ConnectiCare Benefits

FlexPOS Platinum Alternative

Inpatient Coverage

Emergency and Urgent Care

Links

Plan Overview

Medical Deductible	Individual: $1,200 Family: $2,400 Per Person: $1,200
Prescription Drug Deductible	Individual: $200 Family: $400 Per Person: $200
Medical Out-of-Pocket Maximum	Individual: $3,000 Family: $6,000 Per Person: $3,000
Drug Out-of-Pocket Maximum	Individual: Included in medical Family: Included in medical Per Person: Included in medical

Office Visit

Primary Doctor	Standard: $20 Copay
Specialist	Standard: $30 Copay

Inpatient Coverage

Hospital Services

Standard: 10% Coinsurance after deductible

Emergency and Urgent Care

Emergency Room

Standard: $100 Copay after deductible

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