Compare Plans

Not all coverage is the right coverage.

Your healthcare coverage is important to us. Age, family status, medical conditions, hobbies, lifestyle and a myriad of other factors will help you determine if you need a lot or a very little amount of health coverage. This summary will help you understand your plan and its coverage.

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Summary of Medical Benefits

MEC Plus Plan

In-Network

Out-of-Network

Deductible

Individual

Individual Under Family

Family

 

N/A

N/A

N/A

 

N/A

N/A

N/A

Out-of-Pocket Maximum

Individual

Individual Under Family

Family

 

N/A

N/A

N/A

 

N/A

N/A

N/A

Preventive Care Services

No Charge

No Coverage

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

No Coverage

No Coverage

No Coverage

 

No Coverage

No Coverage

No Coverage

Urgent Care Services

No Coverage

No Coverage

Office Visit Lab

Outpatient Lab

Outpatient X-Ray

Outpatient Major Diagnostic

No Coverage

No Coverage

No Coverage

No Coverage

No Coverage

No Coverage

No Coverage

No Coverage

Inpatient Hospital Care

Facility Fee

Physician Fee

 

No Coverage

No Coverage

 

No Coverage

No Coverage

Outpatient Procedures

Facility Fee

Physician Fee

 

No Coverage

No Coverage

 

No Coverage

No Coverage

Emergency Room

Emergency Medical Transportation

No Coverage

No Coverage

No Coverage

No Coverage

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

No Coverage

No Coverage

 

No Coverage

No Coverage

Prescription Drug Coverage

Preventive

Non-Preventive Generic

Non-Preventive Preferred brand

Non-Preventive Non-preferred brand

Non-Preventive Specialty

 

No Charge

No Coverage

No Coverage

No Coverage

No Coverage

 

No Charge

No Coverage

No Coverage

No Coverage

No Coverage

*Please refer to your Summary Plan Description for actual coverage, limitation, and exclusion provisions

 

 

MEC Enhanced Plan

In-Network

Out-of-Network

Deductible

Individual

Individual Under Family

Family

 

N/A

N/A

N/A

 

N/A

N/A

N/A

Out-of-Pocket Maximum

Individual

Individual Under Family

Family

 

N/A

N/A

N/A

 

N/A

N/A

N/A

Preventive Care Services

No Charge

No Coverage

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

$25 Copay

$50 Copay

No Coverage

 

No Coverage

No Coverage

No Coverage

Urgent Care Services

$75 Copay

No Coverage

Inpatient Hospital Care

Facility Fee

Physician Fee

 

No Coverage

No Coverage

 

No Coverage

No Coverage

Outpatient Procedures

Facility Fee

Physician Fee

 

No Coverage

No Coverage

 

No Coverage

No Coverage

Emergency Room

Emergency Medical Transportation

$1,000 benefit per day

No Coverage

No Coverage

No Coverage

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

$1,000 benefit per day

$50 Copay

 

No Coverage

No Coverage

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

 

$10 Copay

No Coverage

No Coverage

No Coverage

 

No Coverage

No Coverage

No Coverage

No Coverage

*Please refer to your Summary Plan Description for actual coverage, limitation, and exclusion provisions

 

 

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