Medica Applause Gold Copay $0 PCP + Rx Copays – EPO
Network type: EPO
Coverage tier: Gold
Primary care visit: No charge
Specialist visit: $70 copay
Urgent care visit: No charge
Showing 17–32 of 46 results
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Medica Applause Silver Copay $0 PCP + Rx Copays – EPO
Network type: EPO
Coverage tier: Silver
Primary care visit: No charge
Specialist visit: $80 copay
Urgent care visit: No charge -
Medica Applause Silver HSA – EPO
Network type: EPO
Coverage tier: Silver
Primary care visit: 25% after deductible
Specialist visit: 25% after deductible
Urgent care visit: 25% after deductible -
Medica Applause Silver Share – EPO
Network type: EPO
Coverage tier: Silver
Primary care visit: 40% after deductible
Specialist visit: 40% after deductible
Urgent care visit: 40% after deductible -
SELECT 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 -
SELECT 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 -
SELECT 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 -
SELECT 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 -
SELECT 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 -
SELECT 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 -
SELECT 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 -
SELECT 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 -
SELECT GOLD I402-01 MAINTENANCE VALUE TIER RX W/DENTAL – HMO
Network type: HMO
Coverage tier: Gold
Primary care visit: $35 copay
Specialist visit: $70 copay
Urgent care visit: $70 copay -
SELECT GOLD I403-01 HSA – 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 -
SELECT GOLD I410-01 STANDARD W/DENTAL W/FIXED COPAY – HMO
Network type: HMO
Coverage tier: Gold
Primary care visit: $30 copay
Specialist visit: $60 copay
Urgent care visit: $45 copay -
SELECT GOLD I410-01 STANDARD W/FIXED COPAY – HMO
Network type: HMO
Coverage tier: Gold
Primary care visit: $30 copay
Specialist visit: $60 copay
Urgent care visit: $45 copay