Compare Plans & Benefits
Compare up to three plans at a time.
Jefferson Health Plans offers Individual and Family Plans with $0 medical deductibles, low-cost generic prescription drug coverage, and no referral requirements. Review the chart below to learn more.*
| Plan Name: | $0 Deductible + Bronze | Total + Bronze | $0 Deductible + Silver | |
|---|---|---|---|---|
| Medical Deductible - Individual/Family | $0/$0 | $7,900/$15,800 | $0/$0 | |
| Drug Deductible | $5,000/$10,000 | Combined | $5,000/$10,000 | |
| Out-of-Pocket Maximum - Individual/Family | $9,450/$18,900 | $9,450/$18,900 | $9,450/$18,900 | |
| No Cost Share PCP Visit | 1/Benefit Year | 1/Benefit Year | 2/Benefit Year | |
| PCP Visit | $55 No Deductible | $45 No Deductible | $45 No Deductible | |
| Specialist Visit | $100 No Deductible | $95 No Deductible | $95 No Deductible | |
| Virtual Care (JeffConnect) | No Charge | No Charge | No Charge | |
| Virtual Care - Primary Care Visit | $55 No Deductible | $45 No Deductible | $45 No Deductible | |
| Virtual Care - Specialist Visit | $100 No Deductible | $95 No Deductible | $95 No Deductible | |
| Acute Stays | $1,800 Per Day After Deductible (Max 5 copays per admit) | $650 Per Day After Deductible (Max 5 copays per admit) | $595 Per Day After Deductible (Max 5 copays per admit) | |
| Mental/Behavioral Health/SUD | $1,800 Per Day After Deductible (Max 5 copays per admit) | $650 Per Day After Deductible (Max 5 copays per admit) | $595 Per Day After Deductible (Max 5 copays per admit) | |
| Delivery and All Inpatient Services for Maternity Care | $1,800 Per Day After Deductible (Max 5 copays per admit) | $650 Per Day After Deductible (Max 5 copays per admit) | $595 Per Day After Deductible (Max 5 copays per admit) | |
| Durable Medical Equipment | 50% Coinsurance After Deductible | 50% Coinsurance After Deductible | 40% Coinsurance After Deductible | |
| Emergency Room Services | $1,200 No Deductible | 50% Coinsurance After Deductible | $975 No Deductible | |
| Imaging (CT/PET Scans, MRIs) | $250 No Deductible | $250 No Deductible | $150 No Deductible | |
| Occupational and Rehabilative Physical Therapy (30 visits combined per year) | $150 No Deductible | $150 No Deductible | $100 No Deductible | |
| Urgent Care Centers or Facilities | $100 No Deductible | $95 No Deductible | $95 No Deductible | |
| Pharmacy Services | Preventative Drugs: No Charge Generic Drugs Tier 1: $35 No Deductible Generic Drugs Tier 2: $35 No Deductible Preferred Brand Drugs: $200 No Deductible Non-Preferred Brand Drugs: $250 Copay After Deductible Specialty Drugs: 50% Coinsurance After Deductible | Preventative Drugs: No Charge Generic Drugs Tier 1: $30 No Deductible Generic Drugs Tier 2: $30 No Deductible Preferred Brand Drugs: $150 No Deductible Non-Preferred Brand Drugs: 50% Coinsurance After Deductible Specialty Drugs: 50% Coinsurance After Deductible | Preventative Drugs: No Charge Generic Drugs Tier 1: $5 No Deductible Generic Drugs Tier 2: $20 No Deductible Preferred Brand Drugs: $100 No Deductible Non-Preferred Brand Drugs: 50% Coinsurance After Deductible Specialty Drugs: 50% Coinsurance After Deductible |
