Medica Quest Silver Copay

Plan Type: PPO
Plan Tier: Silver
Medical Deductible - Individual: $3,700
Medical Deductible - Family: $11,100
Drug Deductible - Individual: Included in Medical
Drug Deductible - Family: Included in Medical
Out of Pocket Max - Individual: $7,600
Out of Pocket Max - Family: $15,200
Primary Care Visit: $30
Specialist Visit: $60
Emergency Room: 40% Coinsurance after deductible
Hospital - Physician: 40% Coinsurance after deductible
Hospital - Facility: 40% Coinsurance after deductible
Link to Full SBC: http://portal.medica.com/visitor/sbcsearch/docdisplay?plancode=1QSCOK&uid=FFM
Plan Brochure: https://www.medica.com/2019QuestOK

Other Coverage:

Child Dental: No
Adult Dental No

Prescription Drug Pricing:

Generic Drugs: $20
Non-Preferred Brand Drugs: 60% Coinsurance after deductible
Preferred Brand Drugs: $120
Specialty Drugs: $550
Link to Full Policy Formulary: https://www.medica.com/DrugListS

About The Carrier

Medica’s mission is to the trusted health plan of choice for customers, members, partners, and our employees, and to be trusted in the community for our unwavering commitment to high-quality, affordable health care.

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