Maine Community Health Options

Health Options Evergreen Bronze PPO NE

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Medical Deductible	Individual: $5,700 Family: $11,400
Medical Out-of-Pocket Maximum	Individual: $8,700 Family: $17,400

Primary Doctor	Standard: $50.00 Copay / 35.00% Coinsurance after deductible
Specialist	Standard: 35.00% Coinsurance after deductible

Preferred Brand Drugs	Standard: 35.00% Coinsurance after deductible
Generic Drugs	Standard: 35.00% Coinsurance after deductible

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