Affordably priced Bronze plan offered through HealthSource RI. This plan has a copay for PCP visits and behavioral health outpatient visits. Preventive services are covered at 100%.
Deductible: $6,825 (Individual) / $13,650 (Family)
Out of Pocket Max: $8,550 (Individual) / $17,100 (Family)
Primary Care/Behavioral Health Office Visits: $25
Specialist/Urgent Care Visits: 30%*
Inpatient/Imaging/Lab Services: 30%*
Pharmacy (Tiers 1-6): $10*/$15*/$40*/$55*/30%*/30%*
What do you need help with today?
- I need a doctor.
- I want to know my rights and privacy.
- I want to know if my medicine is covered.
- I want to access my Pharmacy Member Portal.
- Use this portal to check your medications, sign up for mail order pharmacy and review drug costs
- Formulary Foreword
- You can also sign up for mail order pharmacy by calling: 1-844-254-9483
- I want to access my Behavioral Health Member Portal.
Where can I learn about my benefits?
- Price Information for Your Pharmacy Benefits
- Plan Summary (English) 2023
- Plan Summary (Spanish) 2023
- Certificate of Coverage
- Pediatric Dental Benefits
- Summary of Benefits and Coverage:
- Your Rights and Protections Against Surprise Medical Bills
- Glossary of Health Coverage and Medical Terms
- Credible Coverage Disclosure Notice
Read the latest issue of our quarterly member newsletter, Healthy You.
Questions about INNOVATION? We’re happy to help.
Call us today at 1-855-321-9244.
Understanding Your Health Plan
This is a breakdown of what you can expect from your health plan: