deductible 100% after deductible
Hospice 100% after deductible 60% after deductible
Mental Health and Substance Abuse/Behavioral Health 100% after deductible 60% after deductible
Laboratory Service 100% after deductible 60% after deductible
Rehabilitative and Habilitative Services/Devices 100% after deductible 60% after deductible
Emergency Services 100% after deductible 100% after deductible
PRESCRIPTION DRUGS
Generic 100% after deductible Not Covered
Brand Name Drug Not Covered Not Covered
Non-preferred Brand Not Covered Not Covered
Specialty Not Covered Not Covered
Mail Order Not Covered Not Covered