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Traditional PPO Plans from a Christian Organization

With GuideStone, you can have your own medical plan with great value and shared values!

  • You CAN get affordable rates and plenty of extras.
  • You CAN take your coverage to another eligible ministry.
  • You CAN save on medical care with provider discounts through the Highmark Blue Cross Blue Shield PPO network.
  • You CAN pay less for quality coverage and get additional benefits at no extra cost.

Get A Quote for health coverage now and find a plan your family can afford.

PPO Plans At-A-Glance

Effective January 1, 2017

In-network benefits Health Choice 50001 Health Choice 30001 Health Choice 2000 Health Choice 1000 Health Choice 500
Annual deductibles: Individual /

family
$5,000 / $10,000 $3,000 / $5,000 $2,000 / $4,000 $1,000 / $2,000 $500 / $1,000
Plan pays (co-insurance) [after deductible] 70% 70% 80% 80% 80%
Medical and prescription maximum out-of-pocket: individual/family [in-network services only, including deductible, co-pays and co-insurance] $6,950/$13,000  $6,950/$12,000  $6,950/$11,000  $6,950/$9,000 $6,000/$7,500 
Primary care or retail clinic / specialist visit $25 / $45 $25 / $45 $25 / $45 $25 / $45 $25 / $45
Wellness visits (no deductible)

[per Preventive Care Schedule]
100% 100% 100% 100% 100%
Hospital inpatient [including maternity] and outpatient surgery 70% after deductible 70% after deductible 80% after deductible 80% after deductible 80% after deductible
Emergency room services [deductible does not apply] 70% after $250 co-pay 70% after $250 co-pay 80% after $250 co-pay 80% after $250 co-pay 80% after $250 co-pay
Telemedicine co-pay2 $10 $10 $10 $10 $10
Outpatient services [CT scans, MRI, diagnostic] 70% after deductible 70% after deductible 80% after deductible 80% after deductible 80% after deductible


Prescription Drug Benefits3,4,5

Health Choice 50001 Health Choice 30001 Health Choice 2000 Health Choice 1000 Health Choice 500
Generic co-pay — Retail / home delivery $15 / $30 $15 / $30 $15 / $30 $15 / $30 $15 / $30
Preferred drug co-pay 6 — Retail / home delivery $50 / $100 $50 / $100 $50 / $100 $50 / $100 $50 / $100
Non-preferred drug co-pay6 — Retail / home delivery $75 / $150 $75 / $150 $75 / $150 $75 / $150 $75 / $150
Specialty Generic drug co-pay (up to 30 day supply) $50 $50 $50 $50 $50
Specialty Preferred drug co-pay6 (up to 30 day supply) $75 $75 $75 $75 $75
Specialty Non-preferred drug co-pay6 (up to 30 day supply) $100 $100 $100 $100 $100


1These plans do not constitute “creditable coverage” for Massachusetts residents.

2
Teladoc operates subject to state regulation and may not be available in certain states.

3
If the cost of the prescription is less than the co-pay, the participant pays the full cost of the prescription.

4
Retail available as 30-day supply, mail order as 90-day supply and specialty as 30-day supply through mail order.

5
Retail co-pays increase $10 after the 2nd fill of maintenance drugs. The co-pay increase does not accumulate toward the deductible or the maximum out-of-pocket limit.

6
If non-generic drug is purchased when a generic is available, the participant must pay the generic co-pay plus the increase in the drug cost of the non-generic drug over its generic equivalent. The increase in drug cost does not accumulate toward the deductible or the maximum out-of-pocket limit.

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