Gold Plan
No personal responsibility ( $0.00 ) for medical incidents exceeding $500
Sharing Limit
$125,00 per illness
Sharing limit with Brother's Keeper
Unlimited
Hospitalization (in/out patient)
Included
Surgery
Included
Doctor's Office/Specialist visits
Incident-related
Prescriptions
Incident-related
Physical therapy / Home Health care
Up to 45 visits per incident
Maternity
Unlimited coverage with Brother's Keeper
or $125,000 without Brother's Keeper
Alternative care
Not covered
Cost, per month
$172 You
$344 You + spouse
$516 Both of you + kids
Silver Plan
Max out of pocket $1,000 per incident
Sharing Limit
$125,00 per illness
Sharing limit with Brother's Keeper
An additional $100,000 per illness, per year, up to 1 million dollars
Hospitalization (in/out patient)
Included
Surgery
Included
Doctor's Office/Specialist visits
NOT included
Prescriptions
NOT included
Physical therapy / Home Health care
NOT included
Maternity
Only hospital treatment (up to $125,000 per pregnancy) or up to $2,500 for midwife services per pregnancy
Alternative care
Not covered
Cost, per month
$118 You
$236 You + spouse
$354 Both of you + kids
Bronze Plan
Max out of pocket $5,000 per incident
Sharing Limit
$125,00 per illness
Sharing limit with Brother's Keeper
An additional $100,000 per illness, per year, up to 1 million dollars
Hospitalization (in/out patient)
Included
Surgery
Included
Doctor's Office/Specialist visits
NOT included
Prescriptions
NOT included
Physical therapy / Home Health care
NOT included
Maternity
Only hospital treatment (up to $125,000 per pregnancy) is eligible for sharing
Alternative care
Not covered
Cost, per month
$78 You
$156 You + spouse
$234 Both of you + kids
