Coverage Comparison

Choose a plan from the left-hand box labeled, 'Select a Plan'. Selecting different plan options will allow you to see how the coverage changes with each plan selected for individuals and small employers. Please contact the WINhealth office if you have any questions, need assistance purchasing a plan, or if you are interested in learning more about plans for large employer groups.

Bronze Plan

Coinsurance 20%
Deductible Individual $4,000.00
Deductible Family $8,000.00
Physician Services  
Office Visit Primary Care 20% coinsurance
Office Visit Specialist 20% coinsurance
Chiropractic (limits apply) 20% coinsurance
Outpatient Physician 20% coinsurance
Inpatient Physician 20% coinsurance
Mental Health/Substance Abuse Physician 20% coinsurance
Facility Services  
Outpatient Facility 20% coinsurance
Emergency Room 20% coinsurance
Emergency Transport 20% coinsurance
Urgent Care 20% coinsurance
Inpatient Facility 20% coinsurance
Mental Health/Substance Abuse Outpatient 20% coinsurance
Mental Health/Substance Abuse Inpatient 20% coinsurance
Diagnostic and Therapeutic Services  
Diagnostic (ex. X-rays, laboratory) 20% coinsurance
Imaging (ex. MRI, CT/PET) 20% coinsurance
Pharmacy  
Generic Prescriptions 20% coinsurance
Preferred Brand 20% coinsurance
Non-preferred Brand 20% coinsurance
Specialty 20% coinsurance
Other Services  
Durable Medical Equipment (ex. CPAP, wheelchair) 20% coinsurance
Vision Care Eye Exam (1x annually) (child-only benefit) No Charge
Vision Care Glasses/Lenses (child-only benefit) 20% coinsurance
Habiitative Services (limits apply) 20% coinsurance
Home Health Services 20% coinsurance
Hospice 20% coinsurance
Rehabilitative Services (limits apply) 20% coinsurance
Skilled Nursiving Services (limits apply) 20% coinsurance

Silver Plan

Coinsurance 20%
Deductible Individual $2,000.00
Deductible Family $4,000.00
Physician Services  
Office Visit Primary Care $30 copay/visit
Office Visit Specialist $60 copay/visit
Chiropractic (limits apply) $30 copay/visit
Outpatient Physician 20% coinsurance
Inpatient Physician 20% coinsurance
Mental Health/Substance Abuse Physician 20% coinsurance
Facility Services  
Outpatient Facility 20% coinsurance
Emergency Room $500 copay/visit
Emergency Transport 20% coinsurance
Urgent Care $60 copay/visit
Inpatient Facility $500 copay/day
Mental Health/Substance Abuse Outpatient $30 copay/visit
Mental Health/Substance Abuse Inpatient $500 copay/day
Diagnostic and Therapeutic Services  
Diagnostic (ex. X-rays, laboratory) $30 copay/day
Imaging (ex. MRI, CT/PET) $500 copy/test
Pharmacy  
Generic Prescriptions $10 copay/prescription
Preferred Brand $40 copay/prescription
Non-preferred Brand $80 copay/prescription
Specialty 20% coinsurance
Other Services  
Durable Medical Equipment (ex. CPAP, wheelchair) 20% coinsurance
Vision Care Eye Exam (1x annually) (child-only benefit) No Charge
Vision Care Glasses/Lenses (child-only benefit) 20% coinsurance
Habiitative Services (limits apply) 20% coinsurance
Home Health Services 20% coinsurance
Hospice 20% coinsurance
Rehabilitative Services (limits apply) 20% coinsurance
Skilled Nursiving Services (limits apply) 20% coinsurance

