Medical Plan Comparison

Primary: Tier 1 $0 Copay
Tier 2 Deductible + 50% to OOP Max

Specialist: Tier 1 $100 Copay
Tier 2 Deductible + 50% to OOP Max

$45 Copay / $45 Copay

$40 Copay / $40 Copay

Single Tier 1: $1,500, Tier 2: $3,000
Family Tier 1: $3,000, Tier 2: $6,000

$2,500 / $5,000

$1,500 / $3,000

Tier 1: 20% / Tier 2: 50%

20% In / 40% Out

20% In Network Only

Tier 1: $4,000 / Tier 2: $8,000

$4,500 / $9,000

$4,000

Tier 1: $8,000 / Tier 2: $16,000

$9,000 / $18,000

$8,000

Tier 1: Deductible + 20% to OOP Max
Tier 2: Deductible + 50% to OOP Max

Deductible + 20% to OOP Max

Tier 1: Deductible + 20% to OOP Max
Tier 2: Deductible + 50% to OOP Max

Deductible + 20% to OOP Max

Deductible + 20% to OOP Max
Amb Surgery Center $500 Copay

Generic $20 / Preferred $40 / Non-preferred $60

Generic $20 / Preferred $40 / Non-preferred $60

Generic $20 / Preferred $40 / Non-preferred $60

2 times copay

2 times copay

2 times copay

Covered 100%

Covered 100%

Covered 100%

Covered 100%

$45 Copay

$40 Copay

Covered 100%

Covered 100%

N/A

$45 Copay

$45 Copay

Covered 100%

Tier 1 $500 Copay /
Tier 2 Deductible + 50% to OOP Max

Deductible + 20% to OOP Max

Deductible + 20% to OOP Max

$25 Copay

$45 Copay Office Setting /
Outpatient subject to deductible

Deductible + 20% to OOP Max

$25 Copay

$45 Copay

$40 Copay

Covered 100%

$75 Copay

Office Setting $0 Copay /
Outpatient setting Deductible + 20% to OOP Max

Tier 1: Deductible + 20% to OOP Max
Tier 2: Deductible + 50% to OOP Max