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
Showing 65–80 of 96 results
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QUARTZ ONE 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 -
QUARTZ ONE 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 -
QUARTZ ONE GOLD I410-01 STANDARD – HMO
Network type: HMO
Coverage tier: Gold
Primary care visit: $30 copay
Specialist visit: $60 copay
Urgent care visit: $45 copay -
QUARTZ ONE GOLD I410-01 STANDARD W/DENTAL – HMO
Network type: HMO
Coverage tier: Gold
Primary care visit: $30 copay
Specialist visit: $60 copay
Urgent care visit: $45 copay -
QUARTZ ONE GOLD I420-01 VALUE TIER RX – HMO
Network type: HMO
Coverage tier: Gold
Primary care visit: $15 copay
Specialist visit: $90 copay
Urgent care visit: $90 copay -
QUARTZ ONE SILVER I303-01 VALUE TIER RX – HMO
Network type: HMO
Coverage tier: Silver
Primary care visit: $50 copay
Specialist visit: $100 copay
Urgent care visit: $100 copay -
QUARTZ ONE SILVER I304-01 HSA – 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 -
QUARTZ ONE SILVER I308-01 VALUE TIER RX – HMO
Network type: HMO
Coverage tier: Silver
Primary care visit: $50 copay
Specialist visit: $100 copay
Urgent care visit: $100 copay -
QUARTZ ONE SILVER I308-01 VALUE TIER RX W/DENTAL – HMO
Network type: HMO
Coverage tier: Silver
Primary care visit: $50 copay
Specialist visit: $100 copay
Urgent care visit: $100 copay -
QUARTZ ONE SILVER I309-01 STANDARD – HMO
Network type: HMO
Coverage tier: Silver
Primary care visit: $40 copay
Specialist visit: $80 copay
Urgent care visit: $60 copay -
QUARTZ ONE SILVER I320-01 VALUE TIER RX – HMO
Network type: HMO
Coverage tier: Silver
Primary care visit: $20 copay
Specialist visit: $100 copay
Urgent care visit: $100 copay -
Select Bronze 4000 Ded/9450 MOOP – HMO
Network type: HMO
Coverage tier: Expanded Bronze
Primary care visit: $125 copay
Specialist visit: $250 copay
Urgent care visit: $125 copay -
Select Bronze 7000 Ded/8500 MOOP – HMO
Network type: HMO
Coverage tier: Expanded Bronze
Primary care visit: $35 copay
Specialist visit: $150 copay
Urgent care visit: $75 copay -
Select Bronze 7500 Ded/9400 MOOP – HMO
Network type: HMO
Coverage tier: Expanded Bronze
Primary care visit: $50 copay
Specialist visit: $100 copay
Urgent care visit: $75 copay -
Select Bronze 7900 Ded/7900 MOOP 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