Insurance: Compare Plans
| Plan Type |
|---|
| In Network Deductible: |
| Your cost for In Network Care: |
| Primary Care Copay: |
| Specialist Copay: |
| Preventive Care: |
| ** Outpatient Lab Work: |
| Urgent Care: |
| Emergency Room: |
| ** Outpatient Complex Radiology (MRI/CT): |
| ** Outpatient Surgery: |
| Hospital Admission: |
| In Network Pharmacy: |
| Pharmacy Deductible: |
| Generic: |
| Brand Formulary: |
| Brand Non-Formulary: |
| In Network Out-of-pocket Maximum: |
| Summary of Benefits: |
| Provider Directory (Doctor List): |
| Formulary (Drug List): |
| Monthly premium per family member: |
| Total Family Premium: |