Keystone HMO Gold Classic – HMO
Network type: HMO
Coverage tier: Gold
Primary care visit: $40 copay
Specialist visit: $80 copay
Urgent care visit: $80 copay
Showing 97–112 of 131 results
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Keystone HMO Gold Proactive – HMO
Network type: HMO
Coverage tier: Gold
Primary care visit: $15 copay
Specialist visit: $40 copay
Urgent care visit: $40 copay -
Keystone HMO Silver Basic – HMO
Network type: HMO
Coverage tier: Silver
Primary care visit: $35 copay
Specialist visit: $80 copay
Urgent care visit: 50% after deductible -
Keystone HMO Silver Classic – HMO
Network type: HMO
Coverage tier: Silver
Primary care visit: $35 copay
Specialist visit: $80 copay
Urgent care visit: 30% after deductible -
Keystone HMO Silver Proactive – HMO
Network type: HMO
Coverage tier: Silver
Primary care visit: $40 copay
Specialist visit: $90 copay
Urgent care visit: $90 copay -
Keystone HMO Silver Proactive Basic – HMO
Network type: HMO
Coverage tier: Silver
Primary care visit: $50 copay
Specialist visit: $100 copay
Urgent care visit: $100 copay -
Keystone HMO Silver Proactive Essential – HMO
Network type: HMO
Coverage tier: Silver
Primary care visit: $50 copay
Specialist visit: $100 copay
Urgent care visit: $100 copay -
Keystone HMO Silver Proactive Lite – HMO
Network type: HMO
Coverage tier: Silver
Primary care visit: $50 copay
Specialist visit: $90 copay
Urgent care visit: $90 copay -
my Blue Access PPO Bronze 3800 – PPO
Network type: PPO
Coverage tier: Expanded Bronze
Primary care visit: $65 copay
Specialist visit: $65 copay
Urgent care visit: $100 copay -
my Blue Access PPO Bronze 3800 + Adult Dental and Vision – PPO
Network type: PPO
Coverage tier: Expanded Bronze
Primary care visit: $65 copay
Specialist visit: $65 copay
Urgent care visit: $100 copay -
my Blue Access PPO Bronze 7100 HSA – Custom Drug Benefit – PPO
Network type: PPO
Coverage tier: Expanded Bronze
Primary care visit: No charge after deductible
Specialist visit: No charge after deductible
Urgent care visit: No charge after deductible -
my Blue Access PPO Bronze 8900 – PPO
Network type: PPO
Coverage tier: Bronze
Primary care visit: No charge after deductible
Specialist visit: No charge after deductible
Urgent care visit: No charge after deductible -
my Blue Access PPO Gold 0 – PPO
Network type: PPO
Coverage tier: Gold
Primary care visit: $20 copay
Specialist visit: $20 copay
Urgent care visit: $40 copay -
my Blue Access PPO Gold 0 + Adult Dental and Vision – PPO
Network type: PPO
Coverage tier: Gold
Primary care visit: $20 copay
Specialist visit: $20 copay
Urgent care visit: $40 copay -
my Blue Access PPO Gold 1500 – PPO
Network type: PPO
Coverage tier: Gold
Primary care visit: $35 copay
Specialist visit: $35 copay
Urgent care visit: $70 copay -
my Blue Access PPO Gold 1700 HSA – PPO
Network type: PPO
Coverage tier: Gold
Primary care visit: $20 copay after deductible
Specialist visit: $20 copay after deductible
Urgent care visit: $40 copay after deductible