Bronze Engage

Available only in Benewah, Bonner, Boundary, Kootenai and Shoshone Counties, our Engage plans feature our lowest monthly premiums. Each Engage plan offers two tiers of in-network providers to provide a good balance of choice and cost savings. Have questions? Just give us a call at 855-447-2900.

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Engage Bronze

In Network Out of Network
Deductible
(What’s This?)
Individual: $7,900
Family: $15,800
Individual: $37,500
Family: $75,000
Annual Out-of-Pocket Maximum
(What’s this?)
Individual: $7,900
Family: $15,800
Individual: $75,000
Family: $150,000
Co-insurance
(What’s this?)
You pay 0% You pay 50%
Primary Care Provider and Non-specialist Office Visits
(Find a Provider)
First 3 visits $60 per visit then; 0% after deductible  You pay 70% after deductible
Specialist Office Visit
You pay 0% after deductible You pay 70% after deductible
Emergency Room Visits You pay 0% after deductible You pay 0% 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 0% after deductible per drug
Tier 3 Non-preferred:  You pay 0% after deductible per drug
Tier 4 Specialty: You pay 0% after deductible per drug
Tier 0: You pay $0
Tier 1 Generic: You pay 70% after deductible
Tier 2 Preferred Brand: You pay 70% after deductible
Tier 3 Non-preferred: You pay 70% after deductible
Tier 4 Specialty: You pay 70% after deductible
Preventive Care Services, Immunizations You pay nothing for preventive services in-network–deductible does not apply You pay 70% coinsurance after deductible
Chiropractic Care
(Covered up to 20 visits per year)
You pay 0% after deductible You pay 70% coinsurance after deductible
Diagnostic X-Ray & Lab Services You pay 0% after deductible You pay 70% coinsurance after deductible
Inpatient Hospital Services You pay 0% after deductible You pay 70% coinsurance after deductible
Maternity You pay 0% after deductible You pay 70% coinsurance after deductible
Physician, Surgical & Medical Services You pay 0% after deductible You pay 70% coinsurance after deductible
Outpatient Rehabilitation Services; Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
You pay 0% after deductible You pay 70% coinsurance after deductible
Habilitative Services, Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
You pay 0% after deductible You pay 70% coinsurance after deductible

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Engage Bronze

Tier 1 Network Tier 2 Network Out of Network
Deductible
(What’s This?)
Individual: $7,300
Family: $14,600
Individual: $7,325
Family: $14,650
Individual: $37,500
Family: $75,000
Annual Out-of-Pocket Maximum
(What’s this?)
Individual: $7,350
Family: $14,700
Individual: $7,350
Family: $14,700
Individual: $75,000
Family: $150,000
Coinsurance
(What’s this?)
You pay 50% You pay 50% You pay 70%
Primary Care Provider and Non-specialist Office Visits
(Find a Provider)
You pay $50 copay per visit after deductible You pay $50 copay per visit after deductible You pay 70% coinsurance after deductible
Specialist Office Visits You pay $65 copay per visit after deductible You pay $65 copay per visit after deductible You pay 70% coinsurance after deductible
Emergency Room Visits You pay 0% coinsurance after deductible You pay 0% coinsurance after deductible You pay 0% coinsurance after deductible
Prescription Drugs
(View Drug List)
Tier 0: You pay $0
Tier 1 Generic: You pay 30% per drug after deductible
Tier 2 Preferred Brand: You pay 50% per drug after deductible
Tier 3 Non-preferred: You pay 50% per drug after deductible
Tier 4 Specialty: You pay 50% per drug after deductible
Tier 0: You pay $0
Tier 1 Generic: You pay 30% per drug after deductible
Tier 2 Preferred Brand: You pay 50% per drug after deductible
Tier 3 Non-preferred: You pay 50% per drug after deductible
Tier 4 Specialty: You pay 50% per drug after deductible
Tier 0: You pay $0
Tier 1 Generic: You pay 70% coinsurance after deductible
Tier 2 Preferred Brand: You pay 70% coinsurance after deductible
Tier 3 Non-preferred: You pay 70% coinsurance after deductible
Tier 4 Specialty: You pay 70% 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 You pay 70% coinsurance after deductible
Chiropractic Care
(Covered up to 20 visits per year)
You pay 50% coinsurance after deductible You pay 50% coinsurance after deductible You pay 70% coinsurance after deductible
Diagnostic X-Ray & Lab Services You pay 50% coinsurance after deductible You pay 50% coinsurance after deductible You pay 70% coinsurance after deductible
Inpatient Hospital Services You pay 50% coinsurance after deductible You pay 50% coinsurance after deductible You pay 70% coinsurance after deductible
Maternity You pay 50% coinsurance after deductible You pay 50% coinsurance after deductible You pay 70% coinsurance after deductible
Physician, Surgical & Medical Services You pay 50% coinsurance after deductible You pay 50% coinsurance after deductible You pay 70% coinsurance after deductible
Outpatient Rehabilitation Services; Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
You pay 50% coinsurance after deductible You pay 50% coinsurance after deductible You pay 70% coinsurance after deductible
Habilitative Services, Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
You pay 50% coinsurance after deductible You pay 50% coinsurance after deductible You pay 70% coinsurance after deductible

