Platinum IND POS Plus, Platinum, NS, OON, POS, Dep29, Family Vision, Family Dental, WP – POS
Network type: POS
Coverage tier: Platinum
Primary care visit: $10 copay
Specialist visit: $30 copay
Urgent care visit: $40 copay
Showing 449–464 of 624 results
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Platinum Standard, Platinum, ST, OON, POS, Dep25, Pediatric Dental – POS
Network type: POS
Coverage tier: Platinum
Primary care visit: $15 copay
Specialist visit: $35 copay
Urgent care visit: $55 copay -
POS Bronze 7500 – POS
Network type: POS
Coverage tier: Expanded Bronze
Primary care visit: $50 copay
Specialist visit: $100 copay
Urgent care visit: $75 copay -
POS HDHP Bronze 6250 – POS
Network type: POS
Coverage tier: Expanded Bronze
Primary care visit: 30% coinsurance after deductible
Specialist visit: 30% coinsurance after deductible
Urgent care visit: 30% coinsurance after deductible -
POS Silver 5900 – POS
Network type: POS
Coverage tier: Silver
Primary care visit: $40 copay
Specialist visit: $80 copay
Urgent care visit: $60 copay -
Premier Silver – EPO
Network type: EPO
Coverage tier: Silver
Primary care visit: $30 copay
Specialist visit: $60 copay
Urgent care visit: $60 copay -
Premier Silver + Vision + Adult Dental – EPO
Network type: EPO
Coverage tier: Silver
Primary care visit: $30 copay
Specialist visit: $60 copay
Urgent care visit: $60 copay -
QUARTZ ONE BRONZE I201-01 VALUE TIER RX – 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 ONE BRONZE I203-01 HSA – 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 ONE BRONZE I204-01 VALUE TIER RX – HMO
Network type: HMO
Coverage tier: Expanded Bronze
Primary care visit: $75 copay
Specialist visit: $150 copay
Urgent care visit: $150 copay -
QUARTZ ONE BRONZE I204-01 VALUE TIER RX W/DENTAL – HMO
Network type: HMO
Coverage tier: Expanded Bronze
Primary care visit: $75 copay
Specialist visit: $150 copay
Urgent care visit: $150 copay -
QUARTZ ONE BRONZE I205-01 VALUE TIER RX – HMO
Network type: HMO
Coverage tier: Expanded Bronze
Primary care visit: $75 copay
Specialist visit: $155 copay
Urgent care visit: $155 copay -
QUARTZ ONE BRONZE I205-01 VALUE TIER RX W/DENTAL – HMO
Network type: HMO
Coverage tier: Expanded Bronze
Primary care visit: $75 copay
Specialist visit: $155 copay
Urgent care visit: $155 copay -
QUARTZ ONE BRONZE I206-01 STANDARD – HMO
Network type: HMO
Coverage tier: Expanded Bronze
Primary care visit: $50 copay
Specialist visit: $100 copay
Urgent care visit: $75 copay -
QUARTZ ONE GOLD I401-01 VALUE TIER RX – HMO
Network type: HMO
Coverage tier: Gold
Primary care visit: $30 copay
Specialist visit: $60 copay
Urgent care visit: $60 copay -
QUARTZ ONE GOLD I402-01 MAINTENANCE VALUE TIER RX – HMO
Network type: HMO
Coverage tier: Gold
Primary care visit: $35 copay
Specialist visit: $70 copay
Urgent care visit: $70 copay