MedSurf Data Partnership Plans
Health Benefit Plan
Our Health Benefit Plan offers coverage for medical expenses, including prescription medications, preventive care, and more. Plans are affordable, flexible, and portable with no employer required. You’ll have access to nationwide coverage that travels with you, so you’re protected wherever your work takes you.
Why Choose a Health Benefit Plan?
Affordable Prescription Drug Coverage
Low copays for acute, chronic, and preventive medications.
Comprehensive Preventive Care
Coverage for preventive medications and services to help you stay healthy and avoid costly medical issues.
Reference-Based Pricing (RBP)
Transparent and cost-effective reimbursement method based on Medicare rates, ensuring fair pricing for medical services.
Flexible Plan Options
Tailored plans to meet your healthcare needs, whether for acute care, chronic conditions, or preventive services.
Easy Access to Care
Affordable copays for medications and services, making it easier to access the care you need without financial stress.
Choose your options
Healthy Living Plan
Best For: Individuals or families looking for basic coverage at an affordable price.
Essential Value Plan
Best For: Those who want more comprehensive coverage with moderate costs.
Bronze 2500 Plan
Best For: Individuals or families seeking premium coverage with the lowest out-of-pocket costs.
What benefits does the Health Plan provide?
All covered services are subject to exclusions and limitations - please refer to your plan documents for full breakdown.
Physician Services
Healthy Living Plan (Level I)
Essential Value Plan (Level II)
Bronze 2500 Plan (Level III)
Virtual Primary, Specialist & Pediatric Visit
$0 Copay (unlimited visits/plan year)
$0 Copay (unlimited visits/plan year)
$0 Copay (unlimited visits/plan year)
Virtual Behavioral Health Visit
$0 Copay (7 visits/plan year)
$0 Copay (7 visits/plan year)
Not Covered
Primary Care Office Visit
Not Covered
$60 Copay (6 visits/plan year)
$25 Copay (8 visits/plan year)
Specialist Office Visit
Not Covered
$60 Copay (6 visits/plan year)
$50 Copay (8 visits/plan year)
Urgent Care
$0 Copay (unlimited visits, coverage only at contracted centers)
$50 Copay (unlimited visits/plan year)
$50 Copay (2 visits/plan year)
Deductible inrespect of below benefits
$0
$0
Individual $2,500 - Family $5, 000 (In network)
Hospital or Facility Services
Healthy Living Plan (Level I)
Essential Value Plan (Level II)
Bronze 2500 Plan (Level III)
Inpatient Hospitalization
Not Covered
$350 Copay/admission (3 days/plan year)
$350 Copay/admission (5 days/plan year)
Inpatient Visits (Physician)
Not Covered
3 visits/plan year
5 visits/plan year
Inpatient Surgery (Physician Charges)
Not Covered
2 surgeries/plan year
2 surgeries/plan year
Anesthesia (Limited to 2 inpatient and 1 outpatient procedure/plan year)
Not Covered
Included in Inpatient Hospitalization or Outpatient Hospital or Free Standing Facility Services and Surgery Copay
Included in Inpatient Hospitalization or Outpatient Hospital or Free Standing Facility Services and Surgery Copay
Emergency Room
Not Covered
$350 Copay
After Deductible, $350 Copay (Subject to Reference Based Pricing)
Outpatient: Diagnostic Services
Healthy Living Plan (Level I)
Essential Value Plan (Level II)
Bronze 2500 Plan (Level III)
Laboratory Service (Non-Hospital Based)
Not Covered
$50 Copay - Combined limit of 3 visits/plan year with Radiology
(Non-hospital based) $50 Copay - Combined limit of 3 visits/plan year with Radiology; (Hospital Based) Not Covered 100% Paid by Member
Radiology (Non-Hospital Based)
Not Covered
$50 Copay; Combined limit of 3 visits/plan year with Laboratory Services
(Non-hospital based) $50 Copay - Combined limit of 3 visits/plan year with Laboratory Service; (Hospital Based) Not Covered 100% Paid by Member
CT/MRI/MRA/PET Scan (Prior Authorization Required)
Not Covered
$350 Copay limited to 1/plan year
(Non-hospital based) After deductible, $350 Copay - limited to 1/plan year (Subject to RBP, Reference Based Pricing); (Hospital Based) Not Covered 100% Paid by Member
Other Services
Healthy Living Plan (Level I)
Essential Value Plan (Level II)
Bronze 2500 Plan (Level III)
Allergy Services
Not Covered
$25 Copay (Included in Primary Care Office Visits or Specialist Office Visit limits. The copay applies to the admisitration of the allergy service and is seperate from the copay for the office visit.)
$25 Copay (Included in Primary Care Office Visits or Specialist Office Visit limits. The copay applies to the admisitration of the allergy service and is seperate from the copay for the office visit.)
Chiropractic Services
Not Covered
Not Covered
$50 copay (10 visits/plan year)
Home Health Care
Not Covered
$25 Copay (5 visits/plan year)
$25 copay (10 visits/plan year)
Mental Health, Behavioral Health, or Substance Abuse (Inpatient or Partial Day)
$350 Copay/admission (3 visits/plan year)
$350 Copay/admission (3 visits/plan year)
After deductible, $350 Copay/day; (5 days/plan year; Subject to RBP, Reference Based Pricing)
Mental Health, Behavioral Health, or Substance Abuse (Outpatient)
$350 Copay; (1 visit/plan year)
$350 Copay (1 visit/plan year)
After deductible, $350 Copay/day; (1 visit/plan year; Subject to RBP, Reference Based Pricing)
Emergency Medical Transportation (by land only)
Not Covered
$250 Copay (1 transport/plan year)
$250 Copay/day (1 visit/plan year; Subject to RBP, Reference Based Pricing)
Pharmacy Benefits
Healthy Living Plan (Level I)
Essential Value Plan (Level II)
Bronze 2500 Plan (Level III)
Acute Medications (up to 30-day supply)
$0 Copay
N/A
$0 Copay
Chronic Medications (limited to two (2) 30-day fills, then 90-day fills required)
$0 Copay
$0 Copay
$0 Copay
Tier 1 - ACA Preventive Drugs
$0 Copay
$0 Copay
$0 Copay
PHCS Preventive Services Only
Select: PHCS Practitioner & Ancillary
Select: PHCS Practitioner & Ancillary
Start Your Journey Today
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Call Us
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+1-(800)-617-8012Explore Our Health Benefit Plans
Click below to dive into the detailed terms of our health benefit plans.