Golden Rule of Iowa Plan 100 Plan Information
Golden Rule - Plan 100
Deductibles:
You pay $1,500, $2,500, $5,000, $7,500 or $10,000
Coinsurance Choices you pay 0%
Coinsurance Out-of-Pocket Maximum is $0
Initial Rate Guarantee is 12 months
Physicians (Illness & injury):
Office Visit--History and Exam (Primary Care or Specialist in-network only) is no charge after deductible
No Primary Care Physician/Specialist Referrals Required
Prescription Drugs:
Preferred price card (You pay for prescriptions at the point of sale, at the lowest price available, and submit a claim
to Golden Rule.)
Preferred price card there is no charge after deductible
Annual Maximum is $3,000
Wellness/Preventive Care Benefits
No waiting period
Doctor Office Visit is no charge after deductible
X-ray and lab (in conjunction with the preventive office visit, performed in the doctor;s office
or a network facility) is no charge after deductible
Child Immunizations are no charge after deductible
Preventive Mammogram, Pap Smear, PSA screening are no charge after deductible
Outpatient Expense Benefits
X-ray and lab (performed in the doctor's office or a network facility) are no charge after deductibel
Facility/Hospital for Outpatient Surgery is no charge after deductible
Surgeon, Assistant Surgeon, and Facility Fees are no charge after deductible
Hemodialysis, Radiation, Chemotherapy, Organ Transplant Drugs, CAT scans, and MRIs are no charge after deductible
Emergency Room Fees--Illness you pay $100 copay if not admitted, then no charge after deductible
Emergency Room Fees--Injury there is no charge after deductible
Spine and Back Disorders (CAT Scan and MRI tests are not subject to this limitation) there is no charge after deductible
Mental and Nervous Disorders are no charge after deductible
Other Outpatient Services are no charge after deductible
Inpatient Expense Benefits
Room and Board, ICU, Operating Room, Recovery Room, Prescription Drugs, Physician Visit, and Professional Fees of Doctors,
Surgeons, Nurses are no charge after deductible
Other Inpatient Services are no charge after deductible
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