ConnectiCare Benefits

Choice Catastrophic POS with Dental

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Medical Deductible	Individual: $8,700 Family: $17,400 Per Person: $8,700
Prescription Drug Deductible	Individual: Included in medical Family: Included in medical Per Person: Included in medical
Medical Out-of-Pocket Maximum	Individual: $8,700 Family: $17,400 Per Person: $8,700
Drug Out-of-Pocket Maximum	Individual: Included in medical Family: Included in medical Per Person: Included in medical

Primary Doctor	Standard: $30 Copay for first 3 visits per year; then 0% Coinsurance after deductible
Specialist	Standard: 0% Coinsurance after deductible

Hospital Services

Emergency Room

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