| 20069TX0100024 |
Bronze Classic 4700 |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0100024 |
Bronze Classic 4700 |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0100050 |
Bronze Classic Standard |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0100050 |
Bronze Classic Standard |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0100005 |
Bronze Elite + PCP Saver Plus |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0100005 |
Bronze Elite + PCP Saver Plus |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0100058 |
Buena Salud Plateado Estándar Clásico |
2025 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0100055 |
Gold Classic |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0100055 |
Gold Classic |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510079 |
Gold Classic Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510063 |
Gold Classic Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510071 |
Gold Classic Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510055 |
Gold Classic Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510024 |
Gold Classic Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510020 |
Gold Classic Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510022 |
Gold Classic Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0100053 |
Gold Classic Standard |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0100053 |
Gold Classic Standard |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510065 |
Gold Classic Standard Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510073 |
Gold Classic Standard Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510081 |
Gold Classic Standard Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510057 |
Gold Classic Standard Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510036 |
Gold Classic Standard Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510034 |
Gold Classic Standard Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510032 |
Gold Classic Standard Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0100056 |
Gold Elite |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0100056 |
Gold Elite |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510023 |
Gold Simple Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510080 |
Gold Simple Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510072 |
Gold Simple Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510064 |
Gold Simple Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510056 |
Gold Simple Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510025 |
Gold Simple Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510021 |
Gold Simple Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0100006 |
Silver Classic |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0100006 |
Silver Classic |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0100052 |
Silver Classic Standard |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0100052 |
Silver Classic Standard |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510070 |
Silver Classic Standard Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510062 |
Silver Classic Standard Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510031 |
Silver Classic Standard Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510054 |
Silver Classic Standard Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510035 |
Silver Classic Standard Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510033 |
Silver Classic Standard Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510078 |
Silver Classic Standard Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510052 |
Silver Simple Chronic Care CKM Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510012 |
Silver Simple Chronic Care CKM Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510016 |
Silver Simple Chronic Care CKM Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510040 |
Silver Simple Chronic Care CKM Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510060 |
Silver Simple Chronic Care CKM Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510068 |
Silver Simple Chronic Care CKM Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510076 |
Silver Simple Chronic Care CKM Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510053 |
Silver Simple Diabetes Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510061 |
Silver Simple Diabetes Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510069 |
Silver Simple Diabetes Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510077 |
Silver Simple Diabetes Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510013 |
Silver Simple Diabetes Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510017 |
Silver Simple Diabetes Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510041 |
Silver Simple Diabetes Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510050 |
Silver Simple Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510018 |
Silver Simple Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510058 |
Silver Simple Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510066 |
Silver Simple Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510074 |
Silver Simple Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510014 |
Silver Simple Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510010 |
Silver Simple Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0100025 |
