Compare your 2024 health plans
Use the chart below to compare plan benefits and costs.
For complete benefit details, refer to the plan's Summary of Benefits and Summary of Benefits and Coverage by returning to the homepage and reviewing "Your 2024 health plan resources."
| Compare your benefit choices | ||||
|---|---|---|---|---|
| Plan details | HMO Access+ | Local Access+ | PPO | |
| In-network | In-network | In-network | Non-network | |
| Calendar-year deductible | Individual: $750/ Family: $1,500 | Individual: $750/ Family: $1,500 | ||
| Medical out-of-pocket maximum | Individual: $2,000 / Family: $4,000 | Individual: $1,500 / Family: $3,000 | Individual: $2,500 / Family: $5,000 | Individual: $4,500 / Family: $9,000 |
| Hospital services | ||||
| Primary care physician | $15/visit | $15/visit | $30/visit | 30% |
| Specialist care office visit | $25/visit (referred by primary care physician) | $20/visit (referred by primary care physician) | $50/visit | 30% |
| Preventive health exam | $0 | $0 | $0 | 30% |
| Outpatient x-ray, pathology and laboratory | $0 | $0 | 10% | 30% |
| Outpatient surgery in hospital | $200/surgery | $100/surgery | 10% | 30% - subject to a benefit maximum of $350/day |
| Inpatient facility services | $400/admission | $200/admission | 10% | 30% - subject to a benefit maximum of $600/day |
| Virtual services | ||||
| Teladoc (virtual medical doctor visits) | $0 | $0 | $0 | Not covered |
| Teladoc (mental health professional video or phone consultation) | $0 | $0 | $0 | Not covered |
| Emergency care | ||||
| Urgent care center | $15/visit | $15/visit | $30/visit | 30% |
| Emergency room services | $100/visit | $100/visit | $150/visit plus 10% | $150/visit plus 10% |
| Ambulance services | $100/transport | $100/transport | 10% | 10% |
| Specialty services | ||||
| Pregnancy and maternity care | $15/visit | $15/visit | $30/visit | 30% |
| Infertility testing and treatment | Not covered | Not covered | Not covered | Not covered |
| Acupuncture services | $10/visit (up to 30 visits per member, per calendar year. | $10/visit (up to 30 visits per member, per calendar year) | 10% (up to 12 visits per member, per calendar year) | 30% (up to 12 visits per member, per calendar year) |
| Chiropractic services | $10/visit (up to 30 visits per member, per calendar year) | $10/visit (up to 30 visits per member, per calendar year) | 10% (up to 24 visits per member, per calendar year) | 30% (up to 24 visits per member, per calendar year) |
| Mental health office visit | $15/visit | $15/visit | $30/visit | 30% |
| Mental health inpatient services | $400/admission | $200/admission | 10% | 30% - subject to a benefit maximum of $600/day |
| Substance abuse (inpatient/outpatient) | IP $400/admission / OP $15/visit | IP $200/admission / OP $15/visit | 10% | 30% - subject to a benefit maximum of $600/day |
| Pharmacy benefits | ||||
| Retail prescription (30-day supply) | ||||
| Contraceptive drugs and devices | $0 | $0 | $0 | Applicable Tier 1, Tier 2, or Tier 3 copayment |
| Formulary generic drugs | $10/prescription | $5/prescription | $10/prescription | 25% plus $10/prescription |
| Formulary brand-name drugs | $30/prescription | $20/prescription | $40/prescription | 25% plus $40/prescription |
| Non-formulary brand-name drug | $50/prescription | $35/prescription | $60/prescription | 25% plus $60/prescription |
| Mail-service prescriptions (up to 90-day supply) | ||||
| Contraceptive drugs and devices | $0 | $0 | $0 | Not covered |
| Formulary generic drugs | $20/prescription | $10/prescription | $20/prescription | Not covered |
| Formulary brand-name drugs | $60/prescription | $40/prescription | $80/prescription | Not covered |
| Non-formulary brand-name drug | $100/prescription | $70/prescription | $120/prescription | Not covered |