Premium$0Key Extra BenefitsDental Level 4, Routine Eye Exam, Eyewear Credit, OTC Debit Card, Healthy Food Benefit, Routine Hearing Exam, Hearing Aids, Fitness Program, Virtual Medical Visits, continue reading
2021
August 5, 2020
Premium$0Key Extra BenefitsDental Level 3, Routine Eye Exam, Eyewear Credit, OTC Catalog, Routine Hearing Exam, Hearing Aids, Virtual Medical Visits, Virtual Mental Health Visits, Nurseline, Transportation, continue reading
August 5, 2020
Premium$0Key Extra BenefitsDental Level 4, Routine Eye Exam, Eyewear Credit, OTC Catalog, Routine Hearing Exam, Hearing Aids, Virtual Medical Visits, Virtual Mental Health Visits, Nurseline, Transportation, continue reading
August 5, 2020
Premium$0Key Extra BenefitsDental Level 4, Routine Eye Exam, Eyewear Credit, OTC Catalog, Routine Hearing Exam, Hearing Aids, Virtual Medical Visits, Virtual Mental Health Visits, Nurseline, Transportation, continue reading
August 5, 2020
Premium$19MOOP $6,700PCP$0Specialist$40Referrals RequiredNoInpatient Hospital$335 (days 1-5)Ambulatory Surgery Center$0 or $335Outpatient Hospital$0 or $335Lab Copay$0Rx Deductible$210 tiers 4-5Rx Copays$4/$12/$47/$100/29%Key Extra BenefitsDental Level 3, Routine Eye Exam, Eyewear Credit, continue reading
August 5, 2020
Premium$0 for Full DualsMOOP $0 for Full DualsPCP$0 for Full DualsSpecialist$0 for Full DualsReferrals RequiredNoInpatient Hospital$0 for Full DualsAmbulatory Surgery Center$0 for Full DualsOutpatient Hospital$0 for Full continue reading
August 5, 2020
Premium$0 / Part B Rebate: $30MOOP $6,700PCP$0Specialist$45Referrals RequiredNoInpatient Hospital$395 (days 1-4)Ambulatory Surgery Center$0 or $335Outpatient Hospital$0 or $335Lab Copay$0Rx DeductibleNot coveredRx CopaysNot coveredKey Extra BenefitsDental Level 2, continue reading
August 5, 2020
Premium$49MOOP $6,700PCP$5Specialist$45Referrals RequiredNoInpatient Hospital$395 (days 1-4)Ambulatory Surgery Center$0 or $395Outpatient Hospital$0 or $395Lab Copay$0Rx Deductible$295 tiers 3-5Rx Copays$4/$14/$47/$100/27%Key Extra BenefitsRoutine Eye Exam, Routine Hearing Exam, Hearing Aids, continue reading
August 5, 2020
Premium$49MOOP $4,900PCP$0Specialist$30Referrals RequiredNoInpatient Hospital$265 (days 1-7)Ambulatory Surgery Center$0 or $215Outpatient Hospital$0 or $265Lab Copay$0Rx Deductible$175 tiers 4-5Rx Copays$3/$10/$47/$100/30%Key Extra BenefitsDental Level 2, Routine Eye Exam, Eyewear Credit, continue reading
August 5, 2020
Premium$0MOOP $4,900PCP$0Specialist$45Referrals RequiredNoInpatient Hospital$370 (days 1-5)Ambulatory Surgery Center$0 or $320Outpatient Hospital$0 or $370Lab Copay$0Rx Deductible$275 tiers 3-5Rx Copays$4/$12/$47/$100/28%Key Extra BenefitsRoutine Eye Exam, Eyewear Credit, Routine Hearing Exam, continue reading
August 5, 2020
Premium$0MOOP $6,700PCP$0Specialist$45Referrals RequiredNoInpatient Hospital$370 (days 1-5)Ambulatory Surgery Center$0 or $320Outpatient Hospital$0 or $370Lab Copay$0Rx Deductible$275 tiers 3-5Rx Copays$0/$5/$47/$95/28% (Preferred)Key Extra BenefitsDental Level 1, Routine Eye Exam, Eyewear continue reading
August 4, 2020
Premium$0MOOP $6,700PCP$10Specialist$40Referrals RequiredNoInpatient Hospital$295 (days 1-7)Ambulatory Surgery Center$0 or $245Outpatient Hospital$0 or $295Lab Copay$0Rx Deductible$275 tiers 3-5Rx Copays$4/$12/$47/$100/28%Key Extra BenefitsDental Level 3, Routine Eye Exam, Eyewear Credit, continue reading
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TMG University
