Wellmark Standard Gold HMO – HMO
Network type: HMO
Coverage tier: Gold
Primary care visit: $30 copay
Specialist visit: $60 copay
Urgent care visit: $45 copay
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Wisconsin Preferred Plan – PPO
Network type: PPO
Coverage tier: Low
Basic Dental: 40% after deductible
Major dental care: 50% after deductible
Orthodontics: Not covered
Exams: No charge -
Wisconsin Wellness Essentials – PPO
Network type: PPO
Coverage tier: Low
Basic Dental: 40% after deductible
Major dental care: Not covered
Orthodontics: Not covered
Exams: No charge