- Bronze
- Silver
- Gold
Our Bronze health plans offer a range of benefits, including coverage for the 10 Essential Health Benefits, preventive care and prescription drugs.
$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 |
Our Silver health plans offer a range of benefits, including coverage for the 10 Essential Health Benefits, preventive care and prescription drugs.
$0 Deductible + Silver + 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 + Silver + 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 | 2/Benefit Year | 0 | |
| PCP Visit | $45 No Deductible | $100 No Deductible | |
| Specialist Visit | $95 No Deductible | $130 No Deductible | |
| Virtual Care (JeffConnect) | No Charge | N/A | |
| Virtual Care - Primary Care Visit | $45 No Deductible | $100 No Deductible | |
| Virtual Care - Specialist Visit | $95 No Deductible | $130 No Deductible | |
| Acute Stays | $595 Per Day After Deductible (Max 5 copays per admit) | $1,200 Per Day After Deductible (Max 5 copays per admit) | |
| Mental/Behavioral Health/SUD | $595 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 | $595 Per Day After Deductible (Max 5 copays per admit) | $1,200 Per Day After Deductible (Max 5 copays per admit) | |
| Durable Medical Equipment | 40% Coinsurance After Deductible | 40% Coinsurance After Deductible | |
| Emergency Room Services | $975 No Deductible | $975 No Deductible | |
| Imaging (CT/PET Scans, MRIs) | $150 No Deductible | $150 No Deductible | |
| Occupational and Rehabilative Physical Therapy (30 visits combined per year) | $100 No Deductible | $100 No Deductible | |
| Urgent Care Centers or Facilities | $95 No Deductible | $130 No Deductible | |
| Pharmacy Services | 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 | 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 |
Balanced + Silver + HMO
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 Balanced + Silver + HMO plans.
| Plan Name: | Enhanced Tier | Standard Tier | |
|---|---|---|---|
| Medical Deductible - Individual/Family | $2,400/$4,800 | $6,900/$13,800 | |
| Drug Deductible | $500/$1,000 | $500/$1,000 | |
| Out-of-Pocket Maximum - Individual/Family | $9,450/$18,900 | $9,450/$18,900 | |
| No Cost Share PCP Visit | 2/Benefit Year | 0 | |
| PCP Visit | $45 No Deductible | $95 No Deductible | |
| Specialist Visit | $95 No Deductible | $130 No Deductible | |
| Virtual Care (JeffConnect) | No Charge | N/A | |
| Virtual Care - Primary Care Visit | $45 No Deductible | $95 No Deductible | |
| Virtual Care - Specialist Visit | $95 No Deductible | $130 No Deductible | |
| Acute Stays | $550 Per Day After Deductible (Max 5 copays per admit) | $850 Per Day After Deductible (Max 5 copays per admit) | |
| Mental/Behavioral Health/SUD | $550 Per Day After Deductible (Max 5 copays per admit) | $550 Per Day After Deductible (Max 5 copays per admit) | |
| Delivery and All Inpatient Services for Maternity Care | $550 Per Day After Deductible (Max 5 copays per admit) | $850 Per Day After Deductible (Max 5 copays per admit) | |
| Durable Medical Equipment | 40% Coinsurance After Deductible | 40% Coinsurance After Deductible | |
| Emergency Room Services | $950 No Deductible | $950 No Deductible | |
| Imaging (CT/PET Scans, MRIs) | $150 No Deductible | $150 No Deductible | |
| Occupational and Rehabilative Physical Therapy (30 visits combined per year) | $100 No Deductible | $100 No Deductible | |
| Urgent Care Centers or Facilities | $95 No Deductible | $130 No Deductible | |
| Pharmacy Services | Preventative Drugs: No Charge Generic Drugs Tier 1: $5 No Deductible Generic Drugs Tier 2: $20 No Deductible Preferred Brand Drugs: 50% Coinsurance After 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: 50% Coinsurance After Deductible
Non-Preferred Brand Drugs: 50% Coinsurance After Deductible
Specialty Drugs: 50% Coinsurance After Deductible |
Total + Silver + 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 + Silver + HMO plans.
