Benefits + costs by plan level
When you get services, you may have to pay out-of-pocket costs.
View the Schedule of Benefits for your plan level. These summaries give you information about the costs you have to pay for covered services.
Please note: For certain services, your provider needs to ask us for a prior authorization before sending you to get those services. Your provider knows when and how to ask us for prior authorization if it is required.
2025 Schedule of Benefits:
Direct ConnectorCare AIAN
Direct ConnectorCare I
Direct ConnectorCare II
Direct ConnectorCare III
Direct Catastrophic
Direct Bronze 2850
Direct Silver 2000
Direct Silver 2000 HSA
Direct Silver 2000 II
Direct Gold 1000
Direct Gold 1600
Direct Platinum
For a list of covered benefits, see the covered services section of the Member Handbook 2024 | 2025
Additional information
Small group rate increase
Consumer narrative justification document