Silver Simple PCP Saver |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0100025 |
Silver Simple PCP Saver |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510015 |
Silver Simple PCP Saver Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510067 |
Silver Simple PCP Saver Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510051 |
Silver Simple PCP Saver Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510019 |
Silver Simple PCP Saver Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510075 |
Silver Simple PCP Saver Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510059 |
Silver Simple PCP Saver Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0510011 |
Silver Simple PCP Saver Guided Care |
2025 |
PREFERRED [PCP] [Dentist]
|
Oct 17, 2024 |
| 20069TX0100003 |
Bronze Classic |
2024 |
PREFERRED [PCP] [Dentist]
|
Dec 16, 2023 |
| 20069TX0100024 |
Bronze Classic 4700 |
2024 |
PREFERRED [PCP] [Dentist]
|
Dec 16, 2023 |
| 20069TX0100024 |
Bronze Classic 4700 |
2024 |
PREFERRED [PCP] [Dentist]
|
Dec 16, 2023 |
| 20069TX0200024 |
Bronze Classic 4700 (Choice) |
2024 |
PREFERRED [PCP] [Dentist]
|
Dec 16, 2023 |
| 20069TX0100050 |
Bronze Classic Standard |
2024 |
PREFERRED [PCP] [Dentist]
|
Dec 16, 2023 |
| 20069TX0100050 |
Bronze Classic Standard |
2024 |
PREFERRED [PCP] [Dentist]
|
Dec 16, 2023 |
| 20069TX0200050 |
Bronze Classic Standard (Choice) |
2024 |
PREFERRED [PCP] [Dentist]
|
Dec 16, 2023 |
| 20069TX0100005 |
Bronze Elite + PCP Saver Plus |
2024 |
PREFERRED [PCP] [Dentist]
|
Dec 16, 2023 |
| 20069TX0100005 |
Bronze Elite + PCP Saver Plus |
2024 |
PREFERRED [PCP] [Dentist]
|
Dec 16, 2023 |
| 20069TX0200005 |
Bronze Elite + PCP Saver Plus (Choice) |
2024 |
PREFERRED [PCP] [Dentist]
|
Dec 16, 2023 |
| 20069TX0100012 |
Bronze Elite + Specialist Saver Plus |
2024 |
PREFERRED [PCP] [Dentist]
|
Dec 16, 2023 |
| 20069TX0100055 |
Gold Classic |
2024 |
PREFERRED [PCP] [Dentist]
|
Dec 16, 2023 |
| 20069TX0100055 |
Gold Classic |
2024 |
PREFERRED [PCP] [Dentist]
|
Dec 16, 2023 |
| 20069TX0200055 |
Gold Classic (Choice) |
2024 |
PREFERRED [PCP] [Dentist]
|
Dec 16, 2023 |
| 20069TX0100053 |
Gold Classic Standard |
2024 |
PREFERRED [PCP] [Dentist]
|
Dec 16, 2023 |
| 20069TX0100053 |
Gold Classic Standard |
2024 |
PREFERRED [PCP] [Dentist]
|
Dec 16, 2023 |
| 20069TX0200053 |
Gold Classic Standard (Choice) |
2024 |
PREFERRED [PCP] [Dentist]
|
Dec 16, 2023 |
| 20069TX0100056 |
Gold Elite |
2024 |
PREFERRED [PCP] [Dentist]
|
Dec 16, 2023 |
| 20069TX0100056 |
Gold Elite |
2024 |
PREFERRED [PCP] [Dentist]
|
Dec 16, 2023 |
| 20069TX0200056 |
Gold Elite (Choice) |
2024 |
PREFERRED [PCP] [Dentist]
|
Dec 16, 2023 |
| 20069TX0100006 |
Silver Classic |
2024 |
PREFERRED [PCP] [Dentist]
|
Dec 16, 2023 |
| 20069TX0100006 |
Silver Classic |
2024 |
PREFERRED [PCP] [Dentist]
|
Dec 16, 2023 |
| 20069TX0100052 |
Silver Classic Standard |
2024 |
PREFERRED [PCP] [Dentist]
|
Dec 16, 2023 |
| 20069TX0100052 |
Silver Classic Standard |
2024 |
PREFERRED [PCP] [Dentist]
|
Dec 16, 2023 |
| 20069TX0200052 |
Silver Classic Standard (Choice) |
2024 |
PREFERRED [PCP] [Dentist]
|
Dec 16, 2023 |
| 20069TX0100030 |
Silver Elite Saver Plus |
2024 |
PREFERRED [PCP] [Dentist]
|
Dec 16, 2023 |
| 20069TX0100025 |
Silver Simple PCP Saver |
2024 |
PREFERRED [PCP] [Dentist]
|
Dec 16, 2023 |
| 20069TX0100025 |
Silver Simple PCP Saver |
2024 |
PREFERRED [PCP] [Dentist]
|
Dec 16, 2023 |
| 20069TX0200025 |
Silver Simple PCP Saver (Choice) |
2024 |
PREFERRED [PCP] [Dentist]
|
Dec 16, 2023 |
| 20069TX0100008 |
Silver Simple Specialist Saver |
2024 |
PREFERRED [PCP] [Dentist]
|
Dec 16, 2023 |
| 20069TX0100003 |
Bronze Classic |
2023 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0100024 |
Bronze Classic 4700 |
2023 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0100024 |
Bronze Classic 4700 |
2023 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0200024 |
Bronze Classic 4700 (Choice) |
2023 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0200003 |
Bronze Classic (Choice) ($3 Preferred Generic Drugs + $0 Virtual Urgent Care Visits with Select Providers) |
2023 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100050 |
Bronze Classic Standard |
2023 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0100050 |
Bronze Classic Standard |
2023 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0200050 |
Bronze Classic Standard (Choice) |
2023 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0200012 |
Bronze Elite- $0 Ded+Specialist Saver (Choice) ($3 Preferred Generic Drugs + $0 Virtual Urgent Care Visits with Select Providers) |
2023 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100005 |
Bronze Elite + PCP Saver Plus |
2023 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0100005 |
Bronze Elite + PCP Saver Plus |
2023 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0200005 |
Bronze Elite + PCP Saver Plus (Choice) |
2023 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0100012 |
Bronze Elite + Specialist Saver Plus |
2023 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0100001 |
Bronze Simple ($3 Preferred Generic Drugs + $0 Virtual Urgent Care Visits with Select Providers) |
2023 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200001 |
Bronze Simple (Choice) ($3 Preferred Generic Drugs + $0 Virtual Urgent Care Visits with Select Providers) |
2023 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100014 |
