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<Human>:What are the costs associated with a hospital stay?<Assistant>:The costs associated with a hospital stay, such as the facility fee for the hospital room and the physician/surgeon fees, are covered by the health plan with no charge. However, it's important to remember that other costs may apply, depending on the specific services received during the hospital stay.

<Human>:Does the plan cover services before you meet your deductible?<Assistant>:Yes

<Human>:Are children's eye exams covered?<Assistant>:No

<Human>:What is the record for the most home runs in a single season?<Assistant>:I can't answer your question as I am trained to answer SBC related information, if you have a question in that direction please feel free to ask your query.

<Human>:Are there any services that the plan does not cover?<Assistant>:Yes

<Human>:What is the cost for emergency room care?<Assistant>:250 co-pay

<Human>:Can you see a specialist without a referral?<Assistant>:,Yes, this health plan does not require a referral to see a specialist. This means that individuals have the freedom to choose their specialist and access their services without the need for a referral from another healthcare provider.

<Human>:What is the cost coverage for pregnancy and childbirth services?<Assistant>:The plan covers the total cost of pregnancy and childbirth services, including office visits, professional services for childbirth/delivery, and facility services for childbirth/delivery, for in-network services. However, a 20% co-insurance applies for out-of-network services.

<Human>:What is the cost of emergency medical attention?<Assistant>:Emergency medical attention, including emergency room care, carries a $250 co-pay under the plan. However, the co-pay is waived if the individual is admitted to the hospital following the emergency room visit or for an accidental injury. Emergency medical transportation is covered without charge.

<Human>:How are preventive care, screenings, and immunizations covered?<Assistant>:Preventive care, screenings, and immunizations are covered without charge under the plan. This means that individuals can access these services without having to meet the deductible and without any cost-sharing.

<Human>:What is the cost for childbirth/delivery facility services?<Assistant>:No charge

<Human>:What is the OMB control number and expiration date for HHS?<Assistant>:0938-1146 and 10/31/2022

<Human>:What is the cost of emergency medical attention?<Assistant>:Emergency medical attention, including emergency room care, carries a $250 co-pay under the plan. However, the co-pay is waived if the individual is admitted to the hospital following the emergency room visit or for an accidental injury. Emergency medical transportation is covered without charge.

<Human>:How does using a network provider affect costs?<Assistant>:Using a network provider can reduce healthcare costs. The plan operates a provider network, and individuals will pay less if they use a provider within this network. Conversely, using an out-of-network provider will incur higher costs, and individuals might receive a bill from the provider for the difference between the provider’s charge and what the plan pays.

<Human>:What is the total cost Joe would pay for managing Type 2 Diabetes?<Assistant>:340

<Human>:Can you see a specialist without a referral?<Assistant>:,Yes, this health plan does not require a referral to see a specialist. This means that individuals have the freedom to choose their specialist and access their services without the need for a referral from another healthcare provider.

<Human>:What is the cost of emergency room care?<Assistant>:The cost of emergency room care under this health plan is a $250 co-pay. However, the co-pay is waived if the individual is admitted to the hospital following the emergency room visit or for an accidental injury.

<Human>:What is the cost for childbirth/delivery professional services?<Assistant>:No charge

<Human>:What is the cost for home health care?<Assistant>:No charge

<Human>:What services does the plan cover before the deductible is met?<Assistant>:The plan covers certain items and services even before the deductible is met. However, a copayment or coinsurance may apply. For instance, the plan covers specific preventive services without cost-sharing and before the deductible is met. A comprehensive list of covered preventive services is available on the healthcare.gov website.

<Human>:What does the out-of-pocket limit refer to and what does it include?<Assistant>:The out-of-pocket limit is the maximum amount an individual could pay in a year for covered services. If there are other family members in the plan, they have to meet their own out-of-pocket limits until the overall family out-of-pocket limit has been met. It is important to note that the out-of-pocket limit does not include premiums, balance-billed charges, any pharmacy penalty, and health care that the plan doesn’t cover.

<Human>:What is the cost of prescription drug coverage?<Assistant>:The cost of prescription drug coverage varies depending on the type of drug. For generic drugs, the cost is $10 for a 34-day supply or $20 for a 90-day supply. For preferred brand drugs, the cost is $20 for a 34-day supply or $40 for a 90-day supply. For non-preferred brand drugs, the cost is $40 for a 34-day supply or $80 for a 90-day supply. And for specialty drugs, the cost is $50 for a 34-day supply.

<Human>:What are some of the services covered before meeting the deductible?<Assistant>:This health plan covers some items and services even if the deductible amount has not been met. However, a copayment or coinsurance may apply. For example, this plan covers certain preventive services without cost-sharing and before you meet your deductible. This includes services like routine check-ups, screenings, and immunizations.

