In-Network Services -
Deductible (Individual/Family): $2,500/$5,000
Out-of-Pocket Maximum (Individual/Family): $7,500/$15,000
Primary Care Visit: $30 copay
Specialist Visit: $60 copay
Urgent Care: $50 copay
Prescription Drugs
Generic: $5 copay
Preferred Brand: $50 copay
Non-Preferred Brand: $100 copay