Bronze Simple- HSA |
2023 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200014 |
Bronze Simple- HSA (Choice) |
2023 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100051 |
Bronze Simple- Standard |
2023 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200051 |
Bronze Simple- Standard (Choice) |
2023 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100053 |
Gold Classic Standard |
2023 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0100053 |
Gold Classic Standard |
2023 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0200053 |
Gold Classic Standard (Choice) |
2023 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0100006 |
Silver Classic |
2023 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0100006 |
Silver Classic |
2023 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0200006 |
Silver Classic (Choice) ($3 Preferred Generic Drugs + $0 Virtual Urgent Care Visits with Select Providers) |
2023 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100009 |
Silver Classic- PCP Saver ($3 Preferred Generic Drugs + $0 Virtual Urgent Care Visits with Select Providers) |
2023 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200009 |
Silver Classic- PCP Saver (Choice) ($3 Preferred Generic Drugs + $0 Virtual Urgent Care Visits with Select Providers) |
2023 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100052 |
Silver Classic Standard |
2023 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0100052 |
Silver Classic Standard |
2023 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0200052 |
Silver Classic Standard (Choice) |
2023 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0200030 |
Silver Elite- $0 Ded (Choice) ($3 Preferred Generic Drugs + $0 Virtual Urgent Care Visits with Select Providers) |
2023 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100030 |
Silver Elite Saver Plus |
2023 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0100045 |
Silver Simple- For Diabetes ($0 Diabetic Labs + $100 Monthly Cap for Formulary Insulin + $0 Diabetic Foot and Eye Exams) |
2023 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200045 |
Silver Simple- For Diabetes (Choice) ($0 Diabetic Labs + $100 Monthly Cap for Formulary Insulin + $0 Diabetic Foot and Eye Exams) |
2023 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100025 |
Silver Simple PCP Saver |
2023 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0100025 |
Silver Simple PCP Saver |
2023 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0200025 |
Silver Simple PCP Saver (Choice) |
2023 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0100008 |
Silver Simple Specialist Saver |
2023 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0200008 |
Silver Simple- Specialist Saver (Choice) ($3 Preferred Generic Drugs + $0 Virtual Urgent Care Visits with Select Providers) |
2023 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100003 |
Bronze Classic |
2022 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0100021 |
Bronze Classic- $0 PCP ($0 Virtual Primary Care + $0 Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200021 |
Bronze Classic- $0 PCP (Choice) ($0 Virtual Primary Care + $0 Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100023 |
Bronze Classic- $3250 Ded ($0 Virtual Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200023 |
Bronze Classic- $3250 Ded (Choice) ($0 Virtual Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100039 |
Bronze Classic- $4000 Ded ($0 Virtual Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200039 |
Bronze Classic- $4000 Ded (Choice) ($0 Virtual Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100024 |
Bronze Classic 4700 |
2022 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0100024 |
Bronze Classic 4700 |
2022 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0200024 |
Bronze Classic 4700 (Choice) |
2022 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0200003 |
Bronze Classic (Choice) ($3 Preferred Generic Drugs + $0 Virtual Urgent Care Visits with Select Providers) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100002 |
Bronze Classic- PCP Saver ($0 Virtual Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200002 |
Bronze Classic- PCP Saver (Choice) ($0 Virtual Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100022 |
Bronze Classic- Specialist Saver ($0 Virtual Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200022 |
Bronze Classic- Specialist Saver (Choice) ($0 Virtual Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200012 |
Bronze Elite- $0 Ded+Specialist Saver (Choice) ($3 Preferred Generic Drugs + $0 Virtual Urgent Care Visits with Select Providers) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100041 |
Bronze Elite ($0 Virtual Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100042 |
Bronze Elite- $1000 Ded ($0 Virtual Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200042 |
Bronze Elite- $1000 Ded (Choice) ($0 Virtual Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200041 |
Bronze Elite (Choice) ($0 Virtual Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100005 |
Bronze Elite + PCP Saver Plus |
2022 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0100005 |
Bronze Elite + PCP Saver Plus |
2022 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0200005 |
Bronze Elite + PCP Saver Plus (Choice) |
2022 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0100012 |
Bronze Elite + Specialist Saver Plus |
