| PUSH Care Health Plan |
| Care Navigator $0 and reduced cost options for many services | PPO Network | Out-of-Network |
| Single Deductible | Call for reduced cost or lowest cost options | $2,000 Max Monthly | $4,000 Max Monthly |
| Family Deductible | Call for reduced cost or lowest cost options | $2,000 Max Monthly | $4,000 Max Monthly |
| Coinsurance after Deductible | 100% | 100% | 100% |
| Routine/Preventive Care | 100% | 100% | 100% after Ded |
| Annual Max Cost - Single | $5,000 | $5,000 | $12,700 |
| Annual Max Cost - Family | $10,000 | $10,000 | $25,400 |
| Primary Care Office Visits | Call for reduced cost or lowest cost options | 100% after Ded | 100% after Ded |
| Specialist Office Visits | 100% after Ded | 100% after Ded |
| Psychologist / Psychiatrist Visits | 100% after Ded | 100% after Ded |
| PT / OT | 100% after Ded | 100% after Ded |
| Virtual Visits | 100% after Ded | 100% after Ded |
| Lab & X-Ray | 100% after Ded | 100% after Ded |
| MRI, CT & PET | 100% after Ded | 100% after Ded |
| Outpatient Hospital Services | 100% after Ded | 100% after Ded |
| Inpatient Hospital Services | 100% after Ded | 100% after Ded |
| Urgent Care | 100% after Ded |
| Emergency Room | 100% after Ded |
| Prescription Drugs | |
| Tier 1 | $5 | $5 | Excluded |
| Tier 2 | $50 | $50 | Excluded |
| Tier 3 | $100 | $100 | Excluded |
| Employee | $80 |
| Employee/Spouse: | $410 |
| Employee/Child(ren): | $329 |
| Family: | $615 |
