Access Gold 2 by Univera Healthcare
Scroll down to the Summary of Benefits PDF
Plan Information
- Plan Name
- Access Gold 2
- Insurance Company
- Univera Healthcare
In Network Benefits
- Office Co-pay
- $5 after deductible
- Specialist Co-pay
- $45 after deductible
- Hospital Co-pay
- $1,000 after deductible
- Emergency Room
- $150 after deductible
- Referrals Needed
- No
- Rx: Generic/Brand/High Brand
- $5/$50/50%
- In-Network Deductible (single/family)
- $1,000/$2,000
- In-Network Co-Insurance
- 0%
- Max Out of Pocket (single/family)
- $7,150/$14,300
Out Of Network Benefits
- Co-Insurance
- 40%
- Deductible
- $2,000/$4,000
- Out of Pocket Max (single/family)
- $14,300/28,600
Other Benefits
- Vision/Dental
- Pediatric Vision and Dental; Adult Vision Only
- Renewal Date
- HSA Eligible
- No
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