PHCS Ultra 1000

PHCS PPO Network (reference-based pricing)

PHCS Ultra 1000 — Deductible: $1,000 / $2,000; Max Out of Pocket: $5,000 / $10,000; Office Copays: $20 / $40; Coinsurance: 20% after deductible, up to the plan's allowed amount; Rx: $15 / $45 / $85.

Monthly premiums

Member: $1,211.00/mo
Member & Children: $1,968.00/mo
Member & Spouse: $2,217.00/mo
Member & Family: $2,927.00/mo

Plan details

Deductible (Individual): $1,000
Deductible (Family): $2,000
Out-of-Pocket Max (Individual): $5,000
Out-of-Pocket Max (Family): $10,000
Coinsurance (In-Network): 20%
Primary Care Copay: $20
Specialist Copay: $40
Urgent Care Copay: $40

Plan documents

Summary of Benefits and CoverageSBC

TelemedicineYes — Included

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