This plan is good for an individual who wants a reasonable deductible along with low copayments for common medical services, but no dental or vision benefits. As with all Network Health plans, preventive services are $0. The below chart details the benefits of this plan.
Prestige Silver Plan Highlights |
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DEDUCTIBLE |
Individual |
$6,000 |
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Family |
$12,000 |
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COINSURANCE |
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40% |
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OUT-OF- |
Individual |
$8,900 |
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Family |
$17,800 |
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BENEFITS |
Preventive Care |
$0 |
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Routine Vision Exam |
Not covered |
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Annual Dental Exam |
Not covered |
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Personal Doctor Visit |
$40 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 |
40% after deductible |
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X-ray and Diagnostic Imaging |
40% after deductible |
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All Network Health’s Prestige plans have built-in pharmacy benefits. See the chart below for prescription drug coverage information.
Prestige Silver Pharmacy Benefit Highlights |
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Retail |
Preventive Drugs |
$0 |
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Tier 1 Generic and Adherence Generic Drugs Adherence Generics are limited to specific medications to treat certain conditions and are designated in the comprehensive drug list with the label “$0” and are available at no cost, subject to applicable deductible |
$20 |
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Tier 2 Preferred Brand Drugs |
$40 |
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Tier 3 Non-Preferred Brand Drugs |
$80 after deductible |
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Tier 4 Preferred Specialty Drugs |
$350 after deductible |
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Tier 5 Non-Preferred Specialty Drugs |
$350 after deductible |
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