HSA Available N/A HSA Available N/A Deductible (Single/Family) $500/ $1,000 $3,400/ $6,800 $1,000/ $2,000 Coinsurance 20% 0% 20% Out - of - Pocket Max (Single/Family) $1,500/ $3,000 $3,400/ $6,800 $2,000/ $4,000 Physician/Specialist Visits $10 / $30 Up to Deductible $10 / $30 Preventive Care 100% Covered by Plan 100% Covered by Plan 100% Covered by Plan Hospital | In/Out - Patient 20% after deductible Up to Deductible 20% after deductible Emergency Room $200 after deductible Up to Deductible $200 after deductible Urgent Care Centers $50 Up to Deductible $50 Medical Plan Options Angle Heath - Aetna Network