Medical Deductibles and Co-Pays | Office of Human Resources

Please select the tab below (PPO or HDHP for additional information on medical deductibles and co-pays for 2024.

Deductible/Co-Pay	Amount
Preventive Care	The plan pays 100%.
Primary Physician Co-Pay	$30
Specialist Office Visit Co-Pay	$40
Facility Inpatient Co-Pay	$300
Facility Outpatient Co-Pay	$300
Emergency Room Facility Co-Pay	$300
Calendar Year Deductible (limit of 3 per family)	$500 per individual
Out-of-Pocket Maximum (Individual)	$9,450
Out-of-Pocket Maximum (Family)	$18,900

Deductible/Co-Pay	Amount
Preventive Care	The plan pays 100%.
Deductible	$2,500 single/$5,000 non-single
Coinsurance	The plan pays 80% after the deductible is met.
Out-of-Pocket Maximum (Individual)	$5,000
Out-of-Pocket Maximum (Family)	$10,000