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Access to the benefits and large group pricing on this website is predicated upon joining Elevate Wellness, a national association with over 90,000 members. Learn more









    • Benefits

      Schdeule of Benefits
    • Enrollment

      18th of month Prior to Effective date

    • Issue Ages

      18-64

    • States Available

      Available in All States

    • Dependent Age Limit

      Dependents to age 26

    • Wellness & Preventative

      $0 Copay | 100% Coverage for Mandated Preventative Services

      Adults| Woman| Children
    • Telehealth

      Unlimited
      $0 Consult Fee

    • Deductible | Individual

      $0

    • Deductible | Family

      $0

    • Out of Pocket Maximum Individual

      $0

    • Out of Pocket Maximum Family

      $0

    • Preventive Prescription Generic Drugs

      $0 Copay
      (Limited to preventive only)

    • Prescription Benefits

      Tier 1 = $0 (Over 200 drugs)
      Tier 2 = $10 (Or less)
      Tier 3 = $25 (Over 600 drugs)
      Tier 4 = $50 (Or less)

    • Primary Care Office Visit

      N/A

    • Urgent Care Visit

      N/A

    • Specialist Office Visit

      N/A

    • Outpatient Services (Limited to Mental & Behavioral Health or Substance Abuse)

      N/A

    • Supplemental Hospital Benefit

      N/A

    • Laboratory Service and Radiology

      N/A

    • CT/MRI/MRA/PET Scans

      N/A

    • Inpatient Hospitalization & Inpatient Surgery

      N/A

    • Outpatient Hospital or Free- Standing Facility Services and Surgery

      N/A

    • Emergency Room

      N/A

    • Treatment for Chemical Abuse & Dependency

      N/A

    • Home Health Care

      N/A

    • Pregnancy Benefits

      N/A

    • Benefits

      Schdeule of Benefits
    • Enrollment

      18th of month Prior to Effective date

    • Issue Ages

      18-64

    • States Available

      Available in All States

    • Dependent Age Limit

      Dependents to age 26

    • Wellness & Preventative

      $0 Copay | 100% Coverage for Mandated Preventative Services

      Adults| Woman| Children
    • Telehealth

      Unlimited
      $0 Consult Fee

    • Deductible | Individual

      $0

    • Out of Pocket Maximum Individual

      $8,150

    • Out of Pocket Maximum Family

      $16,300

    • Preventive Prescription Generic Drugs

      $0 Copay
      (Limited to preventive only)

    • Prescription Benefits

      Tier 1 = $0 (Over 200 drugs)
      Tier 2 = $10 (Or less)
      Tier 3 = $25 (Over 600 drugs)
      Tier 4 = $50 (Or less)

    • Primary Care Office Visit

      $35 Copay (Existing Doctor)
      $70 Copay (New Doctor)

    • Urgent Care Visit

      $75 Copay
      (In?Network)

    • Specialist Office Visit

      $75 Copay (Existing Doctor)
      $150 Copay (New Doctor)

    • Outpatient Services (Limited to Mental & Behavioral Health or Substance Abuse)

      $75 Copay (Existing Doctor)
      $150 Copay (New Doctor)

    • Supplemental Hospital Benefit

      $5,000
      (Limited to $1,000 per day;
      maximum of 5 days)

    • Laboratory Service and Radiology

      $50 Copay
      (Per panel tested / per image billed)

    • CT/MRI/MRA/PET Scans

      $500 Copay
      (Per image tested)

    • Inpatient Hospitalization & Inpatient Surgery

      N/A

    • Outpatient Hospital or Free- Standing Facility Services and Surgery

      N/A

    • Emergency Room

      N/A

    • Treatment for Chemical Abuse & Dependency

      N/A

    • Home Health Care

      N/A

    • Pregnancy Benefits

      N/A

    • Benefits

      Schdeule of Benefits
      Summary of Benefits & Coverage
    • Enrollment

      18th of month Prior to Effective date

    • Issue Ages

      18-64

    • States Available

      Available in All States

    • Dependent Age Limit

      Dependent to age 26

    • Wellness & Preventative

      $0 Copay | 100% Coverage for Mandated Preventative Services

      Adults| Woman| Children
    • Telehealth

      Unlimited
      $0 Consult Fee

    • Deductible | Individual

      $0

    • Deductible | Family

      $0

    • Out of Pocket Maximum Individual

      $8,150

    • Out of Pocket Maximum Family

      $16,300

    • Preventive Prescription Generic Drugs

      $0 Copay
      (Limited to preventive only)

