| Network | HMO |
| Exchange | Not Eligible |
| Metal Tier | Bronze |
| Monthly premium | Get Price |
| Annual Deductible - Individual | $5,000.00 |
| Annual Deductible - Family | $10,000.00 |
| Coinsurance | 20% |
| Out-of-pocket Limit - Individual (adjust) | $6,350.00 |
| Out-of-pocket Limit - Family (adjust) | $12,700.00 |
| Primary Doctor Office Visit | $40 copay |
| Specialist | $60 copay |
| Urgent Care | $65 copay |
The plan deductible is $5,000.00 Individual / $10,000.00 Family. This means that you would need to spend $5,000.00 / $10,000.00 in medical services, like lab work and outpatient surgery.
The plan coinsurance is 20%. So if you had an outpatient surgery that cost $1,000, you would pay $200.00 of that cost. HAP would pick up the rest.
All of your copays, deductible and coinsurance payments roll up to your out-of-pocket limit. So for an individual the most you would have to pay is $6,350.00 and for a family the most you would have to pay is $12,700.00
Preventive care coverage is an Essential Health Benefit and fully covered in all of HAPs plans. Preventive care visits like a yearly physical or a yearly visit to the OB/GYN are always free.
| Periodic Health Exam/Immunizations | Covered |
| Well Baby Care | Covered |
| Routine Eye Exam | Covered |
| Routine Hearing Exams | Covered |
| Preventive Related Lab Tests and X-rays | Covered |
| Periodic OB/GYN | Covered |
| Outpatient Lab/X-Ray | $40 copay after deductible |
| Outpatient Surgery | Subject to deductible and coinsurance |
| Emergency Room | $250 copay |
| Inpatient Services | Subject to deductible and coinsurance |
| Prenatal Office Visit | Covered |
| Postnatal Office Visit | $60 copay |
| Labor and Delivery | Subject to deductible and coinsurance |
| Mental Health - Outpatient | $40 copay |
| Substance Abuse - Outpatient | $40 copay |
Dental Coverage is not built into your Personal Alliance plan. However, it is available as an additional coverage option through our partners at Delta Dental. Take a look at the cost estimate below and how it affects your monthly premium and view the plan details.
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No need to worry, HAP has our member's vision benefits covered! Adult vision hardware is covered along with pediatric vision hardware in all 2014 HAP health plans. Pediatric vision care is an Essential Health Benefit. Pediatric is defined as those members under 19 years of age.
Included vision benefits
| Generic Copay | $25.00 |
| Preferred Brand Copay | $100.00 |
| Non Preferred Brand Copay | 50% |
| Specialty Copay | 50% |
If you have any questions, please call a HAP Sales Representative at (855) WITH-HAP between 8 a.m. - 6 p.m. EST Mon - Fri for one-on-one assistance. Prefer email?
Representatives are also available at the following locations to provide a private consultation and answer your health insurance questions with on-the-spot enrollment assistance.
