PLAN A
CO-PAY PLAN INCLUDING
TELEHEALTH, VISION & DENTAL
PLAN A PRICING
FREE Annual Preventative Health & Wellness Check
Prescription Discount Card
In-office Copay Program
- Doctor’s Visits
- Urgent Care
- Physical Therapy
- Specialists Visits
- Chiropractic
- Out Patient Testing
- Dental
- Vision
Total Telehealth Package Through MeMd Including
- Urgent Care Telehealth – Free
- Men’s & Women’s Telehealth Services – Free
- Talk Therapy – $65 Copay Per Session
- Teen Therapy – $65 Copay Per Session
- Telepsychiatry – $229 First Session $99 For Follow Up
- 24/7/365 Phone or Video Appointments
- Prescription Writing As Necessary
MONTHLY PRICING
(per member, per month)
MEMBER
$169
MEMBER + 1
SPOUSE | DEPENDENT
$284
MEMBER + FAMILY
MEMBERS 2 – 5
EACH ADDITIONAL FAMILY MEMBER
$394
$25
PLEASE NOTE: This plan does not have any age limitations or requirements and is not subject to a smoking or vaping surcharge. This is a limited benefit plan which includes coverage on listed services only. This is a no-deductible plan, which means that your included medical claims are paid from the first dollar that is billed.
FREE TOTAL TELEHEALTH BY MEMD 24/7/365
BEHAVIORAL HEALTH AVAILABLE FOR A MINIMAL COPAY
PHCS NETWORK OF PROVIDERS
HealthShare Connection Members have access to the PHCS MultiPlan Network, providing in-network access to a wide variety of medical practitioners and specialists. This network is one of the largest associations of providers in the country.
Additionally, members are free to use providers that are outside of the PHCS Network. Members should note that HSC may not have contract negotiated rates available for doctors and providers outside of the PHCS Network, so their allowance of respective covered billed charges may not go as far with providers that are out-of-network. Thus, in-network providers are highly encouraged, but never required for services included in this plan.
IN-OFFICE COPAY PROGRAM
| COVERAGE | COPAY | COVERED BILLED CHARGES |
|---|---|---|
| General Office Visists | $25 | Up to $1000 |
| Specialist / Behavioral Health Office Visit | $25 | Up to $1000 |
| Chiropractic / Physical therapy Office Visit | $25 | Up to $1000 |
| Urgent Care Visits | $50 | Up to $2000 |
| Lab Work | $25 | Up to $2000 |
| Out-Patient Testing | $200 | Up to $2000 |
| Dental | $25 | Up to $1500 |
| Vision | $25 | $100 Office & $100 Glasses |
PREVENTATIVE WELLNESS CHECK
COVERED SERVICES
COVERED PREVENTATIVE SERVICES
ALL ADULTS
- Blood Pressure Screening
- Cholesterol Screening
- Type II Diabetes Screening
- Syphilis Screening
- HIV Screening
- Sexually Transmitted Infection Prevention Counseling
- Tobacco Use Screening For All Adults & Cessation Interventions
- Aspirin use for men ages 45-79 & women ages 55-79 to prevent CVD when prescribed by a physician
- Colonoscopy (Colorectal cancer screening for adults starting at age 50, limited to one every 5 years)
- Diet counseling
- Immunizations and vaccines (Hepatitis A&B, Herpes, Zoster, Influenza, Measles, Mumps, Tetanus, Rubella, Human Papillomavirus, Meningococcal, Pneumococcal, Diphtheria, Pertussis)
- Abdominal aortic aneurysm one-time screening for age 65-75
- Depression screening & counseling
- Obesity screening
COVERED PREVENTATIVE SERVICES
WOMEN’S SERVICES
- Breast cancer mammography screening every year for women age 40 and over
- Breast cancer chemo prevention counseling
- Cervical cancer screening
- Contraception: Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling, not including abortifacient drugs
- Domestic and interpersonal violence screening and counseling for women
- Gonorrhea screening
- Syphilis screening
- Chlamydia infection screening
- HIV screening and counseling
- Human Papillomavirus (HPV) DNA testing every three years for women with normal cytology results who are age 30 or older
- Osteoporosis screening over age 60
- Tobacco use screening and interventions
- Sexually transmitted infections counseling
- Wellness visits
COVERED PREVENTATIVE SERVICES
PRENATAL / POSTNATAL SERVICES
- Anemia screening on a routine basis
- Bacteria, urinary tract and infection screening
- BRCA counseling and genetic testing for women at higher risk
- Breastfeeding comprehensive support and counseling from trained providers, as well as access to breastfeeding supplies
- Folic acid supplements
- Gestational diabetes screening
- Hepatitis B screening
- Routine prenatal visits
- Rh-incompatibility screening including follow-up testing
- Expanded counseling for pregnant tobacco users
- Delivery, C-Section, Inductions not covered at this time
COVERED PREVENTATIVE SERVICES
NEWBORN SERVICES
- Hearing screening
- Immunization vaccines for children from birth to age 18 with variable doses, according to recommended ages and populations
- Cervical Dysplasia screening and vaccines for Diphtheria, Tetanus, Pertussis, Hepatitis A & B, Human Papillomavirus, Inactivated Poliovirus, Influenza (Flu Shot), Measles, Mumps, Rubella, Meningococcal, Pneumococcal, Rotavirus, Varicella
- Congenital Hypothyroidism screening
- Gonorrhea preventive medication for eyes
- Hemoglobinopathies or sickle sale screening
- Phenylketonuria (PKU) screening
- Iron supplements for newborns to 12 months when prescribed by a physician
COVERED PREVENTATIVE SERVICES
ALL CHILDREN SERVICES
- Autism screening for children, limited to two screenings up to age 24 months
- Vision screening, 5 and younger
- Developmental screening for children under the age of 3 and surveillance throughout childhood
- Lead screening
- Dyslipidemia screening
- Height, Weight and Body Mass Index measurements
- Obesity screening and counseling
- Hematocrit or Hemoglobin screening
- Oral health risk assessment, up to age 10
- Depression screening, 12 and older
- Alcohol and drug use assessments
- Blood pressure screening
- Sexually transmitted infection prevention counseling and screening for adolescents
- Tuberculin testing
FIND A PROVIDER
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Of Doctors Conveniently Located Near You!