| Plan Name: | Enhanced Tier | Standard Tier | |
|---|---|---|---|
| Medical Deductible - Individual/Family | $4,900/$9,800 | $8,000/$16,000 | |
| Drug Deductible | $600/$1,200 | $600/$1,200 | |
| Out-of-Pocket Maximum - Individual/Family | $9,450/$18,900 | $9,450/$18,900 | |
| No Cost Share PCP Visit | 2/Benefit Year | 0 | |
| PCP Visit | $35 No Deductible | $90 No Deductible | |
| Specialist Visit | $85 No Deductible | $125 No Deductible | |
| Virtual Care (JeffConnect) | No Charge | N/A | |
| Virtual Care - Primary Care Visit | $35 No Deductible | $90 No Deductible | |
| Virtual Care - Specialist Visit | $85 No Deductible | $125 No Deductible | |
| Acute Stays | $450 Per Day After Deductible (Max 5 copays per admit) | $800 Per Day After Deductible (Max 5 copays per admit) | |
| Mental/Behavioral Health/SUD | $450 Per Day After Deductible (Max 5 copays per admit) | $450 Per Day After Deductible (Max 5 copays per admit) | |
| Delivery and All Inpatient Services for Maternity Care | $450 Per Day After Deductible (Max 5 copays per admit) | $800 Per Day After Deductible (Max 5 copays per admit) | |
| Durable Medical Equipment | 40% Coinsurance After Deductible | 40% Coinsurance After Deductible | |
| Emergency Room Services | $950 No Deductible | $950 No Deductible | |
| Imaging (CT/PET Scans, MRIs) | $150 No Deductible | $150 No Deductible | |
| Occupational and Rehabilative Physical Therapy (30 visits combined per year) | $100 No Deductible | $100 No Deductible | |
| Urgent Care Centers or Facilities | $85 No Deductible | $125 No Deductible | |
| Pharmacy Services | Preventative Drugs: No Charge Generic Drugs Tier 1: $5 No Deductible Generic Drugs Tier 2: $20 No Deductible Preferred Brand Drugs: 50% Coinsurance After Deductible Non-Preferred Brand Drugs: 50% Coinsurance After Deductible Specialty Drugs: Coinsurance After Deductible | Preventative Drugs: No Charge
Generic Drugs Tier 1: $5 No Deductible
Generic Drugs Tier 2: $20 No Deductible
Preferred Brand Drugs: 50% Coinsurance After Deductible
Non-Preferred Brand Drugs: 50% Coinsurance After Deductible
Specialty Drugs: Coinsurance After Deductible |
Our Gold health plans offer a range of benefits, including coverage for the 10 Essential Health Benefits, preventive care and prescription drugs.
$0 Deductible + Gold + 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 + Gold + HMO plans.
