Illinois DentaTrust – PPO Family High Option – PPO
Network type: PPO
Coverage tier: High
Basic Dental: 20% after deductible
Major dental care: 50% after deductible
Orthodontics: Not covered
Exams: No charge
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Illinois DentaTrust – PPO Family Low Option – PPO
Network type: PPO
Coverage tier: Low
Basic Dental: 50% after deductible
Major dental care: 50% after deductible
Orthodontics: Not covered
Exams: $10 -
Managed Care for Families and Individuals – HMO
Network type: HMO
Coverage tier: Low
Basic Dental: $28
Major dental care: $326
Orthodontics: $2,800
Exams: No charge -
MercyCare HMO Gold Option B – HMO
Network type: HMO
Coverage tier: Gold
Primary care visit: No charge after deductible
Specialist visit: No charge after deductible
Urgent care visit: No charge after deductible -
MercyCare HMO Silver Option A – HMO
Network type: HMO
Coverage tier: Silver
Primary care visit: $50 copay
Specialist visit: $100 copay
Urgent care visit: $100 copay -
MercyCare HMO Silver Option B – HMO
Network type: HMO
Coverage tier: Silver
Primary care visit: No charge after deductible
Specialist visit: No charge after deductible
Urgent care visit: No charge after deductible -
MercyCare HMO Silver Standard – HMO
Network type: HMO
Coverage tier: Silver
Primary care visit: $40 copay
Specialist visit: $80 copay
Urgent care visit: $60 copay -
Mississippi Wellness Essentials Plan – PPO
Network type: PPO
Coverage tier: Low
Basic Dental: 40% after deductible
Major dental care: Not covered
Orthodontics: Not covered
Exams: No charge -
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Plus Bronze CMS Standard – HMO
Network type: HMO
Coverage tier: Expanded Bronze
Primary care visit: $50 copay
Specialist visit: $100 copay
Urgent care visit: $75 copay -
Plus Gold CMS Standard – Rx Copay – HMO
Network type: HMO
Coverage tier: Gold
Primary care visit: $30 copay
Specialist visit: $60 copay
Urgent care visit: $45 copay -
Plus Silver CMS Standard – HMO
Network type: HMO
Coverage tier: Silver
Primary care visit: $40 copay
Specialist visit: $80 copay
Urgent care visit: $60 copay -
Plus with Northwestern Medicine Bronze 5000 Indiv Med Ded – Rx Copay – HMO
Network type: HMO
Coverage tier: Expanded Bronze
Primary care visit: $70 copay
Specialist visit: $110 copay
Urgent care visit: $85 copay -
Plus with Northwestern Medicine Silver 5000 Indiv Med Deductible – HMO
Network type: HMO
Coverage tier: Silver
Primary care visit: No charge
Specialist visit: $60 copay
Urgent care visit: $35 copay -
Savings Bronze 5500 – POS
Network type: POS
Coverage tier: Expanded Bronze
Primary care visit: 50% coinsurance after deductible
Specialist visit: 50% coinsurance after deductible
Urgent care visit: 50% coinsurance after deductible