Get a Plan that Gives You More

Monthly Premium

$0

Monthly Premium

$0

Monthly Premium

$0

Primary Care Doctor Copay

$0

Primary Care Doctor Copay

$0 in-network,
$10 out-of-network

Primary Care Doctor Copay

$0

Specialist Copay

$20

Specialist Copay

$35 in-network,
$60 out-of-network*

Specialist Copay

$20

Inpatient Hospital

$325 copay per day for days 1-5;
$0 copay per day for days 6-90

Inpatient Hospital

$375 copay per day for days 1-5;
$0 copay per day for days 6-90 in-network
40% out-of-network

Inpatient Hospital

$325 copay per day for days 1-5;
$0 copay per day for days 6-90

Emergency Care

$125

Emergency Care

$125

Emergency Care

$125

Prescription Drug Coverage

Yes

Prescription Drug Coverage

Yes

Prescription Drug Coverage

No

Dental (Preventive & Comprehensive)

0% coinsurance

Dental (Preventive & Comprehensive)

0% coinsurance

Dental (Preventive & Comprehensive)

0% coinsurance

OTC Allowances

$25 per quarter

OTC Allowances

$25 per quarter

OTC Allowances

$25 per quarter

Eligible Counties

Brazoria, Fort Bend, Galveston (excluding the island), Harris, Montgomery

Eligible Counties

Austin, Brazoria, Chambers, Fort Bend, Galveston (excluding the island), Grimes, Harris, Liberty, Montgomery, San Jacinto, Walker, Waller, Wharton

Eligible Counties

Austin, Brazoria, Chambers, Fort Bend, Galveston (excluding the island), Grimes, Harris, Liberty, Montgomery, San Jacinto, Walker, Waller, Wharton