BESTOne Advantage Gold – PPO
Network type: PPO
Coverage tier: High
Basic Dental: 10% after deductible
Major dental care: 50% after deductible
Orthodontics: Not covered
Exams: No charge
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BESTOne Base Silver – PPO
Network type: PPO
Coverage tier: Low
Basic Dental: 30% after deductible
Major dental care: 100%
Orthodontics: Not covered
Exams: No charge -
BESTOne Basic Silver – PPO
Network type: PPO
Coverage tier: Low
Basic Dental: 50% after deductible
Major dental care: 70% after deductible
Orthodontics: Not covered
Exams: No charge -
BESTOne Gold Plus – PPO
Network type: PPO
Coverage tier: High
Basic Dental: 30% after deductible
Major dental care: 60% after deductible
Orthodontics: Not covered
Exams: No charge -
Bronze Classic – EPO
Network type: EPO
Coverage tier: Expanded Bronze
Primary care visit: $50 copay, 50% coinsurance after deductible
Specialist visit: 50% coinsurance after deductible
Urgent care visit: $75 copay -
Bronze Classic 4700 – EPO
Network type: EPO
Coverage tier: Expanded Bronze
Primary care visit: $70 copay
Specialist visit: $125 copay
Urgent care visit: $125 copay -
Bronze Classic PCP Saver – EPO
Network type: EPO
Coverage tier: Expanded Bronze
Primary care visit: No charge
Specialist visit: 50% coinsurance after deductible
Urgent care visit: $75 copay -
Bronze Classic Standard – EPO
Network type: EPO
Coverage tier: Expanded Bronze
Primary care visit: $50 copay
Specialist visit: $100 copay
Urgent care visit: $75 copay -
Bronze Elite + PCP Saver Plus – EPO
Network type: EPO
Coverage tier: Expanded Bronze
Primary care visit: $40 copay
Specialist visit: $125 copay
Urgent care visit: $75 copay -
Choice Bronze 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 -
Choice Bronze HSA + Vision + Adult Dental – 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 -
Clear Gold + Vision + Adult Dental – HMO
Network type: HMO
Coverage tier: Gold
Primary care visit: $25 copay
Specialist visit: $60 copay
Urgent care visit: $60 copay -
Clear Silver – 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 -
Clear Silver + Vision + Adult Dental – 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 -
Complete Gold – HMO
Network type: HMO
Coverage tier: Gold
Primary care visit: $15 copay
Specialist visit: $35 copay
Urgent care visit: $35 copay -
Complete Gold + Vision + Adult Dental – HMO
Network type: HMO
Coverage tier: Gold
Primary care visit: $15 copay
Specialist visit: $35 copay
Urgent care visit: $35 copay