Standard Gold – EPO
Network type: EPO
Coverage tier: Gold
Primary care visit: $30 copay
Specialist visit: $60 copay
Urgent care visit: $45 copay
Showing 113–121 of 121 results
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Standard Gold + Vision + Adult Dental – EPO
Network type: EPO
Coverage tier: Gold
Primary care visit: $30 copay
Specialist visit: $60 copay
Urgent care visit: $45 copay -
Standard Gold + Vision + Adult Dental – EPO
Network type: EPO
Coverage tier: Gold
Primary care visit: $30 copay
Specialist visit: $60 copay
Urgent care visit: $45 copay -
Standard Silver – EPO
Network type: EPO
Coverage tier: Silver
Primary care visit: $40 copay
Specialist visit: $80 copay
Urgent care visit: $60 copay -
Standard Silver + Vision + Adult Dental – EPO
Network type: EPO
Coverage tier: Silver
Primary care visit: $40 copay
Specialist visit: $80 copay
Urgent care visit: $60 copay -
Value Bronze Standard POS [{LCSR)] – POS
Network type: POS
Coverage tier: Expanded Bronze
Primary care visit: $50 copay
Specialist visit: $70 copay after deductible
Urgent care visit: $75 copay -
Value Bronze Standard POS HSA [(LCSR)] – POS
Network type: POS
Coverage tier: Expanded Bronze
Primary care visit: 20% after deductible
Specialist visit: 20% after deductible
Urgent care visit: 20% after deductible -
Value Gold Standard POS [(LCSR)] – POS
Network type: POS
Coverage tier: Gold
Primary care visit: $20 copay
Specialist visit: $40 copay
Urgent care visit: $50 copay -
Value Silver Standard POS [(LCSR)] – POS
Network type: POS
Coverage tier: Silver
Primary care visit: $40 copay
Specialist visit: $60 copay
Urgent care visit: $75 copay