HOORAYHEALTHMVP

Plan Benefits

Broad in-network benefits with no annual visit limits on everyday healthcare services.

Essential$0 DEDUCTIBLE
Straightforward coverage with predictable costs for everyday healthcare needs.
Deductible$0 / $0
Out-of-pocket max$8,550 / $17,100
Primary care$25 copay
HH Urgent Care$25 copay

Essential Benefit Details

BenefitEssential
Preventive care$0 copay
Primary care office visit$25 copay
Specialist office visit$50 copay
Basic laboratory services$50 copay
Basic radiology$50 copay
Advanced imaging$350 copay
Hooray Health Urgent Care$25 copay †
Urgent care$50 copay
Emergency room$700 copay **
Inpatient hospital$700 copay **
Outpatient surgery$700 copay
Home health care$25 copay
MaternityIncluded ***
AmbulanceNot covered
Radiation / chemotherapy$600 copay / 50% coinsurance
PrescriptionsPreventive $0, Generic $10, Preferred $45, Non-preferred $100
Virtual urgent care$0 consult, unlimited
Virtual behavioral health$0 consult, 3 per year

* Except for preventive care, applicable copays and coinsurance under the Advantage plan apply after the deductible has been satisfied.

** Emergency room and inpatient hospital services may include separate cost-sharing for facility, professional, surgical, and other covered services received.

*** Maternity services do not have a separate maternity copay. Applicable facility, professional, and surgical cost-sharing applies based on the services received.

† Visits to Hooray Health in-network Urgent Care Centers are subject to the Hooray Health Urgent Care benefit. Members pay a $25 copay for an eligible sickness or accident visit; additional costs may apply based on services received and plan terms.

This is a high-level benefit summary. Refer to the applicable Certificate of Insurance and Schedule of Benefits for complete coverage details, limitations, and exclusions.