Individual Health Plans

HDHMO Qualified 33

In-Network Deductible
Individual: $2,500 | Family: $5,000

Preventive Care
$0

Office Visit
15%

Live Video Doctor Visits
15%

Specialist Visit
15%

Prescription Drugs
Tier 1: $4 Tier 2: 50% Tier 3: 50%

Urgent Care
15%

Emergency Room
15%

Inpatient Hospital
15%

Outpatient Surgery
15%

Plan Documents
2019 Summary of Benefits & Coverage
2019 Health Plan Contract

In-Network Deductible
Individual: $1,700 | Family: $3,400

Preventive Care
$0

Office Visit
$30

Live Video Doctor Visits
$30

Specialist Visit
$50

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

Urgent Care
$70

Emergency Room
$250

Inpatient Hospital
$1,500

Outpatient Surgery
$100

Plan Documents
2019 Summary of Benefits & Coverage
2019 Health Plan Contract

In-Network Deductible
Individual: $3,750 | Family: $7,500

Preventive Care
$0

Office Visit
0% EPC | 10% Non EPC

Live Video Doctor Visit
10%

Specialist Visit
10%

Prescription Drugs
Tier 1: $4 Tier 2: 30% Tier 3: 50%

Urgent Care
10%

Emergency Room
10%

Inpatient Hospital
10%

Outpatient Surgery
10%

Plan Documents
2019 Summary of Benefits & Coverage
2019 Health Plan Contract