2022 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0100001 |
Bronze Simple ($3 Preferred Generic Drugs + $0 Virtual Urgent Care Visits with Select Providers) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200001 |
Bronze Simple (Choice) ($3 Preferred Generic Drugs + $0 Virtual Urgent Care Visits with Select Providers) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100014 |
Bronze Simple- HSA |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200014 |
Bronze Simple- HSA (Choice) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100034 |
Gold Classic- $0 PCP ($0 Virtual Primary Care + $0 Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200034 |
Gold Classic- $0 PCP (Choice) ($0 Virtual Primary Care + $0 Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100013 |
Gold Classic ($0 Virtual Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200013 |
Gold Classic (Choice) ($0 Virtual Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100037 |
Gold Classic- HSA |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200037 |
Gold Classic- HSA (Choice) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100020 |
Gold Classic- Low Ded ($0 Virtual Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200020 |
Gold Classic- Low Ded (Choice) ($0 Virtual Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100035 |
Gold Elite- $0 Ded ($0 Virtual Primary Care + $0 Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200035 |
Gold Elite- $0 Ded (Choice) ($0 Virtual Primary Care + $0 Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100036 |
Gold Elite ($0 Virtual Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200036 |
Gold Elite (Choice) ($0 Virtual Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100033 |
Gold Simple ($0 Virtual Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200033 |
Gold Simple (Choice) ($0 Virtual Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100011 |
Secure |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200011 |
Secure (Choice) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100006 |
Silver Classic |
2022 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0100006 |
Silver Classic |
2022 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0100017 |
Silver Classic- $0 Ded ($0 Virtual Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200017 |
Silver Classic- $0 Ded (Choice) ($0 Virtual Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200006 |
Silver Classic (Choice) ($3 Preferred Generic Drugs + $0 Virtual Urgent Care Visits with Select Providers) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100027 |
Silver Classic- Low Ded ($0 Virtual Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200027 |
Silver Classic- Low Ded (Choice) ($0 Virtual Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100009 |
Silver Classic- PCP Saver ($3 Preferred Generic Drugs + $0 Virtual Urgent Care Visits with Select Providers) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200009 |
Silver Classic- PCP Saver (Choice) ($3 Preferred Generic Drugs + $0 Virtual Urgent Care Visits with Select Providers) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200030 |
Silver Elite- $0 Ded (Choice) ($3 Preferred Generic Drugs + $0 Virtual Urgent Care Visits with Select Providers) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100028 |
Silver Elite- $0 PCP ($0 Virtual Primary Care + $0 Primary Care + $0 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200028 |
Silver Elite- $0 PCP (Choice) ($0 Virtual Primary Care + $0 Primary Care + $0 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100016 |
Silver Elite ($0 Virtual Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200016 |
Silver Elite (Choice) ($0 Virtual Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100030 |
Silver Elite Saver Plus |
2022 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0100026 |
Silver Elite- Specialist Saver ($0 Virtual Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200026 |
Silver Elite- Specialist Saver (Choice) ($0 Virtual Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100015 |
Silver Simple ($0 Virtual Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200015 |
Silver Simple (Choice) ($0 Virtual Primary Care + $3 Drugs) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100045 |
Silver Simple- For Diabetes ($0 Diabetic Labs + $100 Monthly Cap for Formulary Insulin + $0 Diabetic Foot and Eye Exams) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200045 |
Silver Simple- For Diabetes (Choice) ($0 Diabetic Labs + $100 Monthly Cap for Formulary Insulin + $0 Diabetic Foot and Eye Exams) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100029 |
Silver Simple- HSA |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0200029 |
Silver Simple- HSA (Choice) |
2022 |
PREFERRED
|
Sep 06, 2024 |
| 20069TX0100025 |
Silver Simple PCP Saver |
2022 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0100025 |
Silver Simple PCP Saver |
2022 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0200025 |
Silver Simple PCP Saver (Choice) |
2022 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0100008 |
Silver Simple Specialist Saver |
2022 |
PREFERRED [PCP] [Dentist]
|
Sep 06, 2024 |
| 20069TX0200008 |
Silver Simple- Specialist Saver (Choice) ($3 Preferred Generic Drugs + $0 Virtual Urgent Care Visits with Select Providers) |
2022 |
PREFERRED
|
Sep 06, 2024 |
