OAPIN
Open Access+Network
Out-of-Network
Office Visit
Primary Care Physician
$40
No Coverage
Specialist
$80
Consigilio Wellness Center
$0
Deductible
Individual
$500
N/A
Individual + More
$1,000
Coinsurance
20%
Out-of-Pocket Maximum
(includes deductible)
$3,000
$6,000
Prescription Drug
Preventive
Non-Preventive
Retail In-Network
(34 day supply)
Generic
$15
Preferred Brand
$25
Non-Preferred Brand
Mail Order In-Network
(90 day supply)
$30
$50