The PHCS 4500 PPO is built for people who want the clarity of fixed copays for routine care, but also need strong protection when larger medical events occur. Preventive services and telemedicine are always free, while office visits, urgent care, labs, and imaging have set copays so you know what to expect. For hospital stays, surgery, and emergency care, the plan applies coinsurance after the deductible, giving you meaningful coverage against high costs. With national PHCS PPO access, supplemental cash benefits, and included life insurance, this plan balances everyday affordability with long-term security.

• Plan type: Copay-based major medical
• Network: PHCS PPO — national access; plans are not insured by PHCS
• In-network individual deductible: $4,500; family $9,000
• In-network out-of-pocket max: Individual $8,150; family $16,300
• Coinsurance after deductible (in network): 30% member / 70% plan
• Preventive care and telemedicine: $0; unlimited virtual visits for common needs
• Office visits: $40 copay for primary care; $75 copay for specialists; $90 copay for urgent care
• Labs and X-rays: First $500 covered in full, then deductible + 30% coinsurance
• Advanced imaging (CT/MRI/PET): $300 copay
• Hospital, surgery, and ER: Deductible + 30% coinsurance in network (prior authorization required for many services)
• Pharmacy: Preventive generics $0; other prescriptions with fixed copays ($20 generic, $65 preferred brand, $95 non-preferred, $200 specialty)
• Added value: $20,000 Humana life insurance for the primary insured and supplemental Benefit Logistics cash payments for screenings, imaging, ER visits, hospital confinement, and other covered incidents
• Annual maximum benefit: Unlimited

This plan is a strong fit for individuals and families who want predictable copays for routine care while still having protection for major medical needs. Use in-network providers to keep costs consistent, lean on $0 preventive care and telemedicine for everyday health, and rely on fixed copays to manage prescriptions and office visits. If you’d like to confirm whether your doctor participates in the PHCS PPO network, check drug coverage under the formulary, or get a personalized cost estimate, contact Fage Financial today — we’ll guide you step by step through enrollment.