Great choice!

You’re one step away from having the ultimate safeguard for your health and wellness. Of course, nobody wants to think about potential accidents or ailments, but should worst come to worst… you’ll be covered!

Full Plan Details

100% Preventive Care

21 Preventive Services for Adults, 28 Preventive Services for Women, 31 Preventive Services for Children. 100% Coverage for ACA Mandated Preventive Care Services.

Primary Care Office Visit

$20 Copay (Max 3 visits per calendar year)

Specialists Office Visit

$50 Copay (Max 3 visits per calendar year)

Urgent Care

$50 Copay (Max 3 visits per calendar year)

Diagnostic X-Ray, Lab

$50 Copay by DOS (Max 5 services per calendar year)

CT Scan or MRI

$200 Copay (Max 1 CT Scan or MRI per calendar Year)

Telemedicine

Health Advocate offers employees 24/7 access to online medical consultations with MeMD’s advanced telehealth service and national network of US-licensed medical providers for common, minor conditions. This easy access to board-certified providers anytime, anywhere, offers a safe, effective and money-saving alternative for care when an individual’s regular physicians are not available.

Confidential Counseling

A highly trained team of Licensed Professional Counselors and Work/Life Specialists offers confidential 24/7, short-term assistance and resource support for a full range of personal, family and work/life problems. Members or employees have a busy and full life, which is why there are customized plans offered to fit the needs of employees and their busy schedules. In-person counseling appointments and telephonic and video counseling services are available as well.

Health Advocacy

Members or employees and their families are provided with confidential, one-on-one help from an industry expert who knows the ins and outs of the complex healthcare system. A team of trained Personal Health Advocates is skilled at working with healthcare providers, insurance plans and other health-related organizations to resolve complex clinical and administrative issues. Whether it’s deciding the right course of treatment, understanding care options, or resolving a billing issue, there are experts that will help members or employees, no matter what the issue — saving time, money and worry.

Medical Bill Saver

Anytime a member or employee has a medical bill over $400 not covered by their insurance the skilled negotiation team will work with providers to help reduce the amount due. Successful negotiations can save hundreds, and sometimes thousands of dollars. Members will learn from experts how to maximize savings and get the most value.

*3 D MRIs or Contrast Services for MRIs and CT Scans are not covered, pre-authorization required prior to scans.

Prescription Drug Benefits

Tier 1 - Low Cost Generics

$1 Copay

Tier 2 - Generics

10% Coinsurance

Tier 3 - Preferred Brand

20% Coinsurance

Tier 4 - Non-Preferred Brand

40% Coinsurance

Tier 5 - Generic & Preferred Specialty

10% Coinsurance (Plan pays 90% up to a maximum of $150 per Rx)

Tier 6 - Non-Preferred Specialty

20% Coinsurance (Plan pays 80% up to a maximum of $250 per Rx)