Frequently Asked Questions
At Ten99 Health, we aim to make your health benefits experience as clear and straightforward as possible. Below are answers to some of the most common questions about our plans and coverage.
What can I expect when I enroll?
After completing your enrollment, you will receive an email with your group ID and coverage information. About 3 to 5 weeks after, you will receive your physical BCBS card in the mail.
Are there services covered before I meet my deductible?
Yes, in-network preventive care and wellness benefits are covered before you meet your deductible.
What is the out-of-pocket limit for this plan?
For in-network providers, the out-of-pocket limit is $3,800 per person and $11,400 per family per calendar year. Out-of-network providers are not covered. This limit is the maximum amount you could pay in a year for covered services. If you have family members on your plan, they must meet their individual out-of-pocket limits until the overall family limit is reached.
What is not included in the out-of-pocket limit?
The following are not included in the out-of-pocket limit:
- Penalties for failure to obtain pre-authorization
- Premiums
- Balance-billing charges
- Healthcare services that are not covered by the plan
Will I pay less if I use a network provider?
Yes, this plan uses the BCBS IL Participating Provider Organization (PPO) network. Using in-network providers will lower your costs. Out-of-network providers are not covered unless it is an emergency.
Is this a national plan?
Yes, coverage is available in all 50 states.
Do I need a referral to see a specialist?
No, you can see a specialist without needing a referral.
What should I know about my Rx Plan?
You can fill your initial prescription at your local pharmacy. For medications you take longer than two months, you will need to use the OptumRx online prescription service.
Are premiums tax-deductible?
Yes. Self-employed contractors who have a net profit for the year can write off 100% of their health premiums.
Can my LLC pay for my health coverage?
Yes, your LLC can pay for your health coverage, but there are specific tax reporting rules to follow. If the LLC pays, you can still claim a deduction for the premiums paid for your coverage.