Gold Access Care

Access Care plans offer you affordability and great freedom of choice with our widest network of providers, including 85% of Idaho’s doctors and hospitals.  If you qualify for a tax credit, your costs could be even lower. Have questions? Just call us at 855-447-2900.

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Download a 2019 PDF comparison chartDownload a 2018 PDF comparison chartDownload a 2017 PDF comparison chart

Gold Access Care

In Network Out of Network
Deductible
(What’s This?)
Individual: $900
Family: $1,800
Individual: $15,000
Family: $30,000
Annual Out-of-Pocket Maximum
(What’s this?)
Individual: $5,500
Family: $11,000
Individual: $30,000
Family: $60,000
Co-insurance
(What’s this?)
You pay 30% You pay 50%
Primary Care Provider and Non-specialist Office Visits
(Find a Provider)
You pay $25 copay per visit  You pay 50% after deductible
Specialist Office Visit
You pay $35 copay per visit You pay 50% after deductible
Emergency Room Visits You pay 30% after deductible You pay 30% after deductible
Prescription Drugs
(View Drug List)
Tier 0: You pay $0
Tier 1 Generic: You pay $5 per drug
Tier 2 Preferred Brand: You pay 25% per drug after deductible
Tier 3 Non-preferred: You pay 40% per drug after deductible
Tier 4 Specialty: You pay 40% per drug after deductible
Tier 0: You pay $0
Tier 1 Generic: You pay 50% coinsurance after deductible
Tier 2 Preferred Brand: You pay 50% coinsurance after deductible
Tier 3 Non-preferred: You pay 50% coinsurance after deductible
Tier 4 Specialty: You pay 50% coinsurance after deductible
Preventive Care Services, Immunizations You pay nothing for preventive services in-network–deductible does not apply You pay 50% coinsurance after deductible
Chiropractic Care
(Covered up to 20 visits per year)
You pay 30% after deductible You pay 50% coinsurance after deductible
Diagnostic X-Ray & Lab Services You pay 30% after deductible You pay 50% coinsurance after deductible
Inpatient Hospital Services You pay 30% after deductible You pay 50% coinsurance after deductible
Maternity You pay 30% after deductible You pay 50% coinsurance after deductible
Physician, Surgical & Medical Services You pay 30% after deductible You pay 50% coinsurance after deductible
Outpatient Rehabilitation Services; Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
You pay 30% after deductible You pay 50% coinsurance after deductible
Habilitative Services, Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
You pay 30% after deductible You pay 50% coinsurance after deductible

Get Pricing Download a PDF comparison chart

Gold Access Care

In Network Out of Network
Deductible
(What’s This?)
Individual: $850
Family: $1,700
Individual: $25,000
Family: $50,000
Annual Out-of-Pocket Maximum
(What’s this?)
Individual: $5,000
Family: $10,000
Individual: $37,500
Family: $75,000
Co-insurance
(What’s this?)
You pay 30% You pay 50%
Primary Care Provider and Non-specialist Office Visits
(Find a Provider)
You pay $25 copay per visit  You pay 50% after deductible
Specialist Office Visit
You pay $40 copay per visit You pay 50% after deductible
Emergency Room Visits You pay $350 per visit You pay $350 per visit
Prescription Drugs
(View Drug List)
Tier 0: You pay $0
Tier 1 Generic: You pay $5 per drug
Tier 2 Preferred Brand: You pay 25% per drug after deductible
Tier 3 Non-preferred: You pay 35% per drug after deductible
Tier 4 Specialty: You pay 45% per drug after deductible
Tier 0: You pay $0
Tier 1 Generic: You pay 50% coinsurance after deductible
Tier 2 Preferred Brand: You pay 50% coinsurance after deductible
Tier 3 Non-preferred: You pay 50% coinsurance after deductible
Tier 4 Specialty: You pay 50% coinsurance after deductible
Preventive Care Services, Immunizations You pay nothing for preventive services in-network–deductible does not apply You pay 50% coinsurance after deductible
Chiropractic Care
(Covered up to 20 visits per year)
You pay 30% after deductible You pay 50% coinsurance after deductible
Diagnostic X-Ray & Lab Services You pay 30% after deductible You pay 50% coinsurance after deductible
Inpatient Hospital Services You pay 30% after deductible You pay 50% coinsurance after deductible
Maternity You pay 30% after deductible You pay 50% coinsurance after deductible
Physician, Surgical & Medical Services You pay 30% after deductible You pay 50% coinsurance after deductible
Outpatient Rehabilitation Services; Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
You pay 30% after deductible You pay 50% coinsurance after deductible
Habilitative Services, Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
You pay 30% after deductible You pay 50% coinsurance after deductible

Get Pricing Download a PDF comparison chart

Gold Access Care

In Network Out of Network
Deductible
(What’s This?)
$800 individual,
$1,600 family
$2,400 individual,
$4,800 family
Annual Out-of-Pocket Maximum
(What’s this?)
$4,750 individual,
$9,500 family
$14,250 individual,
$28,500 family
Co-insurance
(What’s this?)
You pay 30% You pay 50%
Primary Care Provider and Non-specialist Office Visits
(Find a Provider)
$40 copay per visit You pay 50% after deductible
Specialist Office Visits $40 copay per visit You pay 50% after deductible
Emergency Room Visits You pay 30% after deductible You pay 30% after deductible
Prescription Drugs
(View Drug List)
Tier 0: You pay $0
Tier 1 Generic: You pay 20% per drug
Tier 2 Preferred Brand: You pay 25% per drug
Tier 3 Non-preferred: You pay 45% per drug
Tier 4 Specialty: You pay 45% per drug
Tier 5 Non-preferred Specialty: You pay 45% per drug
Tier 0: You pay $0
Tier 1 Generic: You pay 20% per drug
Tier 2 Preferred Brand: You pay 25% per drug
Tier 3 Non-preferred: You pay 45% per drug
Tier 4 Specialty: You pay 45% per drug
Tier 5 Non-preferred Specialty: You pay 45% per drug
Preventive Care Services, Immunizations You pay nothing for preventive services in-network – deductible does not apply You pay 50% after deductible
Chiropractic Care
(Covered up to 20 visits per year)
You pay $40 copay per visit You pay 50% after deductible
Diagnostic X-Ray & Lab Services You pay 30% after deductible You pay 50% after deductible
Inpatient Hospital Services You pay 30% after deductible You pay 50% after deductible
Maternity You pay 30% after deductible You pay 50% after deductible
Physician, Surgical & Medical Services You pay 30% after deductible You pay 50% after deductible
Outpatient Rehabilitation Services; Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
You pay 30% after deductible You pay 50% after deductible
Habilitative Services, Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
You pay 30% after deductible You pay 50% after deductible

Get PricingDownload a comparison chart