Gold Access Care

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

Gold Access Care

In Network Out of Network
Deductible
(What’s this?)
Individual: $800
Family: $1,600
Individual: $2,400
Family: $4,800
Annual Out-of-Pocket Maximum
(What’s this?)
Individual: $5,750
Family: $11,500
Individual: $17,250
Family: $34,500
Co-insurance
(What’s this?)
You pay 30% You pay 50%
Primary Care Provider & Non-specialist Office Visits
(Find a Provider)
You pay $30 copay per visit You pay 50% after deductible
Specialist Office Visits You pay $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 10% per drug
Tier 2 Preferred Brand: You pay 25% per drug
Tier 3 Non-Preferred: You pay 35% per drug
Tier 4 Specialty: You pay 45% per drug
Tier 0: You pay $0
Tier 1 Generic: You pay 50% after deductible
Tier 2 Preferred Brand: You pay 50% after deductible
Tier 3 Non-Preferred: You pay 50% after deductible
Tier 4 Specialty: You pay 50% after deductible
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
Physical, Occupational & Speech Therapy You pay 30% after deductible You pay 50% after deductible

Get PricingDownload a comparison chart

Gold Access Care

In Network Out of Network
Deductible
(What’s this?)
Individual: $800
Family: $1,600
Individual: $2,400
Family: $4,800
Annual Out-of-Pocket Maximum
(What’s this?)
Individual: $5,750
Family: $11,500
Individual: $17,250
Family: $34,500
Co-insurance
(What’s this?)
You pay 30% You pay 50%
Primary Care Provider & Non-specialist Office Visits
(Find a Provider)
You pay $30 copay per visit You pay 50% after deductible
Specialist Office Visits You pay $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 10% per drug
Tier 2 Preferred Brand: You pay 25% per drug
Tier 3 Non-Preferred: You pay 35% per drug
Tier 4 Specialty: You pay 45% per drug
Tier 0: You pay $0
Tier 1 Generic: You pay 50% after deductible
Tier 2 Preferred Brand: You pay 50% after deductible
Tier 3 Non-Preferred: You pay 50% after deductible
Tier 4 Specialty: You pay 50% after deductible
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
Physical, Occupational & Speech Therapy You pay 30% after deductible You pay 50% after deductible

Get PricingDownload a 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 & 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 $10 copay per drug
Tier 2 Preferred Brand: You pay $30 copay per drug
Tier 3 Non-Preferred: You pay $60 copay per drug
Tier 4 Specialty: You pay $75 copay per drug
Tier 5 Non-preferred Specialty: You pay $225 copay per drug
You pay 50% after deductible
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
Physical, Occupational & Speech Therapy $40 copay per visit You pay 50% after deductible

Get PricingDownload a comparison chart