DVP Essentials 2500

PHCS / Multiplan Network

DVP Essentials 2500 is a limited benefit plan on the PHCS/Multiplan network designed for individuals who want access to basic doctor visits and hospital care at a lower monthly cost. It works best for generally healthy people who primarily need coverage for routine office visits, a potential hospitalization, or an unexpected urgent situation. Be aware this is not comprehensive major medical insurance — it has strict annual limits on visits and services.

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Monthly premiums

member_only: $504.00/mo
child: $654.00/mo
spouse: $704.00/mo
family: $954.00/mo

The DVP Essentials 2500 plan gives you access to the large PHCS/Multiplan network of doctors and hospitals across all 50 states with no referral needed to see a specialist. You can visit a primary care doctor for a $25 copay or a specialist for a $50 copay, with up to 4 combined visits per plan year. Urgent care is covered at a $75 copay for 1 visit per year, and telemedicine calls are included at no cost with unlimited use — a great way to handle minor issues without using up your in-person visit allowance. Preventive care services and a list of preventive generic prescriptions, including vaccines, contraceptives, and certain cholesterol medications, are covered at $0 when done at a non-hospital-based provider. For more serious medical needs, the plan covers up to 5 inpatient hospital days per year, 1 inpatient surgery, 1 outpatient surgery, and 1 emergency room visit per year. These hospital and facility services are subject to a $2,500 individual deductible first, after which the plan pays 50% and you pay 50% of covered costs. The individual out-of-pocket maximum is $9,200. Outpatient diagnostic services like lab work and imaging are also covered — up to 3 visits combined for labs and minor imaging, and 1 visit for major imaging like MRIs or CT scans — after the deductible with 50% coinsurance. Prior authorization is required for most hospital and facility services, and skipping that step can reduce your benefits significantly. On the pharmacy side, preventive generic drugs are covered at $0, while non-preventive generics are available through a discount plan — not a standard copay. Brand-name and specialty drugs are not covered. Notably, this plan does not cover maternity or childbirth services, rehabilitation therapies, durable medical equipment, radiation, chemotherapy, dialysis, skilled nursing facilities, or out-of-network providers at any benefit level. This plan may be a good fit for self-employed individuals or association members who are generally in good health, visit the doctor infrequently, and want protection against a major unexpected medical event while keeping monthly costs lower. However, it is important to understand that this is a limited benefit plan — not traditional major medical insurance — and anyone with ongoing health conditions, regular specialist needs, or prescription drug costs beyond preventive generics should carefully weigh whether the annual service caps and high cost-sharing will meet their needs.

Plan details

Deductible (Individual): $2,500
Deductible (Family): $5,000
Coinsurance (In-Network): 50%
Primary Care Copay: $25
Specialist Copay: $50
Urgent Care Copay: $75

Benefits

Deductible
$2,500 / $5,000
In-Network
Copay
$25 / $50 / $75
PCP / Specialist / Urgent Care
Coinsurance
50% after deductible
Doctor Visits
4 combined/yr
PCP + Specialist + MH
Rx Coverage
$0 preventive
Non-preventive & brand: Discount plan only
Hospitalization
5 days/yr
Surgeries
1 inpatient / 1 outpatient per yr
ER
1 visit/yr
Copay included in hospitalization
Urgent Care
1 visit/yr

DVP Essentials 2500

Monthly premiums

Plan details

Benefits

Plan documents

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