What benefits are covered?

Preventive care is covered in full and at no cost.

Nonpreventive care services are covered, but depending on the plan type, members will have to pay certain costs out-of-pocket. View the benefits and cost-sharing summary for your plan level to learn what you pay for services.

For a full list of covered benefits, see the covered services section of the Member Handbook. (2021 | 2022)

Learn about our health coaching and wellness programs. You can tailor them to your goals. Plus, they're easy and available on your schedule at no additional cost.

What does it cost to get covered services?

After getting certain covered services, members may owe costs like copayments, deductibles and/or coinsurance. These costs apply to medical, behavioral health and pharmacy services.

If you have Direct Bronze 3500 with Coinsurance or Direct Silver 2500 with Coinsurance, your covered services are subject to both deductible and coinsurance charges, in that order.

To learn more about the different types of costs, read our Cost Sharing Made Clear page.