Gold Plan

Coinsurance 20%
Deductible Individual $1,000.00
Deductible Family $1,000.00
Physician Services  
Office Visit Primary Care $20 copay/visit
Office Visit Specialist $40 copay/visit
Chiropractic (limits apply) $20 copay/visit
Outpatient Physician 20% coinsurance
Inpatient Physician 20% coinsurance
Mental Health/Substance Abuse Physician 20% coinsurance
Facility Services  
Outpatient Facility 20% coinsurance
Emergency Room $200 copay/visit
Emergency Transport 20% coinsurance
Urgent Care $40 copay/visit
Inpatient Facility $200 copay/day
Mental Health/Substance Abuse Outpatient $20 copay/visit
Mental Health/Substance Abuse Inpatient $200 copay/day
Diagnostic and Therapeutic Services  
Diagnostic (ex. X-rays, laboratory) $20 copay/day
Imaging (ex. MRI, CT/PET) $200 copay/test
Pharmacy  
Generic Prescriptions $5 copay/prescription
Preferred Brand $40 copay/prescription
Non-preferred Brand $80 copay/prescription
Specialty 20% coinsurance
Other Services  
Durable Medical Equipment (ex. CPAP, wheelchair) 20% coinsurance
Vision Care Eye Exam (1x annually) (child-only benefit) No Charge
Vision Care Glasses/Lenses (child-only benefit) 20% coinsurance
Habiitative Services (limits apply) 20% coinsurance
Home Health Services 20% coinsurance
Hospice 20% coinsurance
Rehabilitative Services (limits apply) 20% coinsurance
Skilled Nursiving Services (limits apply) 20% coinsurance

Platinum Plan

Coinsurance 20%
Deductible Individual $750.00
Deductible Family $1,500.00
Physician Services  
Office Visit Primary Care $10 copay/visit
Office Visit Specialist $20 copay/visit
Chiropractic (limits apply) $10 copay/visit
Outpatient Physician 20% coinsurance
Inpatient Physician 20% coinsurance
Mental Health/Substance Abuse Physician 20% coinsurance
Facility Services  
Outpatient Facility 20% coinsurance
Emergency Room $200 copay/visit
Emergency Transport 20% coinsurance
Urgent Care $20 copay/visit
Inpatient Facility $200 copay/day
Mental Health/Substance Abuse Outpatient $10 copay/visit
Mental Health/Substance Abuse Inpatient $200 copay/day
Diagnostic and Therapeutic Services  
Diagnostic (ex. X-rays, laboratory) $10 copay/day
Imaging (ex. MRI, CT/PET) $200 copay/test
Pharmacy  
Generic Prescriptions $5 copay/prescription
Preferred Brand $40 copay/prescription
Non-preferred Brand $80 copay/prescription
Specialty 20% coinsurance
Other Services  
Durable Medical Equipment (ex. CPAP, wheelchair) 20% coinsurance
Vision Care Eye Exam (1x annually) (child-only benefit) No Charge
Vision Care Glasses/Lenses (child-only benefit) 20% coinsurance
Habiitative Services (limits apply) 20% coinsurance
Home Health Services 20% coinsurance
Hospice 20% coinsurance
Rehabilitative Services (limits apply) 20% coinsurance
Skilled Nursiving Services (limits apply) 20% coinsurance

Catastrophic Plan (Coinsurance applies after deductible is met)

Coinsurance 0%
Deductible Individual $6,350.00
Deductible Family $12,700.00
Physician Services  
Office Visit Primary Care 0% coinsurance
Office Visit Specialist 0% coinsurance
Chiropractic (limits apply) 0% coinsurance
Outpatient Physician 0% coinsurance
Inpatient Physician 0% coinsurance
Mental Health/Substance Abuse Physician 0% coinsurance
Facility Services  
Outpatient Facility 0% coinsurance
Emergency Room 0% coinsurance
Emergency Transport 0% coinsurance
Urgent Care 0% coinsurance
Inpatient Facility 0% coinsurance
Mental Health/Substance Abuse Outpatient 0% coinsurance
Mental Health/Substance Abuse Inpatient 0% coinsurance
Diagnostic and Therapeutic Services  
Diagnostic (ex. X-rays, laboratory) 0% coinsurance
Imaging (ex. MRI, CT/PET) 0% coinsurance
Pharmacy  
Generic Prescriptions 0% coinsurance
Preferred Brand 0% coinsurance
Non-preferred Brand 0% coinsurance
Specialty 0% coinsurance
Other Services  
Durable Medical Equipment (ex. CPAP, wheelchair) 0% coinsurance
Vision Care Eye Exam (1x annually) (child-only benefit) No Charge
Vision Care Glasses/Lenses (child-only benefit) 0% coinsurance
Habiitative Services (limits apply) 0% coinsurance
Home Health Services 0% coinsurance
Hospice 0% coinsurance
Rehabilitative Services (limits apply) 0% coinsurance
Skilled Nursiving Services (limits apply) 0% coinsurance

