5 CITY OF LAMAR PPO HRA B2000 PLAN HDHP/ HSA 2500 PLAN In-Network Out-of-Network In-Network Out-of-Network HOSPITAL SERVICES Emergency Room 20% after deductible 20% after deductible Inpatient 20% after deductible 40% after deductible 20% after deductible 40% after deductible Outpatient Surgery 20% after deductible 40% after deductible 20% after deductible 40% after deductible Urgent Care Services $35 copay, then 20% after deductible 40% after deductible 20% after deductible 40% after deductible MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES Inpatient Services 20% after deductible 40% after deductible 20% after deductible 40% after deductible Outpatient Services Office visit: $35 copay; Other outpatient: 20% after deductible 40% after deductible 20% after deductible 40% after deductible OTHER SERVICES Diagnostic text (x-ray, blood work) 20% after deductible 40% after deductible 20% after deductible 40% after deductible Advanced Imaging (CT/PET scan, MRIs) $200 copay, then 20% after deductible $200 copay, then 40% after deductible 20% after deductible 40% after deductible Maternity Services $35 copay, then 20% after deductible 40% after deductible 20% after deductible 40% after deductible All other maternity hospital/ physician services 20% after deductible 40% after deductible 20% after deductible 40% after deductible Physical, Occupational and Speech Therapy Services $35 copay, then 20% after deductible 40% after deductible 20% after deductible 40% after deductible MEDICAL & PHARMACY TELEMEDICINE BENEFIT Administered by County Health Pool (Anthem Network) Have a health question? Under the weather? With LiveHealth Online, you don’t have to schedule an appointment, drive to the doctor’s office, and then wait for your appointment. In fact, you don’t even have to leave your home or office. Doctors can answer questions, make a diagnosis, and even prescribe basic medications when needed. With LiveHealth Online, you get: • Immediate doctor visits through live video • Your choice of U.S. board-certified doctors • Private, secure and convenient online visits When can you use LiveHealth Online? As always, you should call 911 with any emergency. Otherwise, you can use LiveHealth Online whenever you have a health concern and don’t want to wait. Doctors are available 24 hours a day, seven days a week, 365 days a year.
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