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Premier Plus Platinum National 2018 by MVP

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Plan Information

Plan Name
Premier Plus Platinum National 2018
Insurance Company
MVP

In Network Benefits

Office Co-pay
$15
Specialist Co-pay
$45
Hospital Co-pay
$500
Emergency Room
$200
Referrals Needed
No
Rx: Generic/Brand/High Brand
$5/$30/$50
In-Network Deductible (single/family)
$0
In-Network Co-Insurance
0%
Max Out of Pocket (single/family)
$2,300/$4,600

Out Of Network Benefits

Deductible (single/family)
N/A
Co-Insurance
N/A
Out of Pocket Max (single/family)
N/A

Other Benefits

Vision/Dental
Pediatric Vision Only
Renewal Date
Annual
HSA Eligible
No

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