Metal Tier Comparison** Bronze 60
Silver 70
Gold 80
Platinum 90
No charge
No charge
No charge
No charge
Primary Care
$65
$40
$30
$15
Specialist Visit
$95
$80
$65
$30
Urgent Care
$65
$40
$30
$15
Emergency Room
40%
$400
$350
$150
In-Network Cost Share Preventive Care
(Cost-share waived, if admitted)
s n a l P y l mi a f d n a l a u d i v i d DABLE. In R O F F A . . LOCAL QUALIT
Y
Or Buy VHP Direct
You may be eligible for financial assistance, such as tax credits and cost-sharing subsidies, which can lower your cost for care.
You can also buy one of our non-subsidized VHP Direct Individual & Family Plans with the same benefits and providers as our Covered CA plans. Easy to enroll with just a photo ID and proof that you live in Santa Clara County. All are welcome! Visit www.valleyhealthplan.org to learn more.
Contact VHP at 1.888.421.8444 (toll-free) or brokerrelations@vhp.sccgov.org
Family
Individual
Family
Individual
Family
Individual
Family
Maximum Out-of-Pocket
$7,800
$16,600
$7,800
$15,600
$7,800
$15,600
$4,500
$9,000
Medical Deductible
$6,300
$12,600
$4,000
$8,000
$0
$0
$0
$0
$500
$1,000
$300
$600
$0
$0
$0
$0
Pharmacy Deductible
**VHP also offers a Minimum Coverage Plan. Visit www.valleyhealthplan.org to learn more.
Buy VHP from Covered CA
Visit www.coveredca.com to learn more about financial assistance.
Individual
Primary Care Network Community Clinics Asian Americans for Community Involvement (AACI) Gardner Family Health Network Indian Health Center of Silicon Valley MayView Community Health Center North East Medical Services (NEMS) Planned Parenthood Mar Monte
California IPA
Santa Clara Valley Medical Center (SCVMC) Valley Health Center Clinics
Silicon Valley Medical Development San Jose Medical Group (SJMG)
These Medical Groups refer to SCVMC network specialists.
These Medical Groups may refer to their own network specialists.
Independent Practice Northern California Physicians Network (NCPN) San Benito Medical Associates (SBMA)
Benefits of Being Part of the VHP Family!
Hospital Locations
Pharmacy Locations
Urgent Care Locations
MDLIVE Telehealth
–– –– –– –– ––
–– –– –– –– ––
–– –– –– –– ––
–– Secure, online video, phone, or
O’Connor Hospital Santa Clara Valley Medical Center St. Louise Regional Hospital Stanford Hospital * Lucile Packard Children’s Hospital *
* By referral for services not available at SCVMC
Lab Locations –– Select local labs –– Statewide Quest Diagnostics labs
Nationwide Costco pharmacies Nationwide Safeway pharmacies Nationwide Walgreens pharmacies Select local pharmacies Statewide Raley’s pharmacies
–– –– –– ––
Statewide Concentra Urgent Care Evergreen Urgent Care Gateway Family Medical Center Samaritan Medical Care Center South Valley Family & Occupational Health Center Valley Health Center Bascom Valley Health Center Downtown Valley Health Center East Valley Valley Health Center Moorpark
For details, visit www.healthcare.gov/coverage/preventive-care-benefits
mobile visits
–– 24/7/365 access to urgent and
non-emergency care
–– Board certified primary care providers
–– Behavioral health teletherapy –– Online prescriptions sent directly to
your Plan Pharmacy –– Approximately 200 languages available
Free Preventive Services for Adults
Free Preventive Services for Children
–– –– –– –– –– ––
–– Autism screening –– Behavioral assessments for
–– –– –– –– –– ––
Blood pressure screening Cancer screening Cholesterol screening Diet counseling Depression screening Domestic & interpersonal violence screening and counseling Hepatitis B & C screening HIV screening Immunization vaccines Obesity screening & counseling Tobacco use screening Well-visits
–– –– –– –– –– ––
children (ages 0 to 11 months) Depression screening Fluoride varnish Immunization vaccines Obesity screening & counseling Vision screening Well-visits