Page 7 - Solid Rock Benefits Guide
P. 7
Solid Rock Major Medical Plans
Total Health Care
Total Health Care POS 500/0 with 2500/1250 Optional GAP
Download Medical and GAP Overview Here
Total Health Care POS THC Network Cofinity Network $2,500/$1,250 Split Bucket GAP
Deductible (single/family) $500/$1,000 $1,500/$3,000 Inpatient Benefit $2,500
Co-Insurance 0% 25% Out Patient Benefit $1,250
Out of Pocket Maximum $3,000/$6,000 $3,000/$6,000 Pays "First Dollar" For:
Preventive Services 100% 100%
Office Visits PCP $15 Copay $40 Copay * Deductible & Co Insurance
Office Visits Specialist $30 Copay $50 Copay
Urgent Care $30 Copay $60 Copay * Urgent Care Copay
Emergency Room $200 Copay $200 Copay
In-Patient Hospital 0% after deductible 25% after deductible * Emergency Room
Out-Patient Hospital 0% after deductible 25% after deductible
Prescriptions $10/$50/$80/30% $10/$50/$80/30% * Includes $0 Copay Telemedicine
GAP is optional
Please note: These are brief descriptions. Read plan certificates for limitation, exclusions,
7
and plan specifics.
