№ lp_1_19866
Structured summary document outlining health plan costs, deductibles, copayments, coinsurance, covered services, and network provider information for in-network and out-of-network care.
Year: 2026
Type of Document: Health insurance summary
Organization: UMR
Target Audience: Health plan members
Coverage Details: In-network and out-of-network services
Deductible: $1,000 individual / $2,000 family in-network, $2,000 individual / $4,000 family out-of-network
Out-of-Pocket Limit: $2,500 individual / $5,000 family in-network, $5,000 individual / $10,000 family out-of-network
Copayment and Coinsurance: Specified per service type
Services Covered: Preventive care, primary and specialist care, diagnostic tests, imaging, prescription drugs, outpatient and inpatient care, mental health, maternity, home health
Provider Network: Yes
Referral Requirement: No for specialists
Glossary Reference: www.umr.com
Note: or 1-800-207-3172
Period of Validity: Annual coverage period
Price: 8 / 10 USD
The file will be delivered to the email address provided at checkout within 12 hours.

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