Harvard Pilgrim Health Care

Maine's Choice Plus HMO Silver 5500

Plan Overview

Medical Deductible
  • Individual: $5,500
  • Family: $11,000
  • Per Person: $5,500
Prescription Drug Deductible
  • Individual: Included in Medical
  • Family: Included in Medical
  • Per Person: Included in Medical
Medical Out-of-Pocket Maximum
  • Individual: $8,000
  • Family: $16,000
  • Per Person: $8,000
Drug Out-of-Pocket Maximum
  • Individual: Included in Medical
  • Family: Included in Medical
  • Per Person: Included in Medical

Office Visit

Primary Doctor
  • Standard: $40 Copay
Specialist
  • Standard: $70 Copay

Prescription Drug Information

Preferred Brand Drugs
  • Standard: $50 Copay
Generic Drugs
  • Standard: $5 Copay