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Prestige Silver Essential
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. The below chart details the benefits of this plan.
Prestige Silver Essential Plan Highlights |
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DEDUCTIBLE |
Individual |
$4,000 |
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Family |
$8,000 |
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COINSURANCE |
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40% |
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OUT-OF- |
Individual |
$7,900 |
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Family |
$15,800 |
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BENEFITS |
Preventive Care |
$0 |
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Primary Care Doctor Visit |
$0 for first three visits, then $25 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 per visit after deductible |
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X-ray and Diagnostic Imaging |
$60 per visit |
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Laboratory Outpatient Services |
$30 per visit |
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Prescription drug coverage
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 |
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Adherence Generics (limited only to categories of select antidiabetics, statins and RAS antagonists) |
$2 |
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Generics |
$20 |
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Preferred Brand Drugs |
$80 |
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Non-Preferred Brand Drugs |
35% after deductible (Tier 4) |
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Preferred Specialty Drugs |
35% after deductible (Tier 5) |
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Non-Preferred Specialty Drugs |
50% after deductible (Tier 6) |
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