Elite
$ 133.82
/30 Days
-
Deductible$0(Preferred Provider)
-
Maximum BenefitUnlimited(For each injury or Sickness)
-
Coinsurance90%(Preferred Provider)
-
Out-of-pocket Maximum$5000(Preferred Provider) (Per policy year)
-
Pre-existing Waiting PeriodN/A
-
Prevent Care Services100%(Preferred Provider)
-
Prescription Drugs$15,30%,50%(UnitedHealthcare Pharmacy)
-
Routine Eye Exam$100(Maximum)
-
Vision Care Supplies$100(Maximum)
Popular
Prime
$ 113.7
/30 Days
-
Deductible$100(Preferred Provider)
-
Maximum BenefitUnlimited(For each injury or Sickness)
-
Coinsurance80%(Preferred Provider)
-
Out-of-pocket Maximum$6350(Preferred Provider) (Per policy year)
-
Pre-existing Waiting PeriodN/A
-
Prevent Care Services100%(Preferred Provider)
-
Prescription Drugs$15,30%,50%(UnitedHealthcare Pharmacy)
-
Routine Eye Exam$100(Maximum)
-
Vision Care Supplies$100(Maximum)
Choice
$ 85.7
/30 Days
-
Deductible$1000(Preferred Provider)
-
Maximum BenefitUnlimited(For each injury or Sickness)
-
Coinsurance80%(Preferred Provider)
-
Out-of-pocket Maximum$7350(Preferred Provider) (Per policy year)
-
Pre-existing Waiting PeriodN/A
-
Prevent Care Services100%(Preferred Provider)
-
Prescription Drugs$25,30%,50%(UnitedHealthcare Pharmacy)($250 Deductible)
-
Routine Eye ExamN/A(Maximum)
-
Vision Care SuppliesN/A(Maximum)
Basic
$ 56.7
/30 Days
-
Deductible$500(Preferred Provider)
-
Maximum Benefit$500,000(For each injury or Sickness)
-
Coinsurance80%(Preferred Provider)
-
Out-of-pocket MaximumN/A(Preferred Provider) (Per policy year)
-
Pre-existing Waiting Period12 Months
-
Prevent Care ServicesN/A(Preferred Provider)
-
Prescription DrugsN/A(UnitedHealthcare Pharmacy)
-
Routine Eye ExamN/A(Maximum)
-
Vision Care SuppliesN/A(Maximum)
