SOLO PPO 3000
| Plan Type |
PPO |
| Co-insurance |
100% In-network |
50% Out-of-network |
| Deductible (individual) |
$3,000 (combined In-network/Out-of-network) |
Out-of-Pocket Max
(individual) |
$3,000 In-network |
$10,000 Out-of-network |
| Prescription coverage |
With Rx option
Generic $15
Preferred $30
Non-preferred $50 |
No Rx option
Prescriptions not covered |
| HSA |
No |
| More information |
Summary of Benefits (pdf) |
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