Gold 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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Gold Engage

Tier 1 Network Tier 2 Network Out of Network
Deductible
(What’s This?)
Individual: $900
Family: $1,800
Individual: $1,800
Family: $3,600
Individual: $15,000
Family: $30,000
Annual Out-of-Pocket Maximum
(What’s this?)
Individual: $5,500
Family: $11,000
Individual: $5,500
Family: $11,000
Individual: $30,000
Family: $60,000
Coinsurance
(What’s this?)
You pay 30% 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 $25 copay per visit after deductible You pay 50% coinsurance after deductible
Specialist Office Visits You pay $35 copay per visit You pay $35 copay per visit after deductible You pay 50% coinsurance after deductible
Emergency Room Visits You pay $300 copay per visit You pay $300 copay per visit You pay $300 copay 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
Tier 3 Non-preferred: You pay 45% per drug after deductible
Tier 4 Specialty: You pay 45% per drug after deductible
Tier 0: You pay $0
Tier 1 Generic: You pay $5 per drug
Tier 2 Preferred Brand: You pay 25% per drug
Tier 3 Non-preferred: You pay 45% 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 30% coinsurance after deductible You pay 50% coinsurance after deductible
Chiropractic Care
(Covered up to 20 visits per year)
You pay 30% coinsurance after deductible You pay 30% coinsurance after deductible You pay 50% coinsurance after deductible
Diagnostic X-Ray & Lab Services You pay 30% coinsurance after deductible You pay 30% coinsurance after deductible You pay 50% coinsurance after deductible
Inpatient Hospital Services You pay 30% coinsurance after deductible You pay 30% coinsurance after deductible You pay 50% coinsurance after deductible
Maternity You pay 30% coinsurance after deductible You pay 30% coinsurance after deductible You pay 50% coinsurance after deductible
Physician, Surgical & Medical Services You pay 30% coinsurance after deductible You pay 30% coinsurance 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% coinsurance after deductible You pay 30% coinsurance 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% coinsurance after deductible You pay 30% coinsurance after deductible You pay 50% coinsurance after deductible

Get Pricing Download a PDF comparison chart

Gold Engage

Tier 1 Network Tier 2 Network Out of Network
Deductible
(What’s This?)
Individual: $850
Family: $1,700
Individual: $1,500
Family: $3,000
Individual: $4,500
Family: $9,000
Annual Out-of-Pocket Maximum
(What’s this?)
Individual: $5,000
Family: $10,000
Individual: $5,000 Family: $10,000 Individual: $15,000 Family: $30,000
Coinsurance
(What’s this?)
You pay 30% You pay 30% You pay 50%
Primary Care Provider and Non-specialist Office Visits
(Find a Provider)
$25 copay per visit $25 copay after deductible 50% co-insurance after deductible
Specialist Office Visits $35 copay per visit $35 copay after deductible 50% co-insurance after deductible
Emergency Room Visits $175 copay per visit $175 copay per visit $175 copay per visit
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
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 30% co-insurance after deductible 50% co-insurance after deductible
Chiropractic Care
(Covered up to 20 visits per year)
$35 copay per visit $35 copay after deductible 50% co-insurance after deductible
Diagnostic X-Ray & Lab Services 30% co-insurance after deductible 30% co-insurance after deductible 50% co-insurance after deductible
Inpatient Hospital Services 30% co-insurance after deductible 30% co-insurance after deductible 50% co-insurance after deductible
Maternity 30% co-insurance after deductible 30% co-insurance after deductible 50% co-insurance after deductible
Physician, Surgical & Medical Services 30% co-insurance after deductible 30% co-insurance after deductible 50% co-insurance after deductible
Outpatient Rehabilitation Services; Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
30% co-insurance after deductible 30% co-insurance after deductible 50% co-insurance after deductible
Habilitative Services, Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
30% co-insurance after deductible 30% co-insurance after deductible 50% co-insurance after deductible

Get PricingDownload a comparison chart