METRO AREA COVERAGE

INDIVIDUAL PLAN COVERAGE


Coverage Highlights Deductible Plans

The information below provides a summary of benefits and is not all-inclusive.

IN-NETWORK OUT-OF NETWORK
PLAN NAME PreferredHealth Silver 26 PreferredHealth Expanded Bronze 27
PLAN TYPE HSA qualified HSA qualified
NETWORK PreferredHealth PreferredHealth
DEDUCTIBLE $3,000 individual or
$6,000 family
($3,000 per family member)
$7,000 individual or
$14,000 family
($7,000 per family member)
$15000 individual or
$25000 family
COINSURANCE (% YOU PAY AFTER DEDUCTIBLE) 20% 0% 50%
OUT-OF-POCKET MAXIMUM $6,900 individual or
$13,800 family
($6,900 per family member)
$7,000 individual or
$14,000 family
($7,000 per family member)
Unlimited
PRESCRIPTION DRUG COVERAGE
FORMULARY, 31 DAY SUPPLY ONLY

*NO COVERAGE FOR NON-FORMULARY
Generic: 20% after deductible
Brand formulary: 20% after deductible
Specialty: 50% after deductible
Generic: You pay nothing after deductible
Brand formulary: You pay nothing after deductible
Specialty: You pay nothing after deductible
Not covered
INSULIN ON FORMULARY $25 copay $25 copay

Coverage Highlights Copay Plans

The information below provides a summary of benefits and is not all-inclusive.

IN-NETWORK OUT-OF NETWORK
PLAN NAME PreferredHealth
Gold 28
PreferredHealth
Silver 29
PreferredHealth
Silver 31
PreferredHealth
Expanded Bronze 30
PLAN TYPE Copay Copay Copay Copay
NETWORK PreferredHealth PreferredHealth PreferredHealth PreferredHealth
DEDUCTIBLE $1,850 individual or
$3,700 family
($1,850 per family member)
$3,800 individual or
$7,600 family
($3,800 per family member)
$4,700 individual or
$9,400 family
($4,700 per family member)
$8,550 individual or
$17,100 family
($8,550 per family member)
$15000 individual or
$25000 family
COINSURANCE (% YOU PAY AFTER DEDUCTIBLE) 20% 30% 25% 0% 50%
OUT-OF-POCKET MAXIMUM $7,100 individual or
$14,200 family
($7,100 per family
member)
$8,400 individual or
$16,800 family
($8,400 per family
member)
$8,500 individual or
$17,000 family
($8,500 per family
member)
$8,550 individual or
$17,100 family
($8,550 per family
member)
Unlimited
OFFICE VISITS $25 copay $45 copay $50 copay $125 copay You pay 50% after deductible
SPECIALIST OFFICE VISITS $50 copay $60 copay $75 copay $175 copay
PRESCRIPTION DRUG COVERAGE
FORMULARY, 31 DAY SUPPLY ONLY

*NO COVERAGE FOR NON-FORMULARY
Generic: $5 copay
Brand formulary:
40% after deductible
Specialty: 50% after
deductible
Generic: $25 copay
Brand formulary:
30% after deductible
Specialty:
50% after deductible
Generic: $15 copay
Brand formulary:
25% after deductible
Specialty:
50% after deductible
Generic: $35 copay
Brand formulary:
you pay nothing after
deductible
Not covered
INSULIN ON FORMULARY $25 copay $25 copay $25 copay $25 copay

Find a Doctor

Find a Doctor in the PreferredHealth Network.

Get a Quote

Get a monthly quote and enroll online.

Coverage Information

Select the items below to learn more about the PreferredHealth plan for individuals.

Individual and Family Plans Brochure

Member Assistance Program

Supplemental Accident Coverage

Summary of Benefits and Coverage (SBCs)

Select the plan below to view the SBC.

PreferredHealth Silver 26

PreferredHealth Expanded Bronze 27

PreferredHealth Gold 28

PreferredHealth Silver 29

PreferredHealth Expanded Bronze 30

PreferredHealth Silver 31

Coverage Highlights

  • Vision Exam 100% coverage
  • Eye Glasses or Contacts–one set per year (subject to deductible and coinsurance).

Member Assistance Program

PreferredOne has partnered with Fairview to offer free support for your emotional well-being with Member Assistance Program, benefits to our members include but are not limited to:

  • 3 free counseling appointments per person/per episode
  • 24/7 counselor access for urgent needs
  • Legal Services
  • Financial assistance
  • Family and marital concerns
  • Work/life balance
  • Anxiety
  • Depression
  • Eldercare concerns

Have a Question?

Call between 8:00 a.m. and 4:30 p.m. CST, Monday through Friday. Twin Cities Area: 763.847.3020 Outside the Metro Area: 1.855.717.5267 For Hearing Impaired: 763.847.4013 (TTY).