Premium $0 MOOP $3,400 IN ; $5,100 OON PCP $0 IN ; $50 OON Specialist $30 IN ; $50 OON Referrals Required No Lab Copay $0 continue reading
North Carolina 2021 MAPD
August 6, 2020
Premium $0 MOOP $6,700 PCP $0 Specialist $45 Referrals Required No Inpatient Hospital $395 (days 1-5) Ambulatory Surgery Center $0 or $295 Outpatient Hospital $0 or continue reading
August 6, 2020
Premium$0 / Part B Rebate: $40MOOP $5,900PCP$0Specialist$35Referrals RequiredNoInpatient Hospital$320 (days 1-5)Ambulatory Surgery Center$0 or $220Outpatient Hospital$0 or $320Lab Copay$0Rx DeductibleNot coveredRx CopaysNot coveredKey Extra BenefitsDental Level 2 continue reading
August 6, 2020
Premium$0 / Part B Rebate: $45MOOP $3,600PCP$0Specialist$25Referrals RequiredNoInpatient Hospital$295 (days 1-5)Ambulatory Surgery Center$0 or $195Outpatient Hospital$0 or $295Lab Copay$0X-Ray$14Urgent Care / ER$30 / $90Radiology Services$100Rx DeductibleNot coveredRx continue reading
August 6, 2020
Premium$0MOOP $6,700PCP$0Specialist$45Referrals RequiredNoInpatient Hospital$395 (days 1-5)Ambulatory Surgery Center$0 or $295Outpatient Hospital$0 or $395Lab Copay$0Rx Deductible$250 tiers 3-5Rx Copays$2/$10/$47/$100/28%Key Extra BenefitsPreventative Dental, Routine Eye Exam and Eyewear Credit continue reading
August 6, 2020
Premium$38MOOP $4,900PCP$0Specialist$35Referrals RequiredNoInpatient Hospital$295 (days 1-6)Ambulatory Surgery Center$0 or $145Outpatient Hospital$0 or $245Lab Copay$0X-Ray$14Urgent Care / ER$30 / $90Radiology Services$110Rx Deductible$95 tiers 4-5Rx Copays$2/$8/$47/$100/31%Key Extra BenefitsDental Level continue reading
August 6, 2020
Premium$0MOOP $5,400PCP$0Specialist$45Referrals RequiredNoInpatient Hospital$395 (days 1-4)Ambulatory Surgery Center$0 or $245Outpatient Hospital$0 or $345Lab Copay$0X-Rays$14Urgent Care / ER$30 / $90Radiology Services$110Rx Deductible$170 tiers 4-5Rx Copays$2/$8/$47/$100/30%Key Extra BenefitsDental Level continue reading
August 6, 2020
Premium$48MOOP $4,900PCP$0Specialist$35Referrals RequiredNoInpatient Hospital$345 (days 1-4)Ambulatory Surgery Center$0 or $195Outpatient Hospital$0 or $295Lab Copay$0X-Ray$14Urgent Care / ER$30 / $90Radiology Services$110Rx Deductible$95 tiers 4-5Rx Copays$2/$8/$47/$100/31%Key Extra BenefitsDental ($1,000), continue reading
August 6, 2020
Premium$14MOOP $5,900PCP$0Specialist$45Referrals RequiredNoInpatient Hospital$395 (days 1-4)Ambulatory Surgery Center$0 or $245Outpatient Hospital$0 or $345Lab Copay$0X-Ray$14Urgent Care / ER$30 / $90Radiology Services$110Rx Deductible$170 tiers 3-5Rx Copays$2/$8/$47/$100/30%Key Extra BenefitsPreventative Dental, continue reading
August 6, 2020
Premium$26MOOP $5,900PCP$0Specialist$35Referrals RequiredNoInpatient Hospital$320 (days 1-5)Ambulatory Surgery Center$0 or $220Outpatient Hospital$0 or $320Lab Copay$0Rx Deductible$195 tiers 4-5Rx Copays$2/$8/$47/$100/29%Key Extra BenefitsDental Level 2 ($500), Routine Eye Exam and continue reading
August 6, 2020
Premium$0MOOP $6,700PCP$0Specialist$45Referrals RequiredNoInpatient Hospital$395 (days 1-5)Ambulatory Surgery Center$0 or $295Outpatient Hospital$0 or $395Lab Copay$0X-Ray$14Urgent Care / ER$30 / $90Radiology Services$110Rx Deductible$295 tiers 4-5Rx Copays$2/$8/$47/$100/27%Key Extra BenefitsPreventative Dental, continue reading
August 6, 2020
Premium$38MOOP $3,900PCP$0Specialist$35Referrals RequiredNoInpatient Hospital$345 (days 1-5)Ambulatory Surgery Center$0 or $195Outpatient Hospital$0 or $295Lab Copay$0X-Rays$14Radiology Services$110Rx Deductible$50 tiers 4-5Rx Copays$2/$8/$47/$100/32%Key Extra BenefitsDental Level 4 ($1,000), Routine Eye Exam continue reading
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TMG University
