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Health Plans for Individuals & Families

Plan availability varies by location. Please enter your ZIP code to see plans available in your area.

If members receive services from out-of-network providers, their deductible and out-of-pocket limit will be higher than the amounts listed in the chart below. All plans are available direct with PacificSource.

Advanced options
Gold 1500
Office Visits

Primary care
No deductible, $20

Urgent care
No deductible, $20

Specialist
No deductible, $40

Tier 1 prescription
Drug coverage No deductible, $15

In-network Costs 

Deductible
Individual $1,500
Family $3,000

Out-of-pocket max
Individual $5,000
Family $10,000

Preventive services
No deductible, covered in full

Plan Downloads (PDFs)

More details for this plan on the following networks

Silver 3000
Office Visits

Primary care
No deductible, $35

Urgent care
No deductible, $35

Specialist
After deductible, 40%

Tier 1 prescription
Drug coverage No deductible, $15

In-network Costs 

Deductible
Individual $3,000
Family $6,000

Out-of-pocket max
Individual $8,150
Family $16,300

Preventive services
No deductible, covered in full

Plan Downloads (PDFs)

More details for this plan on the following networks

Silver 4000
Office Visits

Primary care
No deductible, $20

Urgent care
No deductible, $20

Specialist
No deductible, $40

Tier 1 prescription
Drug coverage After deductible, 30%

In-network Costs 

Deductible
Individual $4,000
Family $8,000

Out-of-pocket max
Individual $7,900
Family $15,800

Preventive services
No deductible, covered in full

Plan Downloads (PDFs)

More details for this plan on the following networks

Bronze 7000
Office Visits

Primary care
No deductible, $35

Urgent care
No deductible, $35

Specialist
After deductible, 40%

Tier 1 prescription
Drug coverage After deductible, 40%

In-network Costs 

Deductible
Individual $7,000
Family $14,000

Out-of-pocket max
Individual $8,150
Family $16,300

Preventive services
No deductible, covered in full

Plan Downloads (PDFs)

More details for this plan on the following networks

Bronze HSA 6750
Office Visits

Primary care
After deductible, covered in full

Urgent care
After deductible, covered in full

Specialist
After deductible, covered in full

Tier 1 prescription
Drug coverage After deductible, covered in full

In-network Costs 

Deductible
Individual $6,750
Family $13,500

Out-of-pocket max
Individual $6,750
Family $13,500

Preventive services
No deductible, covered in full

Plan Downloads (PDFs)

More details for this plan on the following networks

Standard Gold
Office Visits

Primary care
No deductible, $20

Urgent care
No deductible, $60

Specialist
No deductible, $40

Tier 1 prescription
Drug coverage No deductible, $10

In-network Costs 

Deductible
Individual $1,000
Family $2,000

Out-of-pocket max
Individual $7,300
Family $14,600

Preventive services
No deductible, covered in full

Plan Downloads (PDFs)

More details for this plan on the following networks

Standard Silver
Office Visits

Primary care
No deductible, $40

Urgent care
No deductible, $70

Specialist
No deductible, $80

Tier 1 prescription
Drug coverage No deductible, $15

In-network Costs 

Deductible
Individual $3,550
Family $7,100

Out-of-pocket max
Individual $8,150
Family $16,300

Preventive services
No deductible, covered in full

Plan Downloads (PDFs)

More details for this plan on the following networks

Standard Bronze
Office Visits

Primary care
No deductible, $45

Urgent care
After deductible, covered in full

Specialist
No deductible, $90

Tier 1 prescription
Drug coverage No deductible, $15

In-network Costs 

Deductible
Individual $7,900
Family $15,800

Out-of-pocket max
Individual $7,900
Family $15,800

Preventive services
No deductible, covered in full

Plan Downloads (PDFs)

More details for this plan on the following networks

Catastrophic+
Office Visits

Primary care
Telemedicine and office combined visits 1-3 no deductible, After deductible, covered in full. Visits 4+ After deductible, covered in full after deductible.

Urgent care
After deductible, covered in full

Specialist
After deductible, covered in full

Tier 1 prescription
Drug coverage After deductible, covered in full

In-network Costs 

Deductible
Individual $8,150
Family $16,300

Out-of-pocket max
Individual $8,150
Family $16,300

Preventive services
No deductible, covered in full

Plan Downloads (PDFs)

More details for this plan on the following networks