Benefit Choices

Benefit Choices, Inc.
We provide the benefits, you make the choices.

Blue Cross/Blue Shield Comprehensive|
Major Medical

Benefit / Service	Comprehensive Benefits at a Glance
Annual calendar year deductible Annual out of pocket maximum Once you meet out of pocket maximum Lifetime benefit maximum	Choose from $100 to $1000 $2,000 per person (limit 2) $0 Copay $1,000,000
Annual Child Wellness Exam Annual Adult Wellness Exam Annual OB/GYN Mammography (for preventive care) Three Lifetime EKGS (For memebers over 50 and if done during routine adult physical exam) Second Surgical Opinions 100% of First $300 of emergency accident care when treatment begins within 72 hours	$ 10 Copay $ 10 Copay $ 10 Copay $ 10 Copay $ 0 Copay $ 0 Copay
365 Days Hospitilization	20% coinsurance (after deductible)
Inpatient Physician Services	20% coinsurance (after deductible)
Ambulatory & Emergency Services	20% coinsurance (after deductible)
Inpatient/Outpatient surgery	20% coinsurance (after deductible)
Diagnostic Test & X-rays	20% coinsurance (after deductible)
Maternity & Prenatal Care	20% coinsurance (after deductible)
Physician Office Visits	20% coinsurance (after deductible)
Inpatient Mental Health and Substance Abuse	20% coinsurance (after deductible)
Physical Therapy/Chiropractic Services (up to 50 visits per year) Radiation and Chemotherapy	20% coinsurance (after deductible) 20% coinsurance (after deductible)
Prescription Drugs ($500 Annual Benefit Limit per person)	20% coinsurance (after deductible)

This outline is intended as a summary only. For complete details, consult your Benefit Guide.

Please note: if you select the $400 or $800 deductible, your coinsurance will be 25%, not 20%.

HOW THE PLAN WORKS

You pay the deductible
(No deductible required for preventive care)

Then Comprehensive Major Medical pays 75% or 80% of the allowed benefit, and you pay 25% or 20% up to your out-of-pocket maximum.

After you meet your out-of-pocket-maximum, the plan pays $100% of the allowed benefit for the rest of the calendar year.

A HEALTH PLAN YOU DESIGN

As a member of the Comprehensive Major Medical plan, you can design a personal health care program that's right for you -- and your budget.

You select your deductible. The higher the deductible, the lower your
monthly premium. And, unlike many other insurance companies, your
deductible is applied towards your out-of-pocket maximum. This limits
the amount of money you will spend on your health care.

You select your out-of-pocket maximum. This is the most that each
individual on your policy spends towards coinsurance and deductible
requirements per year and is based on the deductible you select.

Preventive care included for just $10 per visit. And there is no
deductible to meet.

Families never pay more than two deductibles even if there are more
family members on the policy.

You have complete freedom to choose your own doctors and hospitals.

Carry the card that's recognized and accepted
across Maryland and through-out
the United States.

© 2002 Benefit Choices Inc.