<Human>:What is the cost for specialty drugs?<Assistant>:50 for 34-day supply

<Human>:What is the fastest land animal?<Assistant>:I can't answer your question as I am trained to answer SBC related information, if you have a question in that direction please feel free to ask your query.

<Human>:What is the overall deductible for this plan?<Assistant>:The overall deductible for in-network services is $100 for an individual and $200 for a family. For out-of-network services, the deductible is $250 for an individual and $500 for a family.

<Human>:Why is it advantageous to use a network provider?<Assistant>:Using a network provider is advantageous as it reduces the cost of healthcare services. The plan uses a provider network and individuals will pay less if they use a provider in the plan’s network. However, using an out-of-network provider might result in higher costs and individuals might receive a bill from a provider for the difference between the provider’s charge and what the plan pays, a practice known as balance billing.

<Human>:What is the overall deductible for in-network and out-of-network services in this health plan?<Assistant>:The overall deductible for in-network services is $100 for an individual and $200 for a family. For out-of-network services, the deductible is $250 for an individual and $500 for a family. Generally, the individual must pay all of the costs from providers up to the deductible amount before the plan begins to pay.

<Human>:Will you pay less if you use a network provider?<Assistant>:Yes

<Human>:What is the airspeed velocity of an unladen swallow?<Assistant>:I can't answer your question as I am trained to answer SBC related information, if you have a question in that direction please feel free to ask your query.

<Human>:What is the percentage of cost covered for generic drugs?<Assistant>:The cost for generic drugs is $10 for a 34-day supply or $20 for a 90-day supply. The percentage of the cost covered by the plan would depend on the total cost of the drugs, but the individual's cost would not exceed the stated amounts.

<Human>:Are there services covered before you meet your deductible?<Assistant>:Yes

<Human>:Does the plan cover services before meeting the deductible?<Assistant>:Yes

<Human>:What is the overall deductible for this plan?<Assistant>:The overall deductible for in-network services is $100 for an individual and $200 for a family. For out-of-network services, the deductible is $250 for an individual and $500 for a family.

<Human>:What are the services the plan does not cover?<Assistant>:Acupuncture/ Cosmetic surgery/ Adult dental care/ Hearing aids/ Infertility treatment/ Long-term care/ Adult routine eye care/ Routine foot care/ Weight loss programs

<Human>:What are the costs associated with a hospital stay?<Assistant>:The costs associated with a hospital stay, such as the facility fee for the hospital room and the physician/surgeon fees, are covered by the health plan with no charge. However, it's important to remember that other costs may apply, depending on the specific services received during the hospital stay.

<Human>:What is the cost for rehabilitation services?<Assistant>:No charge

<Human>:What is the cost of emergency room care?<Assistant>:The cost of emergency room care under this health plan is a $250 co-pay. However, the co-pay is waived if the individual is admitted to the hospital following the emergency room visit or for an accidental injury.

<Human>:What is the overall deductible for in-network and out-of-network services in this health plan?<Assistant>:The overall deductible for in-network services is $100 for an individual and $200 for a family. For out-of-network services, the deductible is $250 for an individual and $500 for a family. Generally, the individual must pay all of the costs from providers up to the deductible amount before the plan begins to pay.

<Human>:What is the OMB control number and expiration date for DOL?<Assistant>:1210-0147 and 5/31/2022

<Human>:What is the OMB control number and expiration date for DT?<Assistant>:1545-0047 and 12/31/2019

<Human>:Who can be contacted for grievances and appeals?<Assistant>:Blue Cross and Blue Shield of Michigan/ Michigan Office of Financial and Insurance Regulation/ Employee Benefits Security Administration

<Human>:What is the percentage of cost covered for preferred brand drugs?<Assistant>:The cost for preferred brand drugs is $20 for a 34-day supply or $40 for a 90-day supply. The percentage of the cost covered by the plan would depend on the total cost of the drugs, but the individual's cost would not exceed the stated amounts

<Human>:Who is the current CEO of Apple?<Assistant>:I can't answer your question as I am trained to answer SBC related information, if you have a question in that direction please feel free to ask your query.

<Human>:What is the capital of Australia?<Assistant>:I can't answer your question as I am trained to answer SBC related information, if you have a question in that direction please feel free to ask your query.

<Human>:Does the plan cover services before you meet your deductible?<Assistant>:Yes

<Human>:What is the cost for non-preferred brand drugs?<Assistant>:40 for 34-day supply/ 80 for 90-day supply

<Human>:Who is the author of Pride and Prejudice?<Assistant>:I can't answer your question as I am trained to answer SBC related information, if you have a question in that direction please feel free to ask your query.

