TARO Direct Primary Care Gold $0 Ded ($0 DPC + $0 PCP + $0 Mental Health)

Health Insurance Plan Details (2025 Plan)

Monthly Premium

HMO
$ubsidy
Gold
Deductible
$0 /yr
Max Out-of-Pocket
$7,800 /yr

Details

Deductible (per individual) $0 /yr
Deductible (per family) $0 /yr
Max Out-of-Pocket (per individual) $7,800 /yr
Max Out-of-Pocket (per family) $15,600 /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 HMO
Includes Child Dental? No
Includes Adult Dental? No
Medical Services
Preventive Care No Charge
Primary Care Visit No Charge
Specialist Visit $35 Copay
Emergency Room 50% Coinsurance
Inpatient Facility 50% Coinsurance
Inpatient Physician 50% Coinsurance
Drug Costs
Generic Drugs $15 Copay
Preferred Brand Drugs $50 Copay
Non-preferred Brand Drugs $100 Copay
Specialty Drugs $200 Copay

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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