IN-NETWORK - Multiplan PHCS
$25 co-pay for all outpatient physician office visits at primary care physician office, specialist, urgent care, or retail medical clinic. Plan pays up to $200 for services rendered per visit after co-pay. Max. benefit 4 visits per insured/year

OUT-OF-NETWORK
$25 co-pay for all outpatient physician office visits at primary care physician office, specialist, urgent care, or retail medical clinic. Plan pays up to 125% of Medicare for services rendered per visit after co-pay. Max. benefit 4 visits per insured/year

IN-NETWORK - Multiplan PHCS
No cost for all covered wellness and preventive care services. Max. benefit: 1 exam per year per insured History, Physical Exam, Measurements (height, weight, body mass index).

OUT-OF-NETWORK: Not covered.

IN-NETWORK - Multiplan PHCS
No cost for all covered wellness and preventive care services.

OUT-OF-NETWORK: Not covered.

Covered Preventive Services for Adults
(ages 18 and older)

• Abdominal Aortic Aneurysm Screening - One-time screening for age 65-75
• Blood Pressure screening - One-time per plan year
• Cholesterol screening - One-time per plan year
• Type 2 Diabetes screening - One-time per plan year
• Hepatitis B screening for adults at high risk - One-time per plan year
• Hepatitis C screening for adults at high risk - One-time per plan year
• HIV screening & counseling - One-time per plan year
• Immunization vaccines One-time per plan year per immunization (EACH) - hepatitis A & B, herpes zoster, human papillomavirus, influenza (flu shot), measles, mumps, rubella, meningococcal, pneumococcal, tetanus, diphtheria, pertussis, and varicella
• Obesity screening & counseling - One-time per plan year
• Sexually Transmitted Infection (STI) prevention counseling - One-time per plan year
• Syphilis screening - One-time per plan year

IN-NETWORK - Multiplan PHCS
No cost for all covered wellness and preventive care services.

OUT-OF-NETWORK: Not covered.

Covered Preventive Services for Women
(ages 18 and older)

• BRCA counseling and genetic testing - One-time per plan year for Women at higher risk
• Breast Cancer Mammography Screenings - One-time per plan year for women age 40+
• Breast Cancer Chemo prevention counseling - One-time per plan year
• Cervical Cancer screening - One-time per plan year
• Gestational Diabetes screening - One-time per plan year
• Hepatitis B screening - One-time per plan year
• HIV screening & counseling - One-time per plan year
• Human Papillomavirus (HPV) DNA test - One-time every 3 years for women with normal cytology age 30+
• Osteoporosis screening - One-time per plan year for women age 60+
• Well-woman visits - To obtain recommended preventive services

IN-NETWORK - Multiplan PHCS
No cost for all covered wellness and preventive care services.

OUT-OF-NETWORK: Not covered.

Covered Preventive Services for Children
(ages 18 and older)

• Immunization vaccines One-time per plan year per immunization (EACH) - hepatitis A & B, herpes zoster, human papillomavirus, influenza (flu shot), measles, mumps, rubella, meningococcal, pneumococcal, tetanus, diphtheria, pertussis, and varicella
• Autism screening - Limited to 2 screenings up to age 26 months
• Blood Pressure screening - One-time per plan year
• Congenital Hypothyroidism screening - One-time per plan year for Newborns up to age 3 months
• Phenylketonuria (PKU) screening - One-time per plan year for Newborns up to age 3 months
• Sexually Transmitted Infection (STI) prevention counseling & screening - One-time per plan year for adolescents aged 12 to 17 years
• Tuberculin testing - One-time per plan year
• Vision screening - One-time per plan year for children up to age 5

Patients can choose a dedicated primary care provider who meets both their medical needs and preferences.

For immediate diagnosis, treatment, or direction of acute medical conditions.

Provides solutions 24/7/365 through experienced Behavioral Health clinicians specialized in healing emotional trauma from stress injuries/incidents for members, including suicidal thoughts, addiction, substance abuse, anxiety, relationships, and more.

Physician Care teams identify and manage chronic medical conditions on and ongoing basis.

Prescriptions are immediately sent to the patient’s preferred pharmacy for easy pick up or even home delivery for non-DEA controlled medications.

Comprehensive formulary with over 2000 medications. 200+ of the most commonly prescribe medications for $1. Accepted at over 70,000 participating pharmacies. Includes direct mail order delivery, international pharmacy access, prescription assistance program, pet medications, and discounted diabetic supplies. See Basic Rx Benefit Overview for details.

Patients can choose a dedicated primary care provider who meets both their medical needs and preferences.

For immediate diagnosis, treatment, or direction of acute medical conditions.

Provides solutions 24/7/365 through experienced Behavioral Health clinicians specialized in healing emotional trauma from stress injuries/incidents for members, including suicidal thoughts, addiction, substance abuse, anxiety, relationships, and more.

Physician Care teams identify and manage chronic medical conditions on and ongoing basis.

A comprehensive risk assessment covers physical, lifestyle, behavioral health, and other areas.

Lab tests are delivered to the patient’s doorstep and are easily returned to the lab in pre-paid packaging. Lab results than can be reviewed directly with your virtual primary care physician.

Prescriptions are immediately sent to the patient’s preferred pharmacy for easy pick up or even home delivery for non-DEA controlled medications.

Comprehensive formulary with over 2000 medications. 200+ of the most commonly prescribe medications for $1. Accepted at over 70,000 participating pharmacies. Includes direct mail order delivery, international pharmacy access, prescription assistance program, pet medications, and discounted diabetic supplies. See Basic Rx Benefit Overview for details.