<Human>:Is acupuncture covered?<Assistant>:No

<Human>:Are there services covered before you meet your deductible?<Assistant>:Yes

<Human>:What costs are not included in the out-of-pocket limit?<Assistant>:The out-of-pocket limit does not include premiums, balance-billed charges, any pharmacy penalty, and health care that the plan doesn’t cover. While these expenses are paid by the individual, they do not count toward the out-of-pocket limit.

<Human>:Are there any services that the plan does not cover?<Assistant>:Yes

<Human>:What are the costs associated with mental health, behavioral health, or substance abuse services?<Assistant>:Mental health, behavioral health, or substance abuse services are covered without charge under the plan for both outpatient and inpatient services in-network. However, a 20% co-insurance applies for out-of-network services.

<Human>:What is the role of the Glossary in understanding the health plan?<Assistant>:The Glossary plays a crucial role in helping individuals understand common terms related to health plans. It provides definitions for terms such as allowed amount, balance billing, coinsurance, copayment, deductible, provider, and other underlined terms. This aids in understanding the terms of coverage, cost-sharing, and other aspects of the health plan.

<Human>:Will you pay less if you use a network provider?<Assistant>:Yes

<Human>:What are the cost-sharing amounts for the coverage examples?<Assistant>:Deductibles/ Copayments/ Coinsurance

<Human>:What proportion of the costs for emergency medical attention does the plan cover?<Assistant>:For emergency room care, the plan requires a $250 co-pay, after which it covers the remaining cost. However, the co-pay is waived if the individual is admitted to the hospital following the emergency room visit or for an accidental injury. Emergency medical transportation is covered without charge.

<Human>:What is the cost of outpatient surgery?<Assistant>:Outpatient surgery, including the facility fee and physician/surgeon fees, is covered without charge under the plan for in-network services. However, a 20% co-insurance applies if the services are provided out-of-network.

<Human>:Who won the World Series in 1987?<Assistant>:I can't answer your question as I am trained to answer SBC related information, if you have a question in that direction please feel free to ask your query.

<Human>:What services does the plan cover before the deductible is met?<Assistant>:The plan covers certain items and services even before the deductible is met. However, a copayment or coinsurance may apply. For instance, the plan covers specific preventive services without cost-sharing and before the deductible is met. A comprehensive list of covered preventive services is available on the healthcare.gov website.

<Human>:What is the cost for preferred brand drugs?<Assistant>:20 for 34-day supply/ 40 for 90-day supply

<Human>:What is the population of New York City?<Assistant>:I can't answer your question as I am trained to answer SBC related information, if you have a question in that direction please feel free to ask your query.

<Human>:What is the total cost Mia would pay for a simple fracture?<Assistant>:120

<Human>:How does using a network provider affect costs?<Assistant>:Using a network provider can reduce healthcare costs. The plan operates a provider network, and individuals will pay less if they use a provider within this network. Conversely, using an out-of-network provider will incur higher costs, and individuals might receive a bill from the provider for the difference between the provider’s charge and what the plan pays.

<Human>:Is cosmetic surgery covered?<Assistant>:No

<Human>:Does the plan meet the Minimum Value Standards?<Assistant>:Yes

<Human>:What is the cost coverage for pregnancy and childbirth services?<Assistant>:The plan covers the total cost of pregnancy and childbirth services, including office visits, professional services for childbirth/delivery, and facility services for childbirth/delivery, for in-network services. However, a 20% co-insurance applies for out-of-network services.

<Human>:What is not included in the out-of-pocket limit?<Assistant>:Premiums/ balance-billed charges/ any pharmacy penalty/ and health care this plan doesn't cover

<Human>:How much does the plan cover for diagnostic tests such as X-rays and blood work?<Assistant>:The plan covers the total cost of diagnostic tests such as X-rays and blood work for in-network services. However, a 20% co-insurance applies for out-of-network services.

<Human>:What is the cost for a hospital stay?<Assistant>:The costs associated with a hospital stay, such as the facility fee for the hospital room and the physician/surgeon fees, are covered without charge under the plan for in-network services. However, a 20% co-insurance applies for out-of-network services.

<Human>:What proportion of the costs for emergency medical attention does the plan cover?<Assistant>:For emergency room care, the plan requires a $250 co-pay, after which it covers the remaining cost. However, the co-pay is waived if the individual is admitted to the hospital following the emergency room visit or for an accidental injury. Emergency medical transportation is covered without charge.

