$0 Deductible + Bronze + HMO
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When you choose a Bronze + HMO plan, you’ll get benefits like:
- $0 medical deductible
- $0 virtual care through JeffConnect
- $0 preventive drugs
- Plus more!
Total + Bronze + HMO
Shop. Compare. Enroll.
When you choose a Total + Bronze + HMO plan, you’ll get benefits like:
- $0 virtual care through JeffConnect
- $0 preventive drugs
- Plus more!
$0 Deductible + Bronze + HMO Plan Benefits
Jefferson Health Plans offers affordable Individual and Family Plans with essential benefits, free initial primary care visits, and no referral requirements. Review the chart below to learn more about our $0 Deductible + Bronze + HMO plans.
| Plan Name: | Enhanced Tier | Standard Tier | |
|---|---|---|---|
| Medical Deductible - Individual/Family | $0/$0 | $2,000/$4,000 | |
| Drug Deductible | $5,000/$10,000 | $5,000/$10,000 | |
| Out-of-Pocket Maximum - Individual/Family | $9,450/$18,900 | $9,450/$18,900 | |
| No Cost Share PCP Visit | 1/Benefit Year | 0 | |
| PCP Visit | $55 No Deductible | $100 No Deductible | |
| Specialist Visit | $100 No Deductible | $150 No Deductible | |
| Virtual Care (JeffConnect) | No Charge | N/A | |
| Virtual Care - Primary Care Visit | $55 No Deductible | $100 No Deductible | |
| Virtual Care - Specialist Visit | $100 No Deductible | $150 No Deductible | |
| Acute Stays | $1,800 Per Day After Deductible (Max 5 copays per admit) | $3,000 Per Day After Deductible (Max 5 copays per admit) | |
| Mental/Behavioral Health/SUD | $1,800 Per Day After Deductible (Max 5 copays per admit) | $1,800 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) | $3,000 Per Day After Deductible (Max 5 copays per admit) | |
| Durable Medical Equipment | 50% Coinsurance After Deductible | 50% Coinsurance After Deductible | |
| Emergency Room Services | $1,200 No Deductible | $1,200 No Deductible | |
| Imaging (CT/PET Scans, MRIs) | $250 No Deductible | $250 No Deductible | |
| Occupational and Rehabilative Physical Therapy (30 visits combined per year) | $150 No Deductible | $200 No Deductible | |
| Urgent Care Centers or Facilities | $100 No Deductible | $150 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: $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 |
Total + Bronze + HMO Plan Benefits
Jefferson Health Plans offers affordable Individual and Family Plans with essential benefits, free initial primary care visits, and no referral requirements. Review the chart below to learn more about our Total + Bronze + HMO plans.
| Plan Name: | Enhanced Tier | Standard Tier | |
|---|---|---|---|
| Medical Deductible - Individual/Family | $7,900/$15,800 | $9,450/$18,900 | |
| Drug Deductible | Combined | Combined | |
| Out-of-Pocket Maximum - Individual/Family | $9,450/$18,900 | $9,450/$18,900 | |
| No Cost Share PCP Visit | 1/Benefit Year | 0 | |
| PCP Visit | $45 No Deductible | $95 No Deductible | |
| Specialist Visit | $95 No Deductible | $150 No Deductible | |
| Virtual Care (JeffConnect) | No Charge | No Charge | |
| Virtual Care - Primary Care Visit | $45 No Deductible | $95 No Deductible | |
| Virtual Care - Specialist Visit | $95 No Deductible | $150 No Deductible | |
| Acute Stays | $650 Per Day After Deductible (Max 5 copays per admit) | $900 Per Day After Deductible (Max 5 copays per admit) | |
| Mental/Behavioral Health/SUD | $650 Per Day After Deductible (Max 5 copays per admit) | $650 Per Day After Deductible (Max 5 copays per admit) | |
| Delivery and All Inpatient Services for Maternity Care | $650 Per Day After Deductible (Max 5 copays per admit) | $900 Per Day After Deductible (Max 5 copays per admit) | |
| Durable Medical Equipment | 50% Coinsurance After Deductible | 50% Coinsurance After Deductible | |
| Emergency Room Services | 50% Coinsurance After Deductible | 50% Coinsurance After Deductible | |
| Imaging (CT/PET Scans, MRIs) | $250 No Deductible | $250 No Deductible | |
| Occupational and Rehabilative Physical Therapy (30 visits combined per year) | $150 No Deductible | $150 No Deductible | |
| Urgent Care Centers or Facilities | $95 No Deductible | $150 No Deductible | |
| Pharmacy Services | 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: $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 |
Hours of operation: 8 a.m.-8 p.m., seven days a week, October 1 through March 31
8 a.m.-8 p.m., Monday-Friday, April 1 through September 30
Individual and Family Plans
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Our Individual and Family Plans offer comprehensive benefits for an affordable price. Learn more and find a perfect plan for you!
Bronze
Jefferson Health Plans $0 Deductible + Bronze
Silver
Jefferson Health Plans $0 Deductible + Silver
Gold
Jefferson Health Plans $0 Deductible + Gold