HMO/ Plus Plans
We offer three types of HMO/Plus plans. Use the information in the table to help you choose the plan that best meets your needs. The table does not represent all available benefits, but is intended for comparison purposes.
HMO/Plus Plans
  Select Value Select Med Plus Select Care Plus
Plan Type HMO Plus Plus
Participating Hospitals 11 38 42
Participating Physicians 1,200+ 3,500+ 4,700+
Nonparticipating Coverage Urgent/emergent only Yes Yes
Primary Care Office Visits (participating) $25* $25* $25*
Primary Care Office Visits (nonparticipating) n/a 40% after deductible 40% after deductible
Specialist Office Visits (participating) $40* $40* $40*
Specialist Office Visits (nonparticipating) n/a 40% after deductible 40% after deductible
Coinsurance 20% after deductible 20% participating 40% nonparticipating 20% participating 40% nonparticipating
Deductible Options (participating) $250, $500, $1,000, $2,500, $5,000, $7,500 $250, $500, $1,000, $2,500, $5,000, $7,500 $250, $500, $1,000, $2,500, $5,000, $7,500
Out-of-Pocket Maximum Varies based on deductible level Varies based on deductible level Varies based on deductible level
Prescription Drugs Tier 1: $10 Tier 2: 25%* Tier 3: 50%* Tier 1: $10 Tier 2: 25%* Tier 3: 50%* Tier 1: $10 Tier 2: 25%* Tier 3: 50%*
Emergency Room $200 after deductible $200 participating after deductible $400 nonparticipating after deductible $200 participating after deductible $400 nonparticipating after deductible
Urgent Care $40* $40* $40*
Counties Served Davis, Salt Lake, Weber, and parts of Utah county Beaver, Cache, Davis, Duchesne, Iron, Juab, Millard, Morgan, Salt Lake, Sanpete, Sevier, Summit, Utah, Wasatch, Washington, Weber, and parts of Box Elder, Garfield, Piute, Tooele, Uintah, and Wayne Beaver, Cache, Davis, Duchesne, Garfield, Iron, Juab, Kane, Millard, Morgan, Piute, Rich, Salt Lake, Sanpete, Sevier, Summit, Uintah, Utah, Wasatch, Washington, Wayne, Weber, and parts of Box Elder and Tooele
*Deductible Waiver *Deductible may or may not apply for this service based on plan selected *Deductible may be waived for this service based on plan selected *Deductible may be waived for this service based on plan selected