Maine Community Health Options

Health Options Evergreen Bronze PPO NE Dental

Plan Overview

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

Office Visit

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

Prescription Drug Information

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