Precision Blue 80/60 $3200 (M)

Health Insurance Plan Details (2025 Plan)

Monthly Premium

POS
$ubsidy
Silver
Deductible
$3,200 /yr
Max Out-of-Pocket
$7,700 /yr

Details

Deductible (per individual) $3,200 /yr
Deductible (per family) $9,600 /yr
Max Out-of-Pocket (per individual) $7,700 /yr
Max Out-of-Pocket (per family) $15,400 /yr
Drug Deductible (per individual) Included in Medical
Drug Deductible (per family) Included in Medical
Drug Max Out-of-Pocket (per individual) Included in Medical
Drug Max Out-of-Pocket (per family) Included in Medical
Plan Type POS
Includes Child Dental? Yes
Includes Adult Dental? No
Medical Services
Preventive Care No Charge
Primary Care Visit 20% Coinsurance after deductible
Specialist Visit 20% Coinsurance after deductible
Emergency Room 20% Coinsurance after deductible
Inpatient Facility 20% Coinsurance after deductible
Inpatient Physician 20% Coinsurance after deductible
Drug Costs
Generic Drugs 20% Coinsurance after deductible
Preferred Brand Drugs 40% Coinsurance after deductible
Non-preferred Brand Drugs 40% Coinsurance after deductible
Specialty Drugs 40% Coinsurance after deductible

Plan Documents

Summary of Benefits and Coverage SBC doc
Provider Directory Doctor lookup
Drug Formulary List drug list

* 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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