Premium$0Key Extra BenefitsDental Level 4, Routine Eye Exam, Eyewear Credit, OTC Debit Card, Healthy Food Benefit, Routine Hearing Exam, Hearing Aids, Fitness Program, Fitbit, Virtual Medical continue reading
2021
August 4, 2020
Premium $0 / Part B Rebate : $30 MOOP $6,700 PCP $0 Specialist $40 Referrals Required No Inpatient Hospital $345 (days 1-5) Ambulatory Surgery Center $0 continue reading
August 4, 2020
Premium $0 MOOP $6,700 PCP $0 Specialist $40 Referrals Required No Inpatient Hospital $345 (days 1-5) Ambulatory Surgery Center $0 or $345 Outpatient Hospital $0 or continue reading
August 4, 2020
Premium$19MOOP $5,900PCP$0Specialist$30Referrals RequiredNoInpatient Hospital$250 (days 1-5)Ambulatory Surgery Center$0 or $250Outpatient Hospital$0 or $250Lab Copay$0Rx Deductible$95 tiers 4-5Rx Copays$3/$12/$47/$100/31%Key Extra BenefitsDental Level 4, Routine Eye Exam, Eyewear Credit, continue reading
August 4, 2020
Premium $0 MOOP $6,700 PCP $0 Specialist $45 Referrals Required No Inpatient Hospital $295 (days 1-6) Ambulatory Surgery Center $0 or $295 Outpatient Hospital $0 or continue reading
August 4, 2020
Premium$0MOOP $6,700PCP$0Specialist$35Referrals RequiredNoInpatient Hospital$395 (days 1-3)Ambulatory Surgery Center$0 or $345Outpatient Hospital$0 or $345Lab Copay$0Rx Deductible$195 tiers 3-5Rx Copays$0/$5/$47/$100/29%Key Extra BenefitsDental Level 3, Routine Eye Exam, Eyewear Credit, continue reading
August 4, 2020
Premium $0 MOOP $6,700 PCP $0 Specialist $35 Referrals Required No Inpatient Hospital $345 (days 1-4) Ambulatory Surgery Center $0 or $345 Outpatient Hospital $0 or continue reading
August 4, 2020
Premium$26MOOP $4,500PCP$0Specialist$25Referrals RequiredNoInpatient Hospital$200 (days 1-5)Ambulatory Surgery Center$0 or $200Outpatient Hospital$0 or $200Lab Copay$0Rx Deductible$​0Rx Copays$3/$12/$47/$100/33%Key Extra BenefitsDental Level 4, Routine Eye Exam, Eyewear Credit, OTC Catalog, continue reading
August 4, 2020
Premium$0MOOP $4,900PCP$0Specialist$30Referrals RequiredNoInpatient Hospital$245 (days 1-6)Ambulatory Surgery Center$0 or $245Outpatient Hospital$0 or $245Lab Copay$0Rx Deductible$95 tiers 4-5Rx Copays$3/$12/$47/$100/31%Key Extra BenefitsDental Level 4, Routine Eye Exam, Eyewear Credit, continue reading
August 4, 2020
Premium$0MOOP $6,700PCP$0Specialist$50Referrals RequiredNoInpatient Hospital$350 (days 1-6)Ambulatory Surgery Center$0 or $350Outpatient Hospital$0 or $350Lab Copay$0Rx Deductible$405 tiers 3-5Rx Copays$3/$12/$47/$100/25%Key Extra BenefitsRoutine Eye Exam, Routine Hearing Exam, Hearing Aids, continue reading
August 4, 2020
Premium$28MOOP $4,900PCP$0Specialist$35Referrals RequiredNoInpatient Hospital$250 (days 1-6)Ambulatory Surgery Center$0 or $250Outpatient Hospital$0 or $250Lab Copay$0Rx Deductible$150 tiers 4-5Rx Copays$3/$12/$47/$100/33%Key Extra BenefitsDental Level 4, Routine Eye Exam, Eyewear Credit, continue reading
August 4, 2020
Premium$0MOOP $5,900PCP$0Specialist$40Referrals RequiredNoInpatient Hospital$295 (days 1-6)Ambulatory Surgery Center$0 or $295Outpatient Hospital$0 or $295Lab Copay$0Rx Deductible$150 tiers 4-5Rx Copays$3/$13/$47/$100/30%Key Extra BenefitsDental Level 2, Routine Eye Exam, Eyewear Credit, continue reading
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TMG University
