Performance Plan Overview
Performance Plan Overview
| Platinum | Gold | Silver | Bronze HDHP | ||
|---|---|---|---|---|---|
| Percentage of medical expenses paid by Expert Health Plan | 90% | 80% | 70% | 60% | |
| Annual deductible: individual | $0 | $0 | $4,0001 | $7,000 | |
| Annual deductible: individual | $0 | $0 | $4,0001 | $6,3002 | |
| Annual deductible: family | $0 | $0 | $8,0001 | $12,6002 | |
| Out-of-pocket max: individual | $4,500 | $8,200 | $7,800 | $8,200 | |
| Out-of-pocket max: family | $9,000 | $16,400 | $15,600 | $16,400 | |
| Primary care visit | $15 | $35 | $40 | $65** | |
| Specialist visit | $30 | $65 | $80 | $95** | |
| Preventive care visit | $0 | $0 | $0 | $0 | |
| Urgent care visit | $15 | $35 | $40 | $65** | |
| ER facility visit | $150 | $350 | $400 | 40%* | |
| Hospital facility | 10% | 20% | 20%* | 40%* | |
| 1Plan includes a $300 individual/$600 family prescription drug deductible. 2Plan includes a $500 individual/$1,000 family prescription drug deductible. *Deductible applies **Deductible waived for the first three non-preventive office or urgent care visits. |
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