Individual Health Plans

HMO Hybrid 23

In-Network Deductible
Individual: $750 | Family: $1,500

Preventive Care
$0

Office Visit
$15

Specialist Visit
$40

Prescription Drugs
Tier 1: $1 Tier 2: 20% Tier 3: 50%

Urgent Care
$50

Emergency Room
20%

Inpatient Hospital
20%

Outpatient Surgery
20%

Plan Documents
Summary of Benefits & Coverage
Health Plan Contract

In-Network Deductible
Individual: $600 | Family: $1,200

Preventive Care
$0

Office Visit
$25

Specialist Visit
$40

Prescription Drugs
Tier 1: $10 Tier 2: $35 Tier 3: $70

Urgent Care
$60

Emergency Room
$1,500

Inpatient Hospital
$1,000

Outpatient Surgery
$100

Plan Documents
Summary of Benefits & Coverage
Health Plan Contract

Make an informed decision about which coverage is best for you and your family.

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