Affordably priced Gold plan offered through HealthSource RI. This plan offers low copays on certain services and high coverage once the deductible has been met. Preventive services are covered at 100% and include access to our full network of doctors and hospitals.
Deductible: $2,650 (Individual) / $5,300 (Family)
Out of Pocket Max: $5,650 (Individual) / $11,300 (Family)
Primary Care/Behavioral Health Office Visits: $30 copay
Specialist/Urgent Care Visits: $65 copay
Inpatient/Imaging/Lab Services: Only deductible applies
Pharmacy (Tiers 1-6): $5/$10/$35/$50/30%*/30%*
*after deductible
What do you need help with today?
- I need a doctor.
- I want to know my rights and privacy.
- I want to know if my medicine is covered.
- I want to access my Pharmacy Member Portal.
- Use this portal to check your medications, sign up for mail order pharmacy and review drug costs
- You can also sign up for mail order pharmacy by calling: 1-844-254-9483
- I want to access my Behavioral Health Member Portal.
Where can I learn about my benefits?
- Price Information for Your Pharmacy Benefits
- Plan Summary (English)
- Plan Summary (Spanish)
- Certificate of Coverage
- Pediatric Dental Benefits
- Summary of Benefits and Coverage
- Your Rights and Protections Against Surprise Medical Bills
- Creditable Coverage Disclosure Notice
Read the latest issue of our quarterly member newsletter, Healthy You.
Questions about ESSENTIAL? We’re happy to help.
Call us today at 1-855-321-9244.
Check out this list of commonly used terms to better understand your plan. Here you will find definitions for words like copayment, premium, deductible, and more.