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Peak $9,450 Catastrophic
Health Insurance Plan Details (2024 Plan)
by HealthPartners
Monthly Premium
PPO
$ubsidy
Catastrophic
- Deductible
- $9,450 /yr
- Max Out-of-Pocket
- $9,450 /yr
Details
Deductible (per individual) | $9,450 /yr |
Deductible (per family) | $18,900 /yr |
Max Out-of-Pocket (per individual) | $9,450 /yr |
Max Out-of-Pocket (per family) | $18,900 /yr |
Drug Deductible (per individual) | |
Drug Deductible (per family) | |
Drug Max Out-of-Pocket (per individual) | |
Drug Max Out-of-Pocket (per family) | |
Plan Type | PPO |
Includes Child Dental? | Yes |
Includes Adult Dental? | No |
Out-of-Pocket Costs
Preventive Care | No Charge |
Primary Care Visit | $30 Copay with deductible |
Specialist Visit | Not Applicable |
Emergency Room | Not Applicable |
Inpatient Facility | Not Applicable |
Inpatient Physician | Not Applicable |
Generic Drugs | Not Applicable |
Preferred Brand Drugs | Not Applicable |
Non-preferred Brand Drugs | Not Applicable |
Specialty Drugs | Not Applicable |
Plan Documents
Summary of Benefits and Coverage | SBC doc |
Provider Directory | Doctor lookup |
Drug Formulary List | n/a |
* Figures shown are only for in-network medical costs
** Please check with insurance company if Copay and Coinsurance rates are before or after the deductible
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