    • Prescription Benefits

      Tier 1 = $0 (Over 200 drugs)
      Tier 2 = $10 (Or less)
      Tier 3 = $25 (Over 600 drugs)
      Tier 4 = $50 (Or less)

    • Primary Care Office Visit

      $25 Copay
      (Limit of 8 visits per plan year)

    • Urgent Care Visit

      $50 Copay
      (Limit of 2 visits per plan year)

    • Specialist Office Visit

      $50 Copay
      (Limit of 8 visits per plan year)

    • Outpatient Services (Limited to Mental & Behavioral Health or Substance Abuse)

      N/A

    • Supplemental Hospital Benefit

      N/A

    • Laboratory Service and Radiology

      $50 Copay
      (Limited to 3 per plan year)

    • CT/MRI/MRA/PET Scans

      $350 Copay
      (Limited to 1 per plan year)

    • Inpatient Hospitalization & Inpatient Surgery

      $350 Copay Per Admission
      (Limited to 5 days and 2 surgeries)

    • Outpatient Hospital or Free- Standing Facility Services and Surgery

      $350 Copay
      (Limited to 1 visit per plan year)

    • Emergency Room

      $350 Copay
      (Limited to 1 visit per plan year)

    • Treatment for Chemical Abuse & Dependency

      Outpatient: $25 Copay Per Day
      Inpatient: $250 Copay Per Day
      (Both limited to 5 days per plan year)

    • Home Health Care

      $25 Copay
      (Limited to 10 visits per plan year)

    • Pregnancy Benefits

      N/A

    • Benefits

      Schdeule of Benefits
      Summary of Benefits & Coverage
    • Enrollment

      18th of month Prior to Effective date

    • Issue Ages

      18-64

    • States Available

      Available in All States

    • Dependent Age Limit

      Dependent to age 26

    • Wellness & Preventative

      $0 Copay | 100% Coverage for Mandated Preventative Services

      Adults| Woman| Children
    • Telehealth

      Unlimited
      $0 Consult Fee

    • Deductible | Individual

      $0

    • Deductible | Family

      $0

    • Out of Pocket Maximum Individual

      $5,000

    • Out of Pocket Maximum Family

      $10,000

    • Preventive Prescription Generic Drugs

      $0 Copay
      (Limited to preventive only)

    • Prescription Benefits

      Tier 1 = $0 (Over 200 drugs)
      Tier 2 = $10 (Or less)
      Tier 3 = $25 (Over 600 drugs)
      Tier 4 = $50 (Or less)

    • Primary Care Office Visit

      $15 Copay
      (Limit of 10 visits per plan year)

    • Urgent Care Visit

      $35 Copay
      (Limit of 3 visits per plan year)

    • Specialist Office Visit

      $25 Copay
      (Limit of 10 visits per plan year)

    • Outpatient Services (Limited to Mental & Behavioral Health or Substance Abuse)

      N/A

    • Supplemental Hospital Benefit

      N/A

    • Laboratory Service and Radiology

      $50 Copay
      (Limited to 3 per plan year)

    • CT/MRI/MRA/PET Scans

      $350 Copay
      (Limited to 2 per plan year)

    • Inpatient Hospitalization & Inpatient Surgery

      $350 Copay Per Admission
      (Limited to 7 days and 3 surgeries)

    • Outpatient Hospital or Free- Standing Facility Services and Surgery

      $350 Copay
      (Limited to 2 visit per plan year)

    • Emergency Room

      $350 Copay
      (Limited to 1 visit per plan year)

    • Treatment for Chemical Abuse & Dependency

      Outpatient: $25 Copay Per Day
      Inpatient: $250 Copay Per Day
      (Both limited to 7 days per plan year)

    • Home Health Care

      $25 Copay
      (Limited to 10 visits per plan year)

    • Pregnancy Benefits

      $350 Copay
      (Professional Services)

      $350 Copay Per Admission
      (Childbirth/Delivery)

* ExclusionsPLEASE NOTE: Please refer to the Schedule of Benefits for the official list of Benefits Coverage, Limitations, and Exclusions. If plan comparison differs from the Schedule of Benefits, the Schedule of Benefits will govern.






Access to the insurance plans and large group pricing on this website is predicated upon joining Elevate Wellness, a national association with over 100,000 members.
Click here to Learn more

Questions? Call 866-201-7191 We're standing by to help you make the best decision.

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