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
August 4, 2020
Premium$23MOOP $3,900PCP$0Specialist$25Referrals 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/$13/$47/$100/30%Key Extra BenefitsDental Level 4, Routine Eye Exam, Eyewear Credit, continue reading
August 3, 2020
Premium$0MOOP $4,900PCP$0Specialist$35Referrals 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 4, Routine Eye Exam, Eyewear Credit, continue reading
August 3, 2020
Premium$0PCP$5Specialist$40Referrals RequiredNoInpatient Hospital$295 (days 1-6) ; $0 (days 7-90)MOOP In-network$6,700Rx Deductible​$160 tiers 4-5Rx Preferred$4/$12/$47/$100/30%Key Extra BenefitsDental, Vision, Hearing, Fitness, OTC $25/Quarter for select health and wellness continue reading
August 3, 2020
Premium$0PCP$0Specialist$25Referrals RequiredNoInpatient Hospital$250 (days 1-6) ; $0 (days 7-90)MOOP In-network$3,450Rx DeductibleN/ARx Preferred$0/$8/$45/$95/33%Key Extra BenefitsDental, Vision, Hearing, Fitness, OTC $100/Quarter for select health and wellness products, Transportation continue reading
August 3, 2020
Premium$43PCP$15Specialist$35Referrals RequiredNoInpatient Hospital$265 (days 1-7) ; $0 (days 8-90)MOOP In-network$6,700Rx DeductibleN/ARx Preferred$7/$17/$47/$97/33%Key Extra BenefitsVision, Hearing, Fitness, OTC $25/Quarter for select health and wellness productsMarket Service AreaBristol, continue reading
August 3, 2020
Premium$29.40PCP$20Specialist20%Referrals RequiredNoInpatient Hospital$450 (days 1-4) ; $0 (days 5-90)MOOP In-network$6,700Rx DeductibleN/ARx Preferred$2/$12/$47/$100/27%Key Extra BenefitsDental, Vision, Hearing, Fitness, OTC $100/Month for select health and wellness products, Transportation continue reading
August 3, 2020
Premium$33PCP$0Specialist$25Referrals RequiredNoInpatient Hospital$175 (days 1-5) ; $0 (days 6-90)MOOP In-network$4,900Rx DeductibleN/ARx Preferred$1/$10/$47/$97/33%Key Extra BenefitsDental, Vision, Hearing, Fitness, OTC $100/Quarter for select health and wellness productsMarket Service continue reading
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