Your Medical Benefits
Open Access Plus - OAP
Benefit Summary
Group # 3346200
Open Access Plus (OAP) gives you access to thousands of providers, doctors, hospitals and specialists– plus programs and services to support your whole-health needs.
Find a Provider
Plan Documents
| In-Network | Out-of-Network | |
|---|---|---|
| Plan Name | Open Access Plus - OAP | |
| Plan Coinsurance | Plan pays 80% | Plan pays 60% |
| Plan Deductible (Individual) | Individual: $1,500 | Individual: $2,000 |
| Plan Deductible (Family) | Family: $3,000 | Family: $4,000 |
| Plan Out-of-Pocket (Individual) | Individual: $3,000 | Individual: $6,000 |
| Plan Out-of-Pocket (Family) | Family: $6,000 | Family: $12,000 |
| Primary Care Physician Office Visit | $30 copay, and plan pays 100% | Plan pays 60% |
| Specialist Care Physician Office Visit | $50 copay, and plan pays 100% | Plan pays 60% |
| Emergency Room | Plan pays 80% | |
| Urgent Care | $25 copay, and plan pays 100% | Plan pays 60% |
| Outpatient Radiology | Plan pays 80% | Plan pays 60% |
| Independent Laboratory | Plan pays 80% | Plan pays 60% |
| Formulary Type | Standard | |
| Retail Pharmacy | Retail (per 30-day supply): Generic: You pay $25 Preferred Brand: You pay $40 Non-Preferred Brand: You pay $60 | Not Covered for all benefits |
| Home Delivery Pharmacy | Retail and Home Delivery (per 30-day supply): Specialty: You pay $100 Retail and Home Delivery (per 90-day supply): Generic: You pay $50 Preferred Brand: You pay $80 Non-Preferred Brand: You pay $120 | Not Covered for all benefits |
| Outpatient Therapy and Chiropractic Services | Not Covered for all benefits | |
All plans have exclusions and limitations. For a summary of these exclusions and limitations, view the Summary of Benefits and Coverage.
Benefit Summary
Group # 3346200
Open Access Plus (OAP) gives you access to thousands of providers, doctors, hospitals and specialists– plus programs and services to support your whole-health needs.
| In-Network | Out-of-Network | |
|---|---|---|
| Plan Name | Open Access Plus - OAP | |
| Plan Coinsurance | Plan pays 80% | Plan pays 60% |
| Plan Deductible (Individual) | Individual: $1,500 | Individual: $2,000 |
| Plan Deductible (Family) | Family: $3,000 | Family: $4,000 |
| Plan Out-of-Pocket (Individual) | Individual: $3,000 | Individual: $6,000 |
| Plan Out-of-Pocket (Family) | Family: $6,000 | Family: $12,000 |
| Primary Care Physician Office Visit | $30 copay, and plan pays 100% | Plan pays 60% |
| Specialist Care Physician Office Visit | $50 copay, and plan pays 100% | Plan pays 60% |
| Emergency Room | Plan pays 80% | |
| Urgent Care | $25 copay, and plan pays 100% | Plan pays 60% |
| Outpatient Radiology | Plan pays 80% | Plan pays 60% |
| Independent Laboratory | Plan pays 80% | Plan pays 60% |
| Formulary Type | Standard | |
| Retail Pharmacy | Retail (per 30-day supply): Generic: You pay $25 Preferred Brand: You pay $40 Non-Preferred Brand: You pay $60 | Not Covered for all benefits |
| Home Delivery Pharmacy | Retail and Home Delivery (per 30-day supply): Specialty: You pay $100 Retail and Home Delivery (per 90-day supply): Generic: You pay $50 Preferred Brand: You pay $80 Non-Preferred Brand: You pay $120 | Not Covered for all benefits |
| Outpatient Therapy and Chiropractic Services | Not Covered for all benefits | |
All plans have exclusions and limitations. For a summary of these exclusions and limitations, view the Summary of Benefits and Coverage.