Oscar

Gold Elite- $0 Ded (Choice) ($0 Virtual Primary Care + $0 Primary Care + $3 Drugs)

Prescription Drug Information

Inpatient Coverage

Emergency and Urgent Care

Major Dental Care

Links

Plan Overview

Combined Medical and Drug Deductible	Individual: $0 Family: $0 Per Person: $0
Combined Medical and Drug Out of Pocket Maximum	Individual: $8,000 Family: $16,000 Per Person: $8,000

Office Visit

Primary Doctor	CoPay: $0.00 CoInsurance: Not Applicable Covered: Covered
Specialist	CoPay: $25.00 CoInsurance: Not Applicable Covered: Covered

Prescription Drug Information

Preferred Brand Drugs	CoPay: $50.00 CoInsurance: Not Applicable Covered: Covered
Non Preferred Brand Drugs	CoPay: $250.00 CoInsurance: Not Applicable Covered: Covered
Generic Drugs	CoPay: $10.00 CoInsurance: Not Applicable Covered: Covered Benefit Explanation: See $3 drug list for Preferred Generic Rx.
Specialty Drugs	CoPay: $550.00 CoInsurance: Not Applicable Covered: Covered

Inpatient Coverage

Hospital Services	CoPay: $1000.00 Copay per Day CoInsurance: Not Applicable Covered: Covered Benefit Explanation: Per day copay will apply for a maximum of 3 days.
Inpatient Services	CoPay: $200.00 CoInsurance: Not Applicable Covered: Covered

Emergency and Urgent Care

Emergency Room	CoPay: $500.00 CoInsurance: Not Applicable Covered: Covered
Urgent Care Facility	CoPay: $50.00 CoInsurance: Not Applicable Covered: Covered Benefit Explanation: $0 Virtual Urgent Care visits available—see SOB.

Maternity

Labor and Delivery Hospital Stay	CoPay: $1,000.00 CoInsurance: Not Applicable Covered: Covered Benefit Explanation: Per day copay will apply for a maximum of 3 days.
Pre and Postnatal Office Visit	CoPay: Not Applicable CoInsurance: 0.00% Covered: Covered

Vision

Routine Eye Exams For Children

CoPay: $0.00
CoInsurance: Not Applicable
Covered: Covered
Limit Quantity: 1
Limit Unit : Exam(s) per Benefit Period

Major Dental Care

Routine Dental Checkups for Children	CoPay: Not Applicable CoInsurance: 0.00% Covered: Covered Limit Quantity: 1 Limit Unit : Visit(s) per 6 Months
Basic Dental Care - Child	CoPay: Not Applicable CoInsurance: 20.00% Covered: Covered
Major Dental Care - Child	CoPay: Not Applicable CoInsurance: 50.00% Covered: Covered

Related Articles

You may be interested in these relevant articles from across the HealthMarkets.com network.

What’s the difference between an orthodontist and an endodontist?

Checking in with your family dentist is a good first step to maintaining good…Read More

Read More

What Is a Qualifying Life Event, and How Might It Help You Get Health Benefits?

Have you recently had a qualifying life event? “A qualifying what?” you might ask.…Read More

Read More

A Look at Universal Life Insurance Pros and Cons

Don’t guess if you should enroll in a universal life policy. HealthMarkets can help…Read More

Read More