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| | Deductible | Maximum Out of pocket | Office visit | Hospital stay | Surgery in Hospital | Preventive care/ Well baby care | Prescription drugs |
| AETNA PPO | | In network | out off network | In network | out off network | In network | out off network | In network | out off network | In network | out off network | In network | out off network | Use a Aetna/Blue Shield Pharmacy network to get a better. |
| 500 - gold | $500/$1000 | $1000/$2000 | $2000/$4000 | $4000/$8000 | 100% after $25 copay | 70% allowed amount after deductible | 90% after deductible | 70% allowed amount after deductible | 90% after deductible | 70% allowed amount after deductible | | | | |
| 1000 - standard | $1000/$2000 | $2000/$4000 | $3000/$6000 | $6000/$12000 | 100% after $35 copay | 60% allowed amount after deductible | 80% after deductible | 60% allowed amount after deductible | 80% after deductible | 60% allowed amount after deductible | | | Generitc/brand name:100% after copay | Generitc/brand name:60% after copay |
| 2000 - value | $2000/$4000 | $4000/$8000 | $6000/$12000 | $12000/$24000 | 100% after $40 copay | 60% allowed amount after deductible | 80% after the plan deductible | 60% allowed amount after deductible | 80% after the plan deductible | 60% allowed amount after deductible | | | Generitc/brand name:100% after copay | Generitc/brand name:60% after copay |
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| BLUE SHIELD | Platinum | $0 | $500/$1000 | $1500/$3000 | $1500/$3000 | 100% after $10 copay | 70% allowed amount after deductible | 90% after deductible | 70% allowed amount up to $1500/day. You pay charge excess of $1500 | 90% after deductible | 70% allowed amount up to $1500/day. You pay charge excess of $1500 | 100% after $10 copay | 70% allowed amount after deductible | Generitc/brand name:100% after copay $5/$20 | Generitc/brand name:75% after copay |
| 400 | $400/$800 | $800/$1600 | $1600/$3200 | $3200/$6400 | 100% after $25 copay | 70% allowed amount after deductible | 90% after deductible | 70% allowed amount up to $1500/day. You pay charge excess of $1500 | 90% after deductible | 70% allowed amount up to $1500/day. You pay charge excess of $1500 | No charge (Deductible waived) | 70% allowed amount after deductible | Generitc/brand name:100% after copay | Generitc/brand name:75% after copay |
| 700 | $700/$1400 | $1400/$2800 | $2500/$5000 | $3000/$6000 | 100% after $35 copay | 60% allowed amount after deductible | 80% after the plan deductible | 60% allowed amount up to $1500/day. You pay charge excess of $1500 | 80% after the plan deductible | 60% allowed amount up to $1500/day. You pay charge excess of $1500 | No charge (Deductible waived) | 70% allowed amount after deductible | Generitc/brand name:100% after copay | Generitc/brand name:75% after copay |
| | | | | | Preventive | | Basic | | Major | | Orthodontia | | | |
| DENTAL | | | | | | | | | | | | | | | |
| AETNA | 100 | $100/$300 | $150/$450 | $1,000 maximum per calendar year per person for in-network and out-of-network expenses combined | 100% | 100% | 70% | 60% | 50% | 50% | not covered | not covered | | |
| 25 | $25/$75 | $50/$150 | $1,500 maximum per calendar year per person for in-network and out-of-network expenses combined | 100% | 100% | 90% | 80% | 65% | 50% | Separate benefits are provided | Separate benefits are provided | | |
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| DELTA | 100 | $100/$300 | $150/$450 | $1,000 maximum per calendar year per person for in-network and out-of-network expenses combined | 100% | 100% | 70% | 60% | 50% | 50% | not covered | not covered | | |
| 25 | $25/$75 | $50/$150 | $1,500 maximum per calendar year per person for in-network and out-of-network expenses combined | 100% | 100% | 90% | 80% | 65% | 50% | | | | |
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| MET LIFE | 100 | $100/$300 | $150/$450 | $1,000 maximum per calendar year per person for in-network and out-of-network expenses combined | 100% | 100% | 70% | 60% | 50% | 50% | | | | |
| 25 | $25/$75 | $50/$150 | $1,500 maximum per calendar year per person for in-network and out-of-network expenses combined | 100% | 100% | 90% | 80% | 65% | 50% | Separate benefits are provided | Separate benefits are provided | | |
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