HIP Prime POS gives you low out-of-pocket costs along with the freedom to choose out-of-network providers. You get:
- Coverage for out-of-network services
- Coverage of in-network services
- Low out-of-pocket costs
- Low copays for in-network services
- Value-added wellness and disease management programs
Your In-Network Costs
- PCP office visit: $5
- Well child care: $0
- Specialist office visit: $10
- Diagnostic lab/X-ray: included
- Routine physical exam: $0
- Outpatient mental health: $10
- Urgent care: $5/$10
- Ambulatory surgery: $0
- Ambulance: $0
- Inpatient care: $100
- Anesthesia: included
- Emergency room: $50 (waived if admitted)
City employees can add the following benefit to their HIP Prime POS plan through a payroll or pension deduction:
Prescription drugs ($10 generic and $35 brand drugs from network retail drug stores). Formulary copays are reduced by 50% when utilizing the Mail Order Pharmacy Service for home delivery.
Note: Durable medical equipment and private duty nursing are part of the base POS plan. No rider is needed.
The information in this section is intended to provide general information and highlights regarding the HIP Prime POS plan. It does not provide a complete benefit description. HIP Prime POS Plan coverage is subject to all terms, conditions and limitations contained in the certificate of insurance. Refer to HIP policy form 155-23-GRPHMO (3/99) and 200-23-GRPPOL (9/99).