Premium$27MOOP $3,600PCP$0Specialist$30Referrals RequiredNoInpatient Hospital$295 (days 1-5)Ambulatory Surgery Center$0 or $195Outpatient Hospital$0 or $295Lab Copay$0X-Ray$14Urgent Care / ER$30 / $90Radiology Services$110Rx Deductible$50 tiers 4-5Rx Copays$2/$8/$47/$100/32%Key Extra BenefitsDental Level continue reading
Guilford
August 6, 2020
Premium$0 / Part B Rebate: $50MOOP $6,700PCP$0Specialist$45Referrals RequiredNoInpatient Hospital$430 (days 1-4)Ambulatory Surgery Center$0 or $295Outpatient Hospital$0 or $395Lab Copay$0Urgent Care/ ER$30 / $90X-Ray$14Radiology Services$110Rx Deductible$435 tiers 3-5Rx continue reading
August 6, 2020
Premium$0MOOP $4,500PCP$0Specialist$35Referrals RequiredNoInpatient Hospital$325 (days 1-5)Ambulatory Surgery Center$0 or $225Outpatient Hospital$0 or $325Lab Copay$0X-ray$14Radiology Services$110Rx Deductible$95 tiers 3-5Rx Copays$2/$8/$47/$100/31%Key Extra BenefitsDental Level 4 ($1,000), Routine Eye Exam continue reading
August 5, 2020
Premium$0Key Extra Benefits$3500 dental, $300 vision, $300/qtr OTC, $50/mo fresh food card, hearing aids, Fitness benefits, 48 trips, PERS, meal benefit, virtual doctor visits including mental continue reading
August 5, 2020
Premium$0Key Extra Benefits$2500 dental, $300 vision, $275 /qtr OTC, $55 fresh food card, hearing aids, Fitness benefits, virtual doctor visits, 48 trips, PERS, meal benefit, Virtual 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$49PCP$15Specialist$45Referrals RequiredNoInpatient Hospital$325 (days 1-6) ; $0 (days 7-90)Outpatient Surgery$275 / $325Lab / X-Ray$0 / $0 - $50Radiology$180 - $275Urgent Care / ER$35 / $90MOOP In-network$6,700 continue reading
July 30, 2020
Premium$0 with a $50 Part B GivebackPCP$20Specialist$50Referrals RequiredNoInpatient Hospital$450 (days 1-4) ; $0 (days 5-90)Outpatient Surgery$450Urgent Care / ER$65 / $90Lab / X-Ray$0 / $0 - continue reading
July 30, 2020
Premium$0PCP$35Specialist$25Referrals RequiredNoInpatient Hospital$295 (days 1-6) ; $0 (days 7-90)Outpatient Surgery$245 / $295Urgent Care / ER$0 / $90Lab / X-Ray$0 / $0 - $25Radiology$45 - $275MOOP In-network$3,900 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$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
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