Family Member – Age 23 – $10,000 Initial Unshareable Amount

$210.00/ month with a $100.00 sign-up fee. on the 1st of each month with a 14-day free trial and a $100.00 sign-up fee

  • All your medical needs are met by this plan.
  • The out-of-pocket limit is the IUA you chose: $3,000, $5,000 or $10,000.
  • There’s no lifetime maximum.
  • For an emergency room visit, you’ll pay a $200 Copay. 100% coverage after IUA met.
Doctor visits will cost you:-

Primary Doctor: Network: $50 Copay, 100% coverage after IUA met.
Specialist: Network: $50 Copay, 100% coverage after IUA met.
Other practitioner: Network:$50 Copay, 100% coverage after IUA met.

Hospital services will cost you:-

Inpatient Hospital Services:
Network: $100 Copay per Day, 100% coverage after IUA met.
Inpatient Physician and Surgical Services:
Network: $100 Copay, 100% coverage after IUA met.

Explanation: All member cost sharing varies based upon Place of Service. Please refer to plan documents for additional information.

First payment: November 1, 2020

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Description

Coverage for a complete family household covering all your medical needs for you and your Spouse or Partner, and all your household Dependents.

  •  Members Age at enrollment = 23 Years Old
  •  Annual Initial Unshareable Amount Amount = $10,000 per Year

You need a doctor, we got you covered.*

Additional information

Age

23
Initial Unshareable Amount

$10,000 Per Year
Coverage

Medical Needs
Household Size

Family Household. Coverage for the Primary Member, his/her Spouse or Life Partner, and all household Dependents.

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