What are the main differences between HIP Select PPO Plan #1 and HIP Select PPO Plan #2?

HIP Select PPO Plan #1 and #2, mainly differ in following ways:

1. Prescription Coverage
• Generic prescription drugs are subject to a $15 co-pay. Formulary required (a preapproved list of prescriptions covered by HIP). Brand names and nonformulary prescriptions are NOT covered on PPO #1 versus
• Generic prescription drugs are subject to a $20 co-pay and brand names are subject to a $30 copay. Nonformulary prescriptions are subject to a $50 copay on PPO #2
2. Out of network annual deductible and coinsurance and annual out-of-pocket maximums
• Deductible: $4,000 individual/$8,000 family and 50/50 coinsurance up to the annual out of pocket maximum of $20,000 individual/$40,000 family on PPO #1 versus
• Deductible: $3,000 individual/$6,000 family and 70/30 coinsurance up to the annual out of pocket maximum of $10,000 individual/$20,000 family on PPO #2
3. Speech, Physical, Occupational, and Respiratory Therapy
• When part of an inpatient hospital acute admission (in or out-of-network), it's covered on both PPO # 1 and PPO #2 on a short term basis only and is subject to the deductible and coinsurance
• However, when it's part of an inpatient hospital rehabilitation admission it is NOT covered at all on PPO #1 versus
• Coverage for up to 30 days per calendar year subject to the deductible and coinsurance in network only on PPO #2
• On an outpatient basis, it's NOT covered at all on PPO #1 versus
• Coverage for up to 30 visits per calendar year subject to the specialist office visit copay in-network or subject to the deductible and coinsurance out-of-network on PPO#2
4. Mental Healthcare
• As an inpatient, both PPO #1 and PPO # 2 provide coverage for up to 30 days per calendar year with no copay in network or subject to the deductible and coinsurance out of network
• However, on an outpatient basis, PPO # 1 includes coverage for up to 20 visits per calendar year subject to the specialist office copay in network or subject to the deductible and coinsurance out-of-network on PPO #1 versus
• Coverage for up to 60 visits per calendar year subject to the specialist office copay in network or subject to the deductible and coinsurance out of network on PPO #2

You may also refer to the HIP Comparison Chart for easy reference provided online. For a comprehensive and detailed listing of medical services that are covered, please refer to the summary of benefits provided online on the healthcare page for each plan