Medical

 The co-payment for a primary care physician office visit is $10; specialist is $45.00. 
There is also a deductible for non-copayment services of $500 per family member, with
a maximum deductible of $1,500 for 2 or more family members.  Hospital co-payment
is $50.00 per day with a maximum of 5 days co-payment. Effective July 1, 2011 there
is an unlimited lifetime medical maximum.   See prescription drug information below
for the plan. For more information regarding this plan, providers, and the prescription
benefits please visit www.VHP-StateGroup.com

 

Prescription Drugs

The Vantage Medical Home HMO prescription drug benefit for State employees has five
copay/coinsurance levels, including Tier 4 Non-Preferred Brands with a $95 copay and
Tier 5 Specialty Brands with a 33% coinsurance, up to $150 per drug per month. Prior
authorization and quantity limits are applicable for some drugs.

For more information call 1-844-536-7104 or visit www.VHP-StateGroup.com