Platinum 90 Ambetter PPO – PPO
Network type: PPO
Coverage tier: Platinum
Primary care visit: $15 copay
Specialist visit: $30 copay
Urgent care visit: $15 copay
Showing 193–208 of 255 results
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Platinum 90 EPO – EPO
Network type: EPO
Coverage tier: Platinum
Primary care visit: $15 copay
Specialist visit: $30 copay
Urgent care visit: $15 copay -
Platinum 90 HMO – HMO
Network type: HMO
Coverage tier: Platinum
Primary care visit: $15 copay
Specialist visit: $30 copay
Urgent care visit: $15 copay -
Platinum 90 HMO – HMO
Network type: HMO
Coverage tier: Platinum
Primary care visit: $15 copay
Specialist visit: $30 copay
Urgent care visit: $15 copay -
Platinum 90 HMO – HMO
Network type: HMO
Coverage tier: Platinum
Primary care visit: $15 copay
Specialist visit: $30 copay
Urgent care visit: $15 copay -
Platinum 90 Trio HMO – HMO
Network type: HMO
Coverage tier: Platinum
Primary care visit: $15 copay
Specialist visit: $30 copay
Urgent care visit: $15 copay -
QUARTZ PERFORMANCE BRONZE I201-01 VALUE TIER RX W/FIXED COPAY – IL – HMO
Network type: HMO
Coverage tier: Expanded Bronze
Primary care visit: $80 copay
Specialist visit: 50% coinsurance after deductible
Urgent care visit: 50% coinsurance after deductible -
QUARTZ PERFORMANCE BRONZE I203-01 HSA – IL – HMO
Network type: HMO
Coverage tier: Expanded Bronze
Primary care visit: No charge after deductible
Specialist visit: No charge after deductible
Urgent care visit: No charge after deductible -
QUARTZ PERFORMANCE BRONZE I204-01 VALUE TIER RX – IL – HMO
Network type: HMO
Coverage tier: Expanded Bronze
Primary care visit: $85 copay
Specialist visit: $250 copay
Urgent care visit: $250 copay -
QUARTZ PERFORMANCE BRONZE I204-01 VALUE TIER RX W/DENTAL – IL – HMO
Network type: HMO
Coverage tier: Expanded Bronze
Primary care visit: $85 copay
Specialist visit: $250 copay
Urgent care visit: $250 copay -
QUARTZ PERFORMANCE BRONZE I205-01 VALUE TIER RX – IL – HMO
Network type: HMO
Coverage tier: Expanded Bronze
Primary care visit: $75 copay
Specialist visit: $155 copay
Urgent care visit: $155 copay -
QUARTZ PERFORMANCE BRONZE I205-01 VALUE TIER RX W/DENTAL – IL – HMO
Network type: HMO
Coverage tier: Expanded Bronze
Primary care visit: $75 copay
Specialist visit: $155 copay
Urgent care visit: $155 copay -
QUARTZ PERFORMANCE BRONZE I205-01 VALUE TIER RX W/DENTAL – IL – HMO
Network type: HMO
Coverage tier: Expanded Bronze
Primary care visit: $75 copay
Specialist visit: $155 copay
Urgent care visit: $155 copay -
QUARTZ PERFORMANCE GOLD I401-01 VALUE TIER RX – IL – HMO
Network type: HMO
Coverage tier: Gold
Primary care visit: $30 copay
Specialist visit: $60 copay
Urgent care visit: $60 copay -
QUARTZ PERFORMANCE GOLD I402-01 MAINTENANCE VALUE TIER RX – IL – HMO
Network type: HMO
Coverage tier: Gold
Primary care visit: $35 copay
Specialist visit: $70 copay
Urgent care visit: $70 copay -
QUARTZ PERFORMANCE GOLD I402-01 MAINTENANCE VALUE TIER RX W/DENTAL – IL – HMO
Network type: HMO
Coverage tier: Gold
Primary care visit: $35 copay
Specialist visit: $70 copay
Urgent care visit: $70 copay