Care Within Reach. Access care in or out-of-network with AmeriHealth Point of Service.

Benefits Summary

AmeriHealth ® POS Plus

Benefits Option 6 Option 8 Option 10
  Network Non-Network Network Non-Network Network Non-Network
Deductible NONE $1000 Individual/$3000 Family NONE $2000 Individual/$6000 Family NONE $2000 Individual/$6000 Family
Out-of-Pocket Maximum $5,000 Individual/$10,000 Family $10,000 Individual/$30,000 Family $5,000 Individual/$10,000 Family $10,000 Individual/$30,000 Family $5,000 Individual/$10,000 Family $15,000 Individual/$45,000 Family
Overall Lifetime Maximum Unlimited $5 million Unlimited $5 million Unlimited $5 million
Office Visit (PCP) $20/visit 70% $30/visit 60% $40/visit 60%
Specialist Visit $40/visit 70% $40/visit 60% $50/visit 60%
Inpatient Hospital Care* $250/day (up to 5 days) 70% $300/day (up to 5 days) 60% $300/day (up to 5 days) 60%
Outpatient Rehabilitation Therapy $40/visit 70% $40/visit 60% $50/visit 60%
Outpatient X-Ray (no copay applicable when service performed in ER or office setting) $40 Routine
$80 Complex*		 70% Routine
70% Complex*		 $40 Routine
$80 Complex*		 60% Routine
60% Complex*		 $50 Routine
$100 Complex*		 60% Routine
60% Complex*
Lab 100% 70% 100% 60% 100% 60%
Preventive Care $20/visit 70% $30/visit 60% $40/visit 60%
Maternity Care $40/1st OB Visit
100% Hospital		 70%/1st OB Visit
$200/day Hospital (up to 5 days)		 $40/1st OB Visit
100% Hospital		 60%/1st OB Visit
$300/day Hospital (up to 5 days)		 $50/1st OB Visit
100% Hospital		 60%/1st OB Visit
$400/day Hospital (up to 5 days)
Emergency Care (copay not waived if admitted) $100 70% $100 60% $100 60%

* Copayments and coinsurance apply to out-of-pocket maximum.

** Precertification required

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.

For more information on the terms, limitations, and exclusions of the benefit programs, please contact your independent broker or our Marketing Department at 1-866-681-7368.