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If you would like to purchase a plan, or if you have any questions please contact a representative at (800) 895-2421.

MercyCare HMO Gold Option A - $

MercyCare HMO Gold Option A Details

  • Deductible: $2,000 Single/$4,000 Family
  • Maximum Out of Pocket: $4,000 Single/$8,000 Family
  • Coinsurance: 20%
  • Office Visit- Primary Care: $25 copayment per visit
  • Prescription Drug: $20/$40/$60/25%

MercyCare HMO Gold Option B - $

MercyCare HMO Gold Option B Details

  • Deductible: $1,000 Single/$2,000 Family
  • Maximum Out of Pocket: $3,500 Single/$7,000 Family
  • Coinsurance: 20%
  • Office Visit- Primary Care: $30 copayment per visit
  • Prescription Drug: $20/$40/$60/25%

MercyCare HMO Gold Option C - $

MercyCare HMO Gold Option C Details

  • Deductible: $500 Single/$1,000 Family
  • Maximum Out of Pocket: $5,500 Single/$11,000 Family
  • Coinsurance: 20%
  • Office Visit- Primary Care: $30 copayment per visit
  • Prescription Drug: $10/$25/$50/25%

MercyCare HMO Silver Option A - $

MercyCare HMO Silver Option A Details

  • Deductible: $5,000 Single/$10,000 Family
  • Maximum Out of Pocket: $6,800 Single/$13,600 Family
  • Coinsurance: 30%
  • Office Visit- Primary Care: $30 copayment per visit
  • Prescription Drug: $20/$40/$60/25%

MercyCare HMO Silver Option B - $

MercyCare HMO Silver Option B Details

  • Deductible: $2,500 Single/$5,000 Family
  • Maximum Out of Pocket: $6,800 Single/$13,600 Family
  • Coinsurance: 30%
  • Office Visit- Primary Care: $30 copayment per visit
  • Prescription Drug: $20/$40/$60/25%

MercyCare HMO Silver Option C - $

MercyCare HMO Silver Option C Details

  • Deductible: $3,000 Single/$6,000 Family
  • Maximum Out of Pocket: $6,350 Single/$12,700 Family
  • Coinsurance: 30%
  • Office Visit- Primary Care: 30% coinsurance after deductible
  • Prescription Drug: $10/$25/$50/25%

MercyCare HMO Bronze Option A - $

MercyCare HMO Bronze Option A Details

  • Deductible: $5,000 Single/$10,000 Family
  • Maximum Out of Pocket: $6,800 Single/$13,600 Family
  • Coinsurance: 30%
  • Office Visit- Primary Care: 30% coinsurance after deductible
  • Prescription Drug: $20/$40/$60/25% after deductible

MercyCare HMO Bronze Option B - $

MercyCare HMO Bronze Option B Details

  • Deductible: $3,800 Single/$7,600 Family
  • Maximum Out of Pocket: $6,550 Single/$13,100 Family
  • Coinsurance: 40%
  • Office Visit- Primary Care: 40% coinsurance after deductible
  • Prescription Drug: 40% coinsurance after deductible

MercyCare HMO Bronze Option C - $

MercyCare HMO Bronze Option C Details

  • Deductible: $6,550 Single/$13,100 Family
  • Maximum Out of Pocket: $6,550 Single/$13,100 Family
  • Coinsurance: 0%
  • Office Visit- Primary Care: No charge after deductible
  • Prescription Drug: No charge after deductible

The benefits listed may be contingent on your use of physicians, hospitals and services within MercyCare Health Plans’s provider network.

The rates are approximate and subject to approval by underwriting