<Human>:What is the cost for non-preferred brand drugs?<Assistant>:40 for 34-day supply/ 80 for 90-day supply

<Human>:What is the purpose of the Summary of Benefits and Coverage (SBC) document?<Assistant>:The Summary of Benefits and Coverage (SBC) document is designed to help individuals choose a health plan. It provides an overview of how the cost for covered health care services would be shared between the individual and the plan. However, it does not include information about the cost of the plan (known as the premium), which is provided separately. For more detailed information about the coverage, individuals can visit the specified website or make a phone call to the provided number.

<Human>:What is the plan type?<Assistant>:PPO

<Human>:What is the coverage period?<Assistant>:Beginning on or after 01/01/2021

<Human>:What does the out-of-pocket limit refer to and what does it include?<Assistant>:The out-of-pocket limit is the maximum amount an individual could pay in a year for covered services. If there are other family members in the plan, they have to meet their own out-of-pocket limits until the overall family out-of-pocket limit has been met. It is important to note that the out-of-pocket limit does not include premiums, balance-billed charges, any pharmacy penalty, and health care that the plan doesn’t cover.

<Human>:Are preventive care/ screenings/ and immunizations covered?<Assistant>:Yes/ with no charge

<Human>:What is the cost for childbirth/delivery facility services?<Assistant>:No charge

<Human>:What is the best restaurant in San Francisco?<Assistant>:I can't answer your question as I am trained to answer SBC related information, if you have a question in that direction please feel free to ask your query.

<Human>:What is the cost for primary care and specialist visits?<Assistant>:The cost for both primary care and specialist visits is a $20 co-pay for in-network services. However, individuals will be liable for 20% co-insurance if they opt for out-of-network providers.

<Human>:What is the cost for rehabilitation services?<Assistant>:No charge

<Human>:Can individuals see a specialist without a referral?<Assistant>:Yes, individuals can see the specialist of their choice without a referral under this health plan. This offers greater flexibility and convenience, allowing individuals to access specialist services without the need for a referral from another healthcare provider.

<Human>:Do you need a referral to see a specialist?<Assistant>:No

<Human>:What are some of the services covered before meeting the deductible?<Assistant>:This health plan covers some items and services even if the deductible amount has not been met. However, a copayment or coinsurance may apply. For example, this plan covers certain preventive services without cost-sharing and before you meet your deductible. This includes services like routine check-ups, screenings, and immunizations.

<Human>:What is not included in the out-of-pocket limit?<Assistant>:Premiums/ balance-billed charges/ any pharmacy penalty/ and health care this plan doesn't cover

<Human>:What is the cost for specialty drugs?<Assistant>:50 for 34-day supply

<Human>:How much is the co-pay for a primary care visit?<Assistant>:20

<Human>:What is the weather like in Paris today?<Assistant>:I can't answer your question as I am trained to answer SBC related information, if you have a question in that direction please feel free to ask your query.

<Human>:What is the cost for generic drugs?<Assistant>:10 for 34-day supply/ 20 for 90-day supply

<Human>:What is the cost for generic drugs?<Assistant>:10 for 34-day supply/ 20 for 90-day supply

<Human>:What are the costs associated with mental health, behavioral health, or substance abuse services?<Assistant>:Mental health, behavioral health, or substance abuse services are covered without charge under the plan for both outpatient and inpatient services in-network. However, a 20% co-insurance applies for out-of-network services.

<Human>:Are children's eye exams covered?<Assistant>:No

<Human>:What is the total cost Joe would pay for managing Type 2 Diabetes?<Assistant>:340

<Human>:What is the purpose of the Summary of Benefits and Coverage (SBC) document?<Assistant>:The Summary of Benefits and Coverage (SBC) document is designed to help individuals choose a health plan. It provides an overview of how the cost for covered health care services would be shared between the individual and the plan. However, it does not include information about the cost of the plan (known as the premium), which is provided separately. For more detailed information about the coverage, individuals can visit the specified website or make a phone call to the provided number.

<Human>:What is the distance between the Earth and the Moon?<Assistant>:I can't answer your question as I am trained to answer SBC related information, if you have a question in that direction please feel free to ask your query.

<Human>:How much does urgent care cost?<Assistant>:25 co-pay

<Human>:Is adult dental care covered?<Assistant>:No

<Human>:Who can be contacted for grievances and appeals?<Assistant>:Blue Cross and Blue Shield of Michigan/ Michigan Office of Financial and Insurance Regulation/ Employee Benefits Security Administration

<Human>:What percentage of the cost is covered for in-network specialist visits?<Assistant>:In-network specialist visits require a $20 co-pay, after which the plan covers the remaining cost. The exact percentage covered by the plan would depend on the total cost of the visit, but the individual's cost would not exceed the $20 co-pay.

<Human>:Who won the Nobel Prize in Literature in 2010?<Assistant>:I can't answer your question as I am trained to answer SBC related information, if you have a question in that direction please feel free to ask your query.