Select $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
Medical Services
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
Drug Costs
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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