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Medical
Medical coverage provides you with benefits that help keep you healthy, such as preventive care screenings and
access to urgent care. It also provides important financial protection if you have a serious medical condition.
San
Diego Natural History Museum
provides you with a choice between three different medical plans.
Kaiser
Permanente
HMO
Anthem
Select HMO
(excludes Scripps
Clinic and Scripps
Coastal Providers)
Anthem
HDHP / HSA
Lumenos Plan
HMO Network
HMO Network
In-Network
Out-Of-Network
Member Pays
Member Pays
Member Pays
(after deductible)
Calendar Year Deductible
Individual
Family
(combined Medical and RX)
None
None
None
None
$2,600
$5,200
$7,800
$15,600
Calendar Year Out-of-Pocket
Maximum
Individual
Family
(combined Medical
and RX)
(combined Medical and
RX)
(combined Medical and RX)
$3,000
$6,000
$2,500
$5,000
$5,000
$10,000
$15,000
$30,000
Office Visit
Primary Care Provider (PCP)
$40 Copay / Visit
$20 Copay / Visit
No Charge after
deductible
30% after deductible
Specialist Visit
$40 Copay / Visit
$40 Copay / Visit
Preventive Services
(as defined by Health Care Reform)
No Charge
No Charge
No Charge
(deductible waived)
30% after deductible
Lab and X-ray
(Routine lab and imaging)
$10 Copay
No Charge
No Charge after
deductible
30% after deductible
(up to $350)
Complex Imaging
(MRI, CT Scan, PET Scan, etc.
precertification may be required)
$50 Copay / Test
$100 Copay / Test
No Charge after
deductible
30% after deductible
(up to $800 per test)
Hospitalization
Inpatient
$500 Copay / Per
Admit
$250 Copay / Day
(up to $750 per admit)
No Charge after
deductible
30% after deductible
(up to $1,000 / day)
Outpatient Surgery
$250 Copay /
Procedure
$125 Copay /
Procedure
No Charge after
deductible
30% after deductible
(up to $350 / admission)
Urgent Care
$40 Copay / Visit
$20 Copay / Visit
No Charge after
deductible
30% after deductible
Emergency Room
(copay waived if admitted)
$150 Copay / Visit
$150 Copay / Visit
No Charge after deductible
Chiropractic Care
(rehab services are included in
benefit maximum)
Not Covered
$20 Copay / Visit
(60 visits per calendar
year)
No Charge after
deductible
30% after
deductible
(30 visits per calendar year)