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Bronze Engage

Tier 1 Network Tier 2 Network Out of Network
Deductible
(What’s This?)
Individual: $6,000
Family: $12,000
Individual: $6,500
Family: $13,000
Individual: $19,500
Family: $39,000
Annual Out-of-Pocket Maximum
(What’s this?)
Individual: $7,150
Family: $14,300
Individual: $7,150 Family: $14,300 Individual: $21,450 Family: $42,900
Coinsurance
(What’s this?)
You pay 60% You pay 60% You pay 70%
Primary Care Provider and Non-specialist Office Visits
(Find a Provider)
$40 copay per visit $40 copay after deductible 70% co-insurance after deductible
Specialist Office Visits 60% co-insurance after deductible 60% co-insurance after deductible 60% co-insurance after deductible
Emergency Room Visits 60% co-insurance after deductible 60% co-insurance after deductible 60% co-insurance after deductible
Prescription Drugs
(View Drug List)
Tier 0: You pay $0
Tier 1 Generic: You pay 60% per drug after deductible
Tier 2 Preferred Brand: You pay 60% per drug after deductible
Tier 3 Non-preferred: You pay 80% per drug after deductible
Tier 4 Specialty: You pay 80% per drug after deductible
Tier 5 Non-preferred Specialty: You pay 80% per drug after deductible
Tier 0: You pay $0
Tier 1 Generic: You pay 60% per drug after deductible
Tier 2 Preferred Brand: You pay 60% per drug after deductible
Tier 3 Non-preferred: You pay 80% per drug after deductible
Tier 4 Specialty: You pay 80% per drug after deductible
Tier 5 Non-preferred Specialty: You pay 80% per drug after deductible
Tier 0: You pay $0
Tier 1 Generic: You pay 60% per drug after deductible
Tier 2 Preferred Brand: You pay 60% per drug after deductible
Tier 3 Non-preferred: You pay 80% per drug after deductible
Tier 4 Specialty: You pay 80% per drug after deductible
Tier 5 Non-preferred Specialty: You pay 80% per drug after deductible
Preventive Care Services, Immunizations You pay nothing for preventive services in-network–deductible does not apply 60% co-insurance after deductible 70% co-insurance after deductible
Chiropractic Care
(Covered up to 20 visits per year)
60% co-insurance after deductible 60% co-insurance after deductible 70% co-insurance after deductible
Diagnostic X-Ray & Lab Services 60% co-insurance after deductible 60% co-insurance after deductible 70% co-insurance after deductible
Inpatient Hospital Services 60% co-insurance after deductible 60% co-insurance after deductible 70% co-insurance after deductible
Maternity 60% co-insurance after deductible 60% co-insurance after deductible 70% co-insurance after deductible
Physician, Surgical & Medical Services 60% co-insurance after deductible 60% co-insurance after deductible 70% co-insurance after deductible
Outpatient Rehabilitation Services; Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
60% co-insurance after deductible 60% co-insurance after deductible 70% co-insurance after deductible
Habilitative Services, Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
60% co-insurance after deductible 60% co-insurance after deductible 70% co-insurance after deductible

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