Wellpoint

Wellpoint Essential Gold 800 ($0 Virtual PCP + $0 Select Drugs + Incentives

Plan Overview

Medical Deductible
  • Individual: $800
  • Family: $1,600
  • Per Person: $800
Prescription Drug Deductible
  • Individual: Included in Medical
  • Family: Included in Medical
  • Per Person: Included in Medical
Medical Out-of-Pocket Maximum
  • Individual: $9,000
  • Family: $18,000
  • Per Person: $9,000
Drug Out-of-Pocket Maximum
  • Individual: Included in Medical
  • Family: Included in Medical
  • Per Person: Included in Medical

Office Visit

Primary Doctor
  • Standard: No Charge

Prescription Drug Information

Generic Drugs
  • Standard: $10.00 Copay

Inpatient Coverage

Hospital Services
  • Standard: 30.00% Coinsurance after deductible

Emergency and Urgent Care

Emergency Room
  • Standard: $50.00 Copay
Coverage provided by Wellpoint Maryland, Inc.