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: $2,500 (Individual)/$5,000 (Family)
Out of Pocket Max: $5,000 (Individual)/$10,000 (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
- Formulary Foreword
- 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 Medical Benefits
- Price Information for Your Pharmacy Benefits
- Plan Summary
- Certificate of Coverage
- Pediatric Dental Benefits
- Summary of Benefits and Coverage
- Your Rights and Protections Against Surprise Medical Bills
- Glossary of Health Coverage and Medical Terms
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.
Understanding Your Health Plan
Deductible
The amount you pay annually for covered healthcare services before your insurance plan starts to pay.
Copayment
A fixed amount you pay ($20, for example) for a covered healthcare service.
Co-insurance
The percentage of costs of a covered healthcare service you pay (20%, for example) after you’ve paid your deductible.
Out-of-pocket maximum
The most you will pay for covered healthcare in a year (does not include your monthly premium). Once you reach it, Neighborhood pays for everything.
Monthly premium
Your monthly payment that keeps your health insurance active. It does not count towards your deductible or out-of-pocket maximum.