Plan options for 2021
Platinum
This is a top-level plan with a $0 deductible. The copays listed are not a complete list of services that require a copay.
Monthly premium
High
Deductible
$0
Out-of-pocket maximum
$4,000
PCP office visit copay
$15
Individual annual deductible
Individual annual deductible
An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay.
In network
$0
Out of network
Not covered
Family annual deductible
Family annual deductible
A family annual deductible is the amount you and others on your plan have to pay each year for health services before your health insurance begins to pay.
In network
$0
Out of network
Not covered
Coinsurance percentage
Coinsurance percentage
Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible.
In network
0%
Out of network
Not covered
Embedded coinsurance maximum
Embedded coinsurance maximum
The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.
In network
N/A
Out of network
Not covered
Individual out-of-pocket maximum
Out-of-pocket maximum
This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.
In network
$4,000
Out of network
Not covered
Family out-of-pocket maximum
Out-of-pocket maximum
This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.
In network
$8,000
Out of network
Not covered
PCP office visit copay
PCP office visit copay
This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care.
In network
$15
Out of network
Not covered
Specialist care copay (when referred)
In network
$40
Out of network
Not covered
Retail health clinic copay
In network
$40
Out of network
Not covered
Urgent care copay
In network
$40
Out of network
Not covered
Emergency room copay
In network
$250
Out of network
Not covered
Ambulance copay (when medically necessary)
In network
$100
Out of network
Not covered
Preferred generic pharmacy copay
Preferred generic pharmacy copay
This is what you'll pay when you buy a commonly prescribed generic version of a brand-name drug. This is the lowest copay tier for prescription drugs.
In network
$4
Out of network
Not covered
|
|
|
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|---|---|---|---|
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Individual annual deductible An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay. |
$0 | Not covered | |
|
Family annual deductible A family annual deductible is the amount you and others on your plan have to pay each year for health services before your health insurance begins to pay. |
$0 | Not covered | |
|
Coinsurance percentage Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible. |
0% | Not covered | |
|
Embedded coinsurance maximum The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum. |
N/A | Not covered | |
|
Out-of-pocket maximum This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services. |
$4,000 | Not covered | |
|
Out-of-pocket maximum This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services. |
$8,000 | Not covered | |
|
PCP office visit copay This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care. |
$15 | Not covered | |
|
|
$40 | Not covered | |
|
|
$40 | Not covered | |
|
|
$40 | Not covered | |
|
|
$250 | Not covered | |
|
|
$100 | Not covered | |
|
Preferred generic pharmacy copay This is what you'll pay when you buy a commonly prescribed generic version of a brand-name drug. This is the lowest copay tier for prescription drugs. |
$4 | Not covered |
Gold
This is a mid-level plan with a $0 deductible. The copays listed are not a complete list of services that require a copay.
Monthly premium
Medium
Deductible
$0
Out-of-pocket maximum
$6,500
PCP office visit copay
$20
Individual annual deductible
Individual annual deductible
An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay.
In network
$0
Out of network
Not covered
Family annual deductible
Family annual deductible
A family annual deductible is the amount you and others on your plan have to pay each year for health services before your health insurance begins to pay.
In network
$0
Out of network
Not covered
Coinsurance percentage
Coinsurance percentage
Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible.
In network
0%
Out of network
Not covered
Embedded coinsurance maximum
Embedded coinsurance maximum
The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.
In network
N/A
Out of network
Not covered
Individual out-of-pocket maximum
Out-of-pocket maximum
This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.
In network
$6,500
Out of network
Not covered
Family out-of-pocket maximum
Out-of-pocket maximum
This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.
In network
$13,000
Out of network
Not covered
PCP office visit copay
PCP office visit copay
This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care.
In network
$20
Out of network
Not covered
Specialist care copay (when referred)
In network
$50
Out of network
Not covered
Retail health clinic copay
In network
$50
Out of network
Not covered
Urgent care copay
In network
$50
Out of network
Not covered
Emergency room copay
In network
$250
Out of network
Not covered
Ambulance copay (when medically necessary)
In network
$100
Out of network
Not covered
Preferred generic pharmacy copay
Preferred generic pharmacy copay
This is what you'll pay when you buy a commonly prescribed generic version of a brand-name drug. This is the lowest copay tier for prescription drugs.
In network
$10
Out of network
Not covered
|
|
|
||
|---|---|---|---|
|
Individual annual deductible An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay. |
$0 | Not covered | |
|
Family annual deductible A family annual deductible is the amount you and others on your plan have to pay each year for health services before your health insurance begins to pay. |
$0 | Not covered | |
|
Coinsurance percentage Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible. |
0% | Not covered | |
|
Embedded coinsurance maximum The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum. |
N/A | Not covered | |
|
Out-of-pocket maximum This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services. |
$6,500 | Not covered | |
|
Out-of-pocket maximum This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services. |
$13,000 | Not covered | |
|
PCP office visit copay This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care. |
$20 | Not covered | |
|
|
$50 | Not covered | |
|
|
$50 | Not covered | |
|
|
$50 | Not covered | |
|
|
$250 | Not covered | |
|
|
$100 | Not covered | |
|
Preferred generic pharmacy copay This is what you'll pay when you buy a commonly prescribed generic version of a brand-name drug. This is the lowest copay tier for prescription drugs. |
$10 | Not covered |
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