Celtic Health Insurance SelectPPO Plan

COLORADO HEALTH BENEFITS
Celtic Health Insurance Colorado

CeltiCare "Select" PPO Plan
( Doctor and Hospital Network )

           You receive high quality care for the lowest premium by accessing respected network physicians and hospitals.
           This doctor and hospital PPO offers savings on every visit to any network provider. In offering the CeltiCare Select
           PPO Plan,Celtic is in partnership with Private HealthCare Systems (PHCS), an expansive national network of
           doctors and hospitals.

           Note: The CeltiCare "Select" PPO is available in areas in which there are preferred provider doctors and hospitals.

            Check Providers                                                                                                     Get Quote / Apply Online

Features/Benefits 70/30 80/20 100%

Coinsurance 70/30 Coverage after deductible of the next $10,000 80/20 Coverage after deductible of the next $5,000 100% Coverage after deductible

Deductibles $1000, $2500, $5000, $10000 $250, $500 $1000, $2500, $5000, $10000 $1000, $2500, $5000, $10000

Out-of-Pocket Maximum $4000, $5500, $8000, $13000 $1,250, $1500, $2000, $3500, $6000, $11000 $1000, $2500, $5000, $10000

Lifetime Maximum $7,000,000 $7,000,000 $7,000,000

Non-preventive office visits to Network Provider $15 copay
6 Doctor Visits per Person/Year No deductible applies till 7th visit.
$15 copay
6 Doctor Visits per Person/Year No deductible applies till 7th visit.
$15 copay 6 Doctor Visits per Person/Year No deductible applies till 7th visit.

Emergency Room Deductible (in addition to plan deductible) $50 deductible per visit, if not admitted. $50 deductible per visit, if not admitted. $50 deductible per visit, if not admitted.

Out-of-Network Services at Doctors and Hospitals per occurrence Eligible charges reduced additional 20% no cap.
Does not include medical emergencies.
PPO Network is Nationwide Eligible charges reduced additional 20% no cap.
Does not include medical emergencies.
PPO Network is Nationwide Eligible charges reduced additional 20% no cap.
Network Nationwide

Supplemental Accident $500 per injury $500 per injury $500 per injury

FREE RX Discount Card An average savings of 15% at over 40,000 U.S pharmacies.
See Optional Benefits below.

Psychiatric Care* Inpatient annual maximum of $2,500 per person, per calendar year.   Outpatient annual maximum of $1,000 per person per calendar year. Lifetime maximum of $10,000 per person per inpatient and outpatient combined.

Manipulative Therapy (benefits vary by state) $500 maximum per person, per calendar year.

Hospital Average semi-private room rate.   Intensive care at four times the average semi-private room rate.

Home Health Care 30 visits per person, per calendar year, one visit per day.

Rehabilitation Facility Inpatient - up to 30 days confinement per person, per calendar year.

Rehabilitation Therapy Outpatient - up to 30 visits per person, per calendar year.

Extended Care Facility Up to 12 days of confinement, per person, per calendar year.

Transplants Covered up to amount negotiated by network if Transplant Network used; capped at $100,000 per procedure if insured goes out of network.

Ambulance $3,000 covered per person, per calendar year for emergency air or ground ambulance service.

Optional Features/Benefits CeltiCare Plus Option
Term Life Insurance Option (not available in all states)

            Important Note :The information contained on this web page and the other linked pages is not intended
            to provide full details of Celtic plans and may change at the discretion of Celtic Insurance Company.
            Benefits and Plan details may vary by state. Complete terms of coverage are outlined in the individual
            Certificate Booklets and set forth in the applicable insurance policy.In applying for coverage, the primary
            insured agrees to be bound by the Certificate or Policy. The benefits described in these pages and any
            accompanying literature are the standard benefits offered by Celtic. Policy provisions vary in some states.

Colorado Health Insurance Plans

Health Insurance Colorado