July 30, 2020
Premium$23PCP$10Specialist$35Referrals RequiredNoInpatient Hospital$345 (days 1-5) ; $0 (days 6-90)MOOP In-network$5,900 Rx Deductible$95 tiers 4-5Rx Preferred$2/$8/$45/$95/31%Key Extra BenefitsDental, Vision, Hearing, Fitness, OTC $25/Quarter for select health and continue reading
July 30, 2020
Pairs Well With: Premium Rx Deductible Preferred Retail 30-day Supply Standard Retail 30-day Supply Preferred Mail 90-day Supply Market Service Area continue reading
July 30, 2020
Pairs Well With: Premium Rx Deductible Preferred Retail 30-day Supply Standard Retail 30-day Supply Preferred Mail 90-day Supply Market Service Area continue reading
July 30, 2020
Dental $2500 annually; $0 copayments covers: exams, x-rays, cleanings, fillings, crowns, extractions, dentures Healthy Foods Card N/A Vision Annual exam and $300 credit every year for continue reading
July 30, 2020
Dental $1000 annually; $0 copayments covers: exams, x-rays, cleanings, fillings, crowns, extractions, dentures Healthy Foods Card $75 allowance per month for Healthy Foods Card for members continue reading
July 30, 2020
Dental$2500 annually; $0 copayments covers: exams, x-rays, cleanings, fillings, crowns, extractions, denturesHealthy Foods Card$75 allowance per month for Healthy Foods Card for members to spend at continue reading
July 30, 2020
Premium$0PCP$10Specialist$50Referrals RequiredNoInpatient Hospital$275 (days 1-6) ; $0 (days 7-90)Outpatient Surgery$275Lab / X-Ray$0 - $30 / $0 - $50Urgent Care / ER$65 / $90MOOP In-network$5,400 Rx DeductibleN/ARx continue reading
July 30, 2020
Premium$0 with $50 Part B GivebackPCP$20Specialist$50Referrals RequiredNoInpatient Hospital$240 (days 1-6) ; $0 (days 7-90)Outpatient Surgery $145 / $195Lab / X-Ray$0 / $150-$45Urgent Care / ER$20 / $90Radiology$180 continue reading
July 30, 2020
Premium$85PCP$20Specialist$50Referrals RequiredNoInpatient Hospital$345 (days 1-5) ; $0 (days 6-90)MOOP In-network/Out-network$7,550 Rx Deductible$160 tiers 3-5Rx Preferred$5/$15/$47/$99/30%Key Extra BenefitsDental, Hearing, Fitness, OTC $75/Quarter for select health and wellness continue reading
July 30, 2020
Premium$78PCP$15Specialist$50Referrals RequiredNoInpatient Hospital$360 (days 1-5) ; $0 (days 6-90)MOOP In-network$7,550 Rx Deductible$360 tiers 4-5Rx Preferred$5/$15/$47/$99/26%Key Extra BenefitsVision, Hearing, Fitness, OTC $25/Quarter for select health and wellness continue reading
July 30, 2020
Premium$70PCP$15Specialist$45Referrals RequiredNoInpatient Hospital$450 (days 1-4) ; $0 (days 5-90)MOOP In-network$6,700 Rx Deductible$265 tiers 4-5Rx Preferred$4/$12/$47/$100/28%Key Extra BenefitsHearing, Fitness, OTC $25/Quarter for select health and wellness productsMarket continue reading
July 30, 2020
Premium$0PCP$0Specialist$30Referrals RequiredNoInpatient Hospital$345 (days 1-4) ; $0 (days 5-90)Outpatient Surgery$295 / $345Urgent Care / ER$20 / $90Lab / X-Ray$0 / $0 - $20Radiology$180 - $275MOOP In-network$4,350 continue reading
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