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Dual network: HIP HMO in NY · Cigna PPO outside NY (no referral)

175 HIP HMO Brand Rx

Dual network: HIP HMO in NY · Cigna PPO outside NY (no referral)

No-deductible HIP HMO with full brand-name drug coverage. $30 office copay, $60 specialist, no referrals needed. Three-tier Rx at $25 / $50 / $100 after a $300 prescription deductible. $1,500 inpatient and $500 outpatient surgery copays, $300 emergency room. $7,350 / $14,700 out-of-pocket maximum.

Monthly premiums

Member
$1,788.00/mo
Member & Family
$4,203.00/mo

The only Local 175 plan that covers brand-name drugs — $116/mo more than generic-only, with no medical deductible at all

Plan details

Deductible (Individual)
$0
Deductible (Family)
$0
Out-of-Pocket Max (Individual)
$7,350
Out-of-Pocket Max (Family)
$14,700
Coinsurance (In-Network)
0%
Primary Care Copay
$30
Specialist Copay
$60
ER Copay
$300

Benefits

  • Rx Coverage

    $25 / $50 / $100

    Generic / preferred brand / non-preferred brand, after a $300 Rx deductible

  • Deductible

    $0

    No medical deductible

  • Max Out of Pocket

    $7,350 / $14,700

    In-network; accumulates plan year

  • Copay

    $30 / $60

    PCP / Specialist

  • Referrals

    Not required

    Non-gated — see a specialist directly

  • Hospital Admission

    $1,500 per admission

    Preauthorization required

  • Outpatient Surgery

    $500 copay

  • Emergency Room

    $300 copay

    Waived if admitted

  • Laboratory

    Included

    Covered by the office visit copay

  • Coinsurance

    0%

    Plan pays 100% after copays

  • Dependents

    To Age 26

  • Work Requirement

    Work Required

Plan documents

Networknational

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