Key Medical Benefits |
HDHP EPO Value Plan |
EPO Core Plan |
Office Visits Preventive |
$ 0 |
$ 0 |
Primary |
10 % after deductible |
$ 45 * or 20 % after deductible |
Specialty |
10 % after deductible |
$ 65 * or 20 % after deductible |
Copay Visit Combined Maximum * |
Not applicable |
12 copay visits per member per plan year |
Virtual Health |
$ 0 after deductible |
$ 0 after deductible |
Other visits Lab Services |
10 % after deductible |
20 % after deductible |
Urgent Care |
$ 75 , after deductible |
$ 75 |
Emergency Room |
10 % after deductible |
20 % after deductible |
Outpatient |
10 % after deductible |
20 % after deductible |
Inpatient |
10 % after deductible |
20 % after deductible |
Medical Coinsurance % You Pay After Deductible |
10 % |
20 % |
Medical Annual Deductible Single |
$ 2,250 |
$ 1,750 |
Family ( 2x Single ) |
$ 4,500 |
$ 3,500 |
Medical + Prescription Annual Maximum Single |
$ 6,000 |
$ 6,000 |
Family ( 2x Single ) |
$ 12,000 |
$ 12,000 |
Prescriptions Preventive |
$ 0 |
$ 0 |
Tier 1 - Generic |
10 % after deductible |
15 %, maximum of $ 25 |
Tier 2 - Brand |
10 % after deductible |
25 %, maximum of $ 125 |
Tier 3 - Non-Preferred Brand |
10 % after deductible |
40 % |
Tier 4 - Specialty |
10 % after deductible |
50 % |