Elite Health Plus USA

Elite Health Plus USA is a copay-based medical plan with a $1,000 individual deductible that covers everyday care like doctor visits, urgent care, and prescriptions at predictable flat rates. It is best suited for generally healthy individuals who want lower-cost access to routine and preventive care but do not need coverage for major hospitalizations or surgeries. Be aware that this plan has no out-of-pocket maximum and excludes several significant services.

Enroll Now

Monthly premiums

Member: $522.28/mo
Member & Spouse: $858.81/mo
Member & Children: $894.89/mo
Member & Family: $1,203.76/mo

Elite Health Plus USA is designed to make routine, day-to-day healthcare affordable and accessible. You will pay a $35 copay for primary care visits, $75 for specialist visits, and $150 for urgent care. Preventive wellness visits are covered at $0, and telemedicine is also available at no cost. Prescription drugs are covered through the VaultRx Plus formulary, with preventive generics at $0 (Tier 1), and other medications ranging from $15 or less (Tier 2) up through Tier 5 for higher-cost drugs — though note that prescription drug benefits are subject to a combined monthly maximum of $250 per individual, after which you pay full price for the rest of the month. For more serious care, there is a $1,000 individual / $2,000 family deductible that applies before coinsurance kicks in. Emergency room visits carry a $500 copay followed by 50% coinsurance, with coverage limited to one ER visit per year. Hospital inpatient room and board has a $500 copay followed by 40% coinsurance and is capped at a 5-day limit. Lab work carries a $50–$100 copay per visit, and imaging such as CT scans and MRIs has a $500 copay per image — but important to note, lab and radiology services are not covered if performed at a hospital facility. There are meaningful gaps in this plan that every shopper should understand before enrolling. This plan does not cover inpatient surgery, outpatient or free-standing facility procedures, ambulance services, chemotherapy or radiation, home health care, chemical dependency treatment, or facility-based maternity (childbirth and delivery). Professional maternity services are also not covered. Additionally, this plan has no out-of-pocket maximum, meaning there is no annual cap on what you could owe in a given year. This plan is best suited for relatively healthy individuals who primarily need coverage for routine doctor visits, preventive care, and common prescriptions, and who are comfortable taking on significant financial risk for hospitalizations or major medical events. If you anticipate needing surgery, hospital stays, or ongoing specialty care, you should carefully weigh whether this plan's benefit structure meets your needs. Members can manage their benefits through the BenefitsHero mobile app, which provides access to ID cards, claims information, telemedicine, and plan guidance.

Benefits

Deductible
$1,000 / $2,000
Copay
$35 / $75 / $150
PCP / Specialist / Urgent Care
Coinsurance
50% after deductible
Rx Coverage
$0 / ≤$15 / ≤$30 / ≤$40
T1 Preventive (200+ $0 generics) / T2 / T3 / T4
Hospitalization
$500 copay
5 days/yr
ER
$500 copay
1 visit/yr
Lab Work
$50-$100 copay per visit depending on test/service. NOT covered if provided at a hospital.
Imaging
$500 copay
CT/MRI/MRA/PET · not covered if hospital-based
Pregnancy
Subject to co-pays and limitations

Elite Health Plus USA

Monthly premiums

Benefits

Plan documents

Available in

Ready to see your rate?