Benefits & Coverage

Insurance Type
Individual Health Insurance
Insurance Provider
Independence Blue Cross
Plan Type
PPO
Deductible
$5000
Out-of-Pocket Maximum
$5000
Plan Highlights

    Cost & Coverage

    Estimated Monthly Base Rate
    Estimated monthly premium starts at $98.00
    How many applications are denied?
    23% of the applicants were denied
    How accurate is this estimate?
    26% of the applicants ended up paying a higher amount than the quoted price
    Deductible
    Individual: $5000
    Family: $10000
    In-Network Out-of-Pocket Limit
    Individual: $5000
    Family: $10000
    What is included in the in-network out-of-pocket limit?
    Deductible
    Is this plan Health Savings Account (HSA) eligible?
    No
    How can I find a doctor in this plan's network?
    Plan Type
    PPO

    Health Services Options

    Service
    In Network
    Out of Network
    Primary care physician office visit
    Not Covered
    50% Coinsurance after deductible
    Specialist
    Not Covered
    50% Coinsurance after deductible
    Diagnostic Test (X-ray, blood work)
    Not Covered
    50% Coinsurance after deductible
    Outpatient Facility Fee
    Not Covered
    50% Coinsurance after deductible
    Outpatient Physician/Surgeon Fee
    Not Covered
    50% Coinsurance after deductible
    Hospital facility fee
    Not Covered
    50% Coinsurance after deductible
    Hospital physician/surgeon fee
    Not Covered
    50% Coinsurance after deductible
    Emergency Room
    Not Covered
    Not Covered

    Drug Services

    Generic Drugs
    Coverage: Not Covered
    Preferred Brand Drugs
    Coverage: Not Covered
    Specialty Drugs
    Coverage: Not Covered

    Mental Health or Substance Abuse Services

    Service
    In Network
    Out of Network
    Mental/behavioral health outpatient services
    Not Covered
    Not Covered
    Mental/behavioral health inpatient services
    Not Covered
    Not Covered
    Substance use disorder inpatient services
    Not Covered
    Not Covered
    Substance use disorder outpatient services
    Not Covered
    Not Covered

    Maternity Services

    Service
    In Network
    Out of Network
    Prenatal/postnatal care
    Not Covered
    Not Covered
    Delivery and all inpatient services for maternity care
    Not Covered
    Not Covered

    Coverage Options Summary

    Included Benefits
    • Durable medical equipment
    • Emergency Transportation
    • Habilitation
    • Home health care
    • Hospice
    • Imaging (CT/PET scans, MRIs)
    • Inpatient rehabilitation
    • Non-preferred brand drugs
    • Skilled nursing care
    • Other practitioner office visit
    • Outpatient rehabilitation
    • Preventive care, screening, immunization
    • Urgent Care
    Excluded Benefits
    • Acupuncture
    • Cosmetic surgery
    • Dental care adult
    • Dental check up children
    • Eye exam adult
    • Eye glasses children
    • Hearing Aid
    • Infertility treatment
    • Long Term Care
    • Private duty nursing
    • Routine eye exam children
    • Routine foot care
    • Routine hearing tests
    • Weight loss program
    Limited Benefits
    • Bariatric surgery
    • Chiropractic
    • Non-emergency care outside U.S.

    What To Know

    • 23%of the applicants were denied
    • 26%of the applicants ended up paying a higher amount than the quoted price
    • Deductible amount is NOT included as part of the out-of-pocket limit

    Physician Directory

    List of doctors that accepts Personal Choice PPO $5000 H.S.A Plan in Pennsylvania

    /
    GILMAN, GARY
    2701 HOLME AVE
    PHILA, PA 19152
    SULIT, ARMANDO
    8 W GIRARD AVE
    PHILADELPHIA, PA 19123
    MORESCHI, MICHELLE
    1600 W GIRARD AVE
    PHILA, PA 19130
    HASHIM, ATIA
    6827 GERMANTOWN AVE
    PHILADELPHIA, PA 19119
    CHIKWENDU, NNAEMEKA
    10 E MORELAND AVE
    PHILADELPHIA, PA 19118
    FRIEDMAN, RICHARD
    10 E MORELAND AVE
    PHILADELPHIA, PA 19118
    MCELHAUGH, WILLIAM
    10 E MORELAND AVE
    PHILADELPHIA, PA 19118
    DELGIORNO, THOMAS
    10 E MORELAND AVE
    PHILADELPHIA, PA 19118
    FUMO, PETER
    10 E MORELAND AVE
    PHILADELPHIA, PA 19118
    JONES, EDWARD
    10 E MORELAND AVE
    PHILADELPHIA, PA 19118
    PERRINS, LEIGHTON
    3998 RED LION RD
    PHILADELPHIA, PA 19114
    EMMERICH, HARRY
    3998 RED LION RD
    PHILADELPHIA, PA 19114
    Details
    GARY GILMAN, MD
    Phone Number
    (215) 331-0515
    Office Locations
    2701 HOLME AVE
    PHILA, PA 19152
    2701 HOLME AVE PHILA PA, 19152

    Community Q&A

    Do you have questions about this plan?

    Get answers from the HealthPocket community.
    0 question | 0 answers

    Similar Plans

    Similar Plans to Personal Choice PPO $5000 H.S.A Plan in Pennsylvania

    PremiumPlan NameMetal Level
    $48.00
    PersonalBlue PPO QHDHP $5000 100/50

    Not Available

    Select
    $54.00
    MyChoice PPO 8

    Not Available

    Select
    $60.04
    98191 PA Rewards 5000

    Not Available

    Select
    $66.17
    CelticSaver HSA PPO 100% 5000 Deductible

    Not Available

    Select
    $75.20
    PPOBlue HDHP $3500/$7000 Medically Underwritten

    Not Available

    Select
    $87.00
    Personal Choice PPO $8000 Deductible

    Not Available

    Select

    Useful Links

     

     

    Speak With A Licensed Agent Now About Your Insurance Options

    (800) 471-6156

    (800) 471-6156