| Plan Name: | Enhanced Tier | Standard Tier | |
|---|---|---|---|
| Medical Deductible - Individual/Family | $0/$0 | $500/$1,000 | |
| Drug Deductible | Combined | Combined | |
| Out-of-Pocket Maximum - Individual/Family | $9,450/$18,900 | $9,450/$18,900 | |
| No Cost Share PCP Visit | 2/Benefit Year | 0 | |
| PCP Visit | $25 No Deductible | $60 No Deductible | |
| Specialist Visit | $70 No Deductible | $100 No Deductible | |
| Virtual Care (JeffConnect) | No Charge | N/A | |
| Virtual Care - Primary Care Visit | $25 No Deductible | $60 No Deductible | |
| Virtual Care - Specialist Visit | $70 No Deductible | $100 No Deductible | |
| Acute Stays | $350 Per Day After Deductible (Max 5 copays per admit) | $550 Per Day After Deductible (Max 5 copays per admit) | |
| Mental/Behavioral Health/SUD | $350 Per Day After Deductible (Max 5 copays per admit) | $350 Per Day After Deductible (Max 5 copays per admit) | |
| Delivery and All Inpatient Services for Maternity Care | $350 Per Day After Deductible (Max 5 copays per admit) | $550 Per Day After Deductible (Max 5 copays per admit) | |
| Durable Medical Equipment | 50% Coinsurance After Deductible | 50% Coinsurance After Deductible | |
| Emergency Room Services | $450 No Deductible | $450 No Deductible | |
| Imaging (CT/PET Scans, MRIs) | $80 No Deductible | $80 No Deductible | |
| Occupational and Rehabilative Physical Therapy (30 visits combined per year) | $70 No Deductible | $70 No Deductible | |
| Urgent Care Centers or Facilities | $70 No Deductible | $100 No Deductible | |
| Pharmacy Services | 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 | 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 |
Total + Gold + 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 + Gold + HMO plans.
| Plan Name: | Enhanced Tier | Standard Tier | |
|---|---|---|---|
| Medical Deductible - Individual/Family | $500/$1,000 | ||
| Drug Deductible | $1,000/$2,000 | $1,000/$2,000 | |
| Out-of-Pocket Maximum - Individual/Family | $9,450/$18,900 | $9,450/$18,900 | |
| No Cost Share PCP Visit | 2/Benefit Year | 0 | |
| PCP Visit | $20 No Deductible | $60 No Deductible | |
| Specialist Visit | $65 No Deductible | $100 No Deductible | |
| Virtual Care (JeffConnect) | No Charge | N/A | |
| Virtual Care - Primary Care Visit | $20 No Deductible | $60 No Deductible | |
| Virtual Care - Specialist Visit | $65 No Deductible | $100 No Deductible | |
| Acute Stays | $300 Per Day After Deductible (Max 5 copays per admit) | ||
| Mental/Behavioral Health/SUD | $300 Per Day After Deductible (Max 5 copays per admit) | $300 Per Day After Deductible (Max 5 copays per admit) | |
| Delivery and All Inpatient Services for Maternity Care | $300 Per Day After Deductible (Max 5 copays per admit) | $500 Per Day After Deductible (Max 5 copays per admit) | |
| Durable Medical Equipment | 50% Coinsurance After Deductible | 50% Coinsurance After Deductible | |
| Emergency Room Services | $400 No Deductible | $400 No Deductible | |
| Imaging (CT/PET Scans, MRIs) | $100 No Deductible | $100 No Deductible | |
| Occupational and Rehabilative Physical Therapy (30 visits combined per year) | $65 No Deductible | $75 No Deductible | |
| Urgent Care Centers or Facilities | $65 No Deductible | $100 No Deductible | |
| Pharmacy Services | Preventative Drugs: No Charge Generic Drugs Tier 1: $0 No Deductible Generic Drugs Tier 2: $10 No Deductible Preferred Brand Drugs: $100 No Deductible Non-Preferred Brand Drugs: 50% Coinsurance After Deductible Specialty Drugs: Coinsurance After Deductible | Preventative Drugs: No Charge Generic Drugs Tier 1: $0 No Deductible Generic Drugs Tier 2: $10 No Deductible Preferred Brand Drugs: $100 No Deductible Non-Preferred Brand Drugs: 50% Coinsurance After Deductible Specialty Drugs: Coinsurance After Deductible |
Individual and Family Plans
Call Today to Learn More and Enroll
Call 1-833-435-1990(TTY 1-844-222-2070) to speak with a licensed benefits advisor.
Bronze
Jefferson Health Plans $0 Deductible + Bronze
Silver
Jefferson Health Plans $0 Deductible + Silver
Gold
Jefferson Health Plans $0 Deductible + Gold