Compare PLANs

Benefit Bronze Silver Gold Platinum Catastrophic *
Coinsurance 20% 20% 20% 20% 0%
Deductible Individual $4,000.00 $2,000.00 $1,000.00 $750.00 $6,350.00
Deductible Family $12,700.00 $12,000.00 $10,000.00 $3,000.00 $12,700.00
Physician Services          
Office Visit Primary Care 20%
coinsurance
$30
copay/visit
$20
copay/visit
$10
copay/visit
0%
coinsurance
Office Visit Specialist 20%
coinsurance
$60
copay/visit
$40
copay/visit
$20
copay/visit
0%
coinsurance
Chiropractic
(limits apply)
20%
coinsurance
$30
copay/visit
$20
copay/visit
$10
copay/visit
0%
coinsurance
Outpatient Physician 20%
coinsurance
20%
coinsurance
20%
coinsurance
20%
coinsurance
0%
coinsurance
Inpatient Physician 20%
coinsurance
20%
coinsurance
20%
coinsurance
20%
coinsurance
0%
coinsurance
Mental Health/Substance
Abuse Physician
20%
coinsurance
20%
coinsurance
20%
coinsurance
20%
coinsurance
0%
coinsurance
Facility Services          
Outpatient Facility 20%
coinsurance
20%
coinsurance
20%
coinsurance
20%
coinsurance
0%
coinsurance
Emergency Room 20%
coinsurance
$500
copay/visit
$200
copay/visit
$200
copay/visit
0%
coinsurance
Emergency Transport 20%
coinsurance
20%
coinsurance
20%
coinsurance
20%
coinsurance
0%
coinsurance
Urgent Care 20%
coinsurance
$60
copay/visit
$40
copay/visit
$20
copay/visit
0%
coinsurance
Inpatient Facility 20%
coinsurance
$500
copay/day
$200
copay/day
$200
copay/day
0%
coinsurance
Mental Health/Substance
Abuse Outpatient
20%
coinsurance
$30
copay/visit
$20
copay/visit
$10
copay/visit
0%
coinsurance
Mental Health/Substance
Abuse Inpatient
20%
coinsurance
$500
copay/day
$200
copay/day
$200
copay/day
0%
coinsurance
Diagnostic and Therapeutic Services          
Diagnostic
(ex. X-rays, laboratory)
20%
coinsurance
$30
copay/day
$20
copay/day
$10
copay/day
0%
coinsurance
Imaging
(ex. MRI, CT/PET)
20%
coinsurance
$500 copy/test $200
copay/test
$200
copay/test
0%
coinsurance
Pharmacy          
Generic Prescriptions 20%
coinsurance
$10
copay/prescription
$5 copay/prescription $5 copay/prescription 0%
coinsurance
Preferred Brand 20%
coinsurance
$40
copay/prescription
$40
copay/prescription
$40
copay/prescription
0%
coinsurance
Non-preferred Brand 20%
coinsurance
$80
copay/prescription
$80
copay/prescription
$80
copay/prescription
0%
coinsurance
Specialty 20%
coinsurance
20%
coinsurance
20%
coinsurance
20%
coinsurance
0%
coinsurance
Other Services          
Durable Medical Equipment
(ex. CPAP, wheelchair)
20%
coinsurance
20%
coinsurance
20%
coinsurance
20%
coinsurance
0%
coinsurance
Vision Care Eye Exam
(1x annually) (child-only benefit)
No Charge No Charge No Charge No Charge No Charge
Vision Care Glasses/Lenses (child-only benefit) 20%
coinsurance
20%
coinsurance
20%
coinsurance
20%
coinsurance
0%
coinsurance
Habiitative Services (limits apply) 20%
coinsurance
20%
coinsurance
20%
coinsurance
20%
coinsurance
0%
coinsurance
Home Health Services 20%
coinsurance
20%
coinsurance
20%
coinsurance
20%
coinsurance
0%
coinsurance
Hospice 20%
coinsurance
20%
coinsurance
20%
coinsurance
20%
coinsurance
0%
coinsurance
Rehabilitative Services
(limits apply)
20%
coinsurance
20%
coinsurance
20%
coinsurance
20%
coinsurance
0%
coinsurance
Skilled Nursiving Services
(limits apply)
20%
coinsurance
20%
coinsurance
20%
coinsurance
20%
coinsurance
0%
coinsurance