PHCS PPO
As seen on
At the point of care
What you'll actually pay
when you use it.
- Office visitsA flat copay, per visit
- The same copay every timeNo deductible to meet first
- Specialist visitsA flat copay, per visit
- No coinsurance at the visitYou pay the copay, not a percentage of the bill
- Walk-in urgent careNot an emergency, but it can't wait
- The same flat copayWhatever the visit costs
- Basic laboratory workA flat copay for basic labs
- Bigger lab work differsIt runs on the 40 / 60 split below
The team checks your doctor, your hospital and your pharmacy by name before you enroll, so you know exactly where you stand before anything is signed.
Some benefits on this plan carry day or service limits, listed in the next section. Ask the team how the plan counts visits, days and services before you receive care.
High-cost services
The big stuff is a 40 / 60 split.
No deductible first. You pay 40% of the bill, the plan pays 60%, and your share of covered services stops at $4,000 for the year, $8,000 for a family. Each service below carries its stated limit, printed right where you can read it.
Covered services, subject to plan terms, limitations, exclusions and authorization requirements. Limits are counted by the plan, so confirm how visits, days and services are counted before you receive care.
Prescriptions
Your drugs run on a
discount card.
Generic, preferred and non-preferred medications all run through a discount card. You show the card at a participating pharmacy and pay the discounted price for the prescription.
A discount card is a discount program, not an insured prescription benefit. Bring your prescription list to the first call and the team will tell you what each one would actually cost.
Monthly rates
Straightforward pricing,
No-surprises coverage.
Rates are quoted monthly and are separate from copays and the 40% share. Ask the team for the all-in monthly figure for your household before anything is signed. Rates remain subject to eligibility, underwriting, plan changes and final approval.
For your records
The plan brochure,
yours to keep.
All four pages: the copays, the 40 / 60 split, the stated limits and the monthly rates, in the plan's own words. Open it, keep it, bring it to your first call. If anything here and the plan documents disagree, the plan documents win.
Do your research
Go ahead, look us up.
Three steps, and the plan is yours.
One call, (817) 205-6257. Ask anything, no pressure.
The team walks you through it, right on the phone.
And never on your own. The team sticks with you after you enroll, for every question, every claim, every step.
Quick answers
Asked all the time.
The team checks your doctor, your hospital and your pharmacy by name before you enroll, so you know exactly where you stand before anything is signed.
Fast. But start dates come with real deadlines, and they vary. The sooner you call, the sooner you're covered.
There is nothing to pay down before the plan starts working. Copays start at the first visit, and the big stuff runs on the 40 / 60 split, with the gap plan covering the first $5,000 on the biggest services. $4,000 individual, $8,000 family is the out-of-pocket maximum for covered services, and the day and service limits are printed on this page.
ready when you are
Questions about the PHCS PPO?
The team picks up.
Call the team: (817) 205-6257 · thehealthyinsurancedude.com