Cox HealthPlans Gold Preferred $500 Deductible – EPO

Description

Health Care Plan Details

Network type	EPO
Deductible	Success Your progress has been saved. We have sent an email to with a link to continue your application ×
Out-of-pocket max	$7,500 per person $15,000 per family
Metal tier	Gold

Visit Copay

Primary care visit	$25 copay
Specialist visit	40% coinsurance after deductible
Preventive care visit	No charge

Urgent, Emergency Care, and Hospital Care

Urgent care	40% coinsurance after deductible
Emergency room	37% coinsurance after deductible
Ambulance	40% coinsurance after deductible
Hospital stay (facility)	37% coinsurance after deductible
Hospital stay (physician)	40% coinsurance after deductible
Outpatient procedure (facility)	40% coinsurance after deductible
Outpatient procedure (physician)	40% coinsurance after deductible
Physical rehabilitation	40% coinsurance after deductible

Maternitowny and Pregnancy

Well baby care	No charge
Labor, delivery, hospital stay	40% coinsurance after deductible

Pharmacy, Drugs, and Medication

Generic	No charge
Brand	40% coinsurance after deductible
Non-preferred Brand	40% coinsurance after deductible
Specialty	40% coinsurance after deductible

Lab Tests and Diagnostic Procedures

X-rays	40% coinsurance after deductible
Imaging (CT/PET/MRI)	37% coinsurance after deductible
Blood work	40% coinsurance after deductible

Mental and Psychiatric Health Care

Mental Health outpatient services	40% coinsurance after deductible
Psychiatric hospital stay	37% coinsurance after deductible

Health Plan Provider Information

Health Plan Benefits	https://www.thinkinghealthforward.com/files/96384MO0220018-01%20Gold%20Preferred%20On%20Exchange.pdf
Drug and medication plan formulary	https://client.formularynavigator.com/Search.aspx?siteCode=3041785512
Search doctor list	https://www.thinkinghealthforward.com/providers/