ConnectiCare Benefits

Passage Bronze Alternative PCP POS

Plan Overview

Medical Deductible
  • Individual: $7,000
  • Family: $15,000
  • Per Person: $7,000
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

Office Visit

Primary Doctor
  • Standard: $0 Copay
Specialist
  • Standard: $60 Copay after deductible

Inpatient Coverage

Hospital Services
  • Standard: 50% Coinsurance after deductible

Emergency and Urgent Care

Emergency Room
  • Standard: 50% Coinsurance after deductible
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