Platinum PPO/EPO Plan Details
Edit Choose Your Household Size ComponentChoose Your Household Type
Individual
Family
Individual
$4,500
$9,000
Out-of-Pocket Maximum
$0
$0
Medical Deductible
$0
$0
Pharmacy Deductible
Free Preventive Care
Your health plan isn’t just there for you when you’re sick. Stay healthy with annual checkups, immunizations, screenings and more — all at no extra cost to you.
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Free
Wellness Visits
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Free
Screenings and Immunizations
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Free
Prenatal Care
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Free
Screening and Counseling for ChildrenGetting well is a steal with a Platinum plan.
$15
Doctor Visits
$30
Specialist Visits
$15
Mental Health Outpatient Visits and Services
Surprise bills are a thing of the past.
$150
Ambulance Trip
$150
Emergency Room Visit
$15
Urgent Care Visit
Stay out of the red while you recuperate.
Home Health
10%
of Bill
Durable Medical Equipment
10%
of Bill
Skilled Nursing Care
10%
of Bill
Free preventive care, vision care and dental cleanings and exams for children.
The medical services you need, at our most affordable rates.
$15
Lab Tests
$30
X-rays and Diagnostic Imaging
Imaging
10%
of Bill (CT/PET scans, MRIs)
Hospital Facility Fee
10%
of Bill
Things to Know

Need help applying?
You can get help from a certified enrollment counselor right away. It’s always free and confidential. Talk to someone about your options and have them guide you through the process. You can enroll in person, by phone or online.
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