Wellpoint

Wellpoint Essential Silver 2500 ($0 Virtual PCP + $0 Select Drugs + Incenti

Plan Overview

Medical Deductible
  • Individual: $2,500
  • Family: $5,000
  • Per Person: $2,500
Prescription Drug Deductible
  • Individual: Included in Medical
  • Family: Included in Medical
  • Per Person: Included in Medical
Medical Out-of-Pocket Maximum
  • Individual: $9,200
  • Family: $18,400
  • Per Person: $9,200
Drug Out-of-Pocket Maximum
  • Individual: Included in Medical
  • Family: Included in Medical
  • Per Person: Included in Medical

Office Visit

Primary Doctor
  • Standard: $20.00 Copay

Prescription Drug Information

Generic Drugs
  • Standard: $10.00 Copay

Inpatient Coverage

Hospital Services
  • Standard: 40.00% Coinsurance after deductible

Emergency and Urgent Care

Emergency Room
  • Standard: $75.00 Copay
Coverage provided by Wellpoint Maryland, Inc.