Foundation Hospital Care
General Benefits
| In-Network Benefits | Out-Of-Network Benefits |
| Foundation Hospital Care pays 80% and you pay 20% of covered expenses after you meet your calendar year deductible. | Foundation Hospital Care pays 60% and you pay 40% of covered expenses after you meet your calendar year deductible. |
| Emergency Room visit is subject to a $200 copayment amount and calendar year deductible, then pays 80% and you pay 20%. | Emergency Room visit is subject to a $200 copayment amount and calendar year deductible, then pays 80% and you pay 20%. |
