August 3, 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
August 3, 2020
Premium$22PCP20%Specialist20%Referrals RequiredNoInpatient Hospital$490 (days 1-4) ; $0 (days 5-90)MOOP In-network$7,550 Rx Deductible$445 tiers 3-5Rx Preferred$0/$15/$47/$100/25%Key Extra BenefitsDental, Vision, Hearing, Fitness, OTC $100/Quarter for select health and continue reading
August 3, 2020
Premium$0PCP$0Specialist$35Referrals RequiredNoInpatient Hospital$345 (days 1-4) ; $0 (days 5-90)MOOP In-network$5,900 Rx DeductibleN/ARx Preferred$4/$12/$47/$100/33%Key Extra BenefitsVision, Hearing, Fitness, OTC $50/Quarter for select health and wellness productsMarket Service continue reading
August 3, 2020
Premium$0PCP$10Specialist$35Referrals RequiredNoInpatient Hospital$500 per admissionMOOP In-network$3,400 Rx DeductibleN/ARx PreferredN/AKey Extra BenefitsDental, Vision, Hearing, Fitness, OTC $75/Quarter for select health and wellness productsMarket Service AreaAccomack, Alexandria City, continue reading
August 3, 2020
Premium ​ PCP ​ Specialist ​ Referrals Required ​ Inpatient Hospital ​ MOOP In-network ​ Rx Deductible ​ Rx Preferred ​ Key Extra Benefits ​ Market continue reading
August 3, 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
August 3, 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
August 3, 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
August 3, 2020
Premium ​ PCP ​ Specialist ​ Referrals Required ​ Inpatient Hospital ​ MOOP In-network ​ Rx Deductible ​ Rx Preferred ​ Key Extra Benefits ​ Market continue reading
August 3, 2020
Premium$0 with a $50 Part B GivebackPCP$20Specialist$50Referrals RequiredNoInpatient Hospital$195 (days 1-6) ; $0 (days 7-90)MOOP In-network$6,700 Rx DeductibleN/ARx PreferredN/AKey Extra BenefitsDental, Vision, Hearing, Fitness, OTC $30/Quarter continue reading
August 3, 2020
Premium$0PCP$0Specialist$45Referrals RequiredNoInpatient Hospital$345 (days 1-4) ; $0 (days 5-90)MOOP In-network$7,550 Rx Deductible​N/ARx Preferred$4/$12/$47/$100/33%Key Extra BenefitsVision, Hearing, Fitness, OTC $30/Quarter for select health and wellness productsMarket Service continue reading
August 3, 2020
Premium$15PCP20%Specialist20%Referrals RequiredNoInpatient Hospital$490 (days 1-4) ; $0 (days 5-90)MOOP In-network$7,550 Rx Deductible$445 tiers 3-5Rx Preferred$0/$17/$47/$95/25%Key Extra BenefitsDental, Vision, Hearing, Fitness, OTC $100/Quarter for select health and continue reading
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