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Silver Pro Plus EPO by Healthfirst New York

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Plan Information

Plan Name
Silver Pro Plus EPO
Insurance Company
Healthfirst New York

In Network Benefits

Office Co-pay
$35
Specialist Co-pay
$70
Hospital Co-pay
40% after deductible
Emergency Room
$600 after deductible
Referrals Needed
No
Rx: Generic/Brand/High Brand
$20/$60/$110
In-Network Deductible (single/family)
$2,950/$5,900
In-Network Co-Insurance
40%
Max Out of Pocket (single/family)
$7,900/15,800

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
Vision and Dental
HSA Eligible
No

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