

Monthly premiums, out-of-pocket maximums, and CMS star ratings for 9 plans.
| Plan Name | Type | Monthly Premium | Max Out-of-Pocket | Star Rating |
|---|---|---|---|---|
| Jefferson Health Plans Select (HMO D-SNP) | HMO | $32.70 | $9,250.00 | ★★★★★ |
| Jefferson Health Plans Dual Pearl (HMO D-SNP) | HMO | $32.70 | $9,250.00 | ★★★★★ |
| Jefferson Health Plans Giveback (HMO) | HMO | $0.00 | $9,250.00 | ★★★★★ |
| Jefferson Health Plans Complete (HMO) | HMO | $0.00 | $6,500.00 | ★★★★★ |
| Jefferson Health Plans Special (HMO D-SNP) | HMO | $32.70 | $9,250.00 | ★★★★★ |
| Jefferson Health Plans Prime (HMO) | HMO | $32.70 | $6,000.00 | ★★★★★ |
| Jefferson Health Plans Flex Pro (PPO) | PPO | $18.00 | $9,000.00 | |
| Jefferson Health Plans Flex Plus (PPO) | PPO | $32.70 | $10,000.00 | |
| Jefferson Health Plans Flex (PPO) | PPO | $0.00 | $10,000.00 |
Primary care copays, specialist visits, OTC credit, and dental maximums.
| Plan Name | PCP Copay | Specialist | OTC Credit | Dental Max |
|---|---|---|---|---|
| Jefferson Health Plans Select (HMO D-SNP) | $0.00 | $0.00 | $300.00 | Included |
| Jefferson Health Plans Dual Pearl (HMO D-SNP) | $0.00 | $0.00 | $200.00 | Included |
| Jefferson Health Plans Giveback (HMO) | $0.00 | $40.00 | $30.00 | Included |
| Jefferson Health Plans Complete (HMO) | $0.00 | $25 | $125.00 | Included |
| Jefferson Health Plans Special (HMO D-SNP) | $0.00 | $0.00 | $250.00 | Included |
| Jefferson Health Plans Prime (HMO) | $0.00 | $20 | $130.00 | Included |
| Jefferson Health Plans Flex Pro (PPO) | $0.00 | $0.00 | $150.00 | Included |
| Jefferson Health Plans Flex Plus (PPO) | $0.00 | $20 | $165.00 | Included |
| Jefferson Health Plans Flex (PPO) | $0.00 | $25.00 | $160.00 | Included |






