Premium $0 Plan Deductible $0 MOOP $7,550 IN/OON PCP (unlimited) $0 IN/OON Specialist (unlimited) $0 IN/OON Inpatient Hospital $225 (days 1-5) IN/OON Outpatient Surgery: Hospital $200 continue reading
2021
July 13, 2020
Premium $0 Plan Deductible $0 MOOP $7,550 IN/OON PCP (unlimited) $0 IN/OON Specialist (unlimited) $0 IN/OON Inpatient Hospital $225 (days 1-5) IN/OON Outpatient Surgery: Hospital $200 continue reading
July 13, 2020
Premium $0 Plan Deductible $0 MOOP $7,550 IN/OON PCP (unlimited) $0 IN/OON Specialist (unlimited) $15 IN/OON Inpatient Hospital $290 (days 1-5) IN/OON Outpatient Surgery: Hospital $290 continue reading
July 13, 2020
Premium $0 Plan Deductible $0 MOOP $7,550 IN/OON PCP (unlimited) $0 IN/OON Specialist (unlimited) $0 IN/OON Inpatient Hospital $225 (days 1-5) IN/OON Outpatient Surgery: Hospital $200 continue reading
July 13, 2020
Premium $0 Plan Deductible $0 MOOP $7,550 IN/OON PCP (unlimited) $0 IN/OON Specialist (unlimited) $20 IN/OON Inpatient Hospital $295 (days 1-5) IN/OON Outpatient Surgery: Hospital $275 continue reading
July 13, 2020
Premium $0 MOOP $6,600 applies to in-network Medicare-covered benefits PCP $0 Specialist $15 Inpatient Hospital $325 (days 1-5) ; $0 (days 6-90) Ambulatory Surgery Center $0 continue reading
July 13, 2020
Premium $19.20 MOOP $6,600 applies to in-network Medicare-covered benefits PCP $0 Specialist $0 Inpatient Hospital $180 (days 1-10) ; $0 (days 11-90) Ambulatory Surgery Center $0 continue reading
July 13, 2020
Premium $0 MOOP $6,700 applies to in-network Medicare-covered benefits PCP $0 Specialist $15 Inpatient Hospital $325 (days 1-5) ; $0 (days 6-90) Ambulatory Surgery Center $0 continue reading
July 13, 2020
Premium $0 MOOP $6,700 applies to in-network Medicare-covered benefits PCP $0 Specialist $15 Inpatient Hospital $325 (days 1-5) ; $0 (days 6-90) Ambulatory Surgery Center $0 continue reading
July 13, 2020
Premium $27.30 MOOP $6,700 applies to in-network Medicare-covered benefits PCP $0 Specialist $0 Inpatient Hospital $500 per stay Ambulatory Surgery Center $0 - $110 Lab $0 continue reading
July 13, 2020
Premium $0 MOOP $6,700 applies to in-network Medicare-covered benefits PCP $0 Specialist $15 Inpatient Hospital $​325 (days 1-5) ; $0 (days 6-90) Ambulatory Surgery Center $0 continue reading
July 13, 2020
Premium$29MOOP$3,900 applies to in-network Medicare-covered benefitsPCP$0Specialist$10Inpatient Hospital$225 (days 1-5) ; $0 (days 6-90) Ambulatory Surgery Center$0 - $175Urgent Care/ Emergency Room$10/$90Lab/X-rays$0/$10Radiology Services$0-$195Rx Deductible$0RX Preferred Cost Share continue reading
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