Make it AmeriHealth, for coverage and services that meets your needs.

Benefits Summary

AmeriHealth® PPO

Receive care from any provider without a referral in-network or out-of-network. Some services may require preauthorization.

Benefits AmeriHealth PPO 10/20/70 AmeriHealth PPO 20/30/60 AmeriHealth PPO 1020/80/50
  In-Network Out-of-Network In-Network Out-of-Network In-Network Out-of-Network
Deductible (Individual/Family) NONE $300/$600 $1,500/$3,000 $3,000/$6,000 $1,000/$2,000 (in-network/out-of-network combined)
After Deductible, Plan Pays 100% 70% 80% 60% 80% 50%
Out-of-Pocket (Individual/Family) NONE $2,000/$4,000 $5,000/$10,000 $10,000/$20,000 $3,000/$6,000 $10,000/$20,000
Overall Lifetime Maximum Unlimited $1 Million Unlimited $100,000 Unlimited $500,000
Primary Care Provider Office Visit $10 70% $20 60% $20 50%
Specialist Office Visit $20 70% $30 60% $30 50%
Inpatient Hospital Care $75 per day, $375 per adm 70% 80% 60% 80% 50%
Lab 100% 70% 100% 60% 100% 50%
Preventive Care Office Visits $10 70% $20 60% $20 50%
Routine GYN Exam/Pap Smear 100% 70% 100% 60% 100% 50%
Maternity Care: First OB Visit $10 (100% thereafter) 70% $20 (100% thereafter) 60% $20 (100% thereafter) 50%
Maternity Care:
Inpatient Hospital		 $75 per day, $375 per adm 70% 80% 60% 80% 50%
Emergency Care $40 (waived if admitted) $40 (waived if admitted) $40 (waived if admitted) $40 (waived if admitted) 80% (not waived if admitted) 80% (not waived if admitted)

The above table illustrates some of the benefit programs available. This managed care plan may not cover all your health care expenses. This information has been extracted from and is subject to the terms and conditions of all applicable group contracts and member handbooks.