Current Medical Plans
YMCA of Northern Rock County (#7067)

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National Market Place Plan Level Equilavent
Medical Coverage
Wellness Exams & Preventive Visits
Deductible
Coinsurance
Primary Care Provider(PCP) Virtual Visit(VV) Specialists
Inpatient Hospital
Outpatient Hospital
Emergency Room
Urgent Care/Convenience Care
Annual Out-Of-Pocket Maximum
Lifetime Maximum
Prescription Drugs
Retail Network (31 days)
Mail Order (90 days)
Specialty Drugs
HDHP 4000
Qualified High Deductible Plan
In-Network Out-of-Network
100% Not Subject To Deductible Mammogram & Pap Smear Only 60%
$4,000/Ind. $8,000/Fam. $10,000/Ind. $20,000/Fam.
80% 60%
80% 60%
80% 60%
80% 60%
80%
80% 60%
$7,050/Ind. $14,100/Fam. $15,000/Ind. $30,000/Fam.
UNLIMITED
In-Network Out-of-Network
80% Not Covered