ConnectiCare Benefits

Choice Gold Standard POS

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Medical Deductible	Individual: $1,300 Family: $2,600 Per Person: $1,300
Prescription Drug Deductible	Individual: $50 Family: $100 Per Person: $50
Medical Out-of-Pocket Maximum	Individual: $5,250 Family: $10,500 Per Person: $5,250
Drug Out-of-Pocket Maximum	Individual: Included in medical Family: Included in medical Per Person: Included in medical

Primary Doctor	Standard: $20 Copay
Specialist	Standard: $40 Copay

Hospital Services

Standard: $500 Copay per Day after deductible to a maximum of $1000 per admission

Emergency Room

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