This plan is good for an individual who wants a reasonable deductible along with low copayments for common medical services. You'll receive your first three primary care doctor visits for $0 and any additional visits are $25. As with all Network Health plans, preventive services are $0. In addition, you get a $0 annual vision exam and dental exam for each covered member. The below chart details the benefits of this plan.
Prestige Silver Essential Plan Highlights |
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DEDUCTIBLE |
Individual |
$4,600 |
|
Family |
$9,200 |
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COINSURANCE |
|
40% |
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OUT-OF- |
Individual |
$9,100 |
|
Family |
$18,200 |
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BENEFITS |
Preventive Care |
$0 |
|
Routine Vision Exam |
$0 |
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Annual Dental Exam |
$0 |
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Personal Doctor Visit |
$0 for first three visits, per family member, then $25 per visit |
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Virtual Visit |
$0 per visit |
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Specialist Visit |
$80 per visit |
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Chiropractic |
40% after deductible |
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Hospital Stay |
40% after deductible |
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Emergency Room |
$500 after deductible per visit |
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X-ray and Diagnostic Imaging |
$60 per visit |
All Network Health’s Prestige plans have built-in pharmacy benefits. See the chart below for prescription drug coverage information.
Prestige Silver Essential Pharmacy Benefit Highlights |
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Retail |
Preventive Drugs |
$0 |
Adherence Generics |
$0 |
|
Tier 1 Generics |
$20 |
|
Tier 2 Preferred Brand Drugs |
$80 |
|
Tier 3 Non-Preferred Brand Drugs |
50% after deductible |
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Tier 4 Preferred Specialty Drugs |
40% after deductible |
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Tier 5 Non-Preferred Specialty Drugs |
50% after deductible |