Compare the Ley 95 plans and choose the coverage that best fits you and your family .
Rates for individual, couple, and family coverage
Immediate emergency care
Hospital stays and inpatient care
Consultations and treatments without hospitalization
Diagnostic tests and medical studies
Therapies and necessary medical equipment
Major medical care and specialized equipment
Covered prescription medications
Preventive care and ongoing management
Exams, lenses, and vision benefits
Diagnosis, prevention, and dental treatments
Rates for individual, couple, and family coverage
| Individual | |
|---|---|
| Rubí | $213 |
| Plata | $356 |
| Mandatoria | $779 |
| Couple | |
| Rubí | $385 |
| Plata | $842 |
| Mandatoria | $1,843 |
| Family of 3 or more | |
| Rubí | $475 |
| Plata | $1,128 |
| Mandatoria | $2,467 |
Immediate emergency care
| Accident | |
|---|---|
| Rubí | $0 |
| Plata | $0 |
| Mandatoria | $0 |
| Illness | |
| Rubí | $30 Preferred Network $75 Other Facilities |
| Plata | $50 |
| Mandatoria | $40 |
Hospital stays and inpatient care
| Total Including Mental Health | |
|---|---|
| Rubí | $0 Preferred Network $250 Other Facilities |
| Plata | $0 Preferred Network $100 Other Facilities |
| Mandatoria | $75 |
| Partial Mental Health | |
| Rubí | $0 Preferred Network $150 Other Facilities |
| Plata | $0 Preferred Network $75 Other Facilities |
| Mandatoria | $75 |
Consultations and treatments without hospitalization
| Primary Care Physician | |
|---|---|
| Rubí | $10 |
| Plata | $8 |
| Mandatoria | $58 |
| Specialist | |
| Rubí | $18 |
| Plata | $12 |
| Mandatoria | $10 |
| Sub-Specialist | |
| Rubí | $20 |
| Plata | $18 |
| Mandatoria | $15 |
| Psychiatry | |
| Rubí | $18 |
| Plata | $12 |
| Mandatoria | $10 |
| Psychologist | |
| Rubí | $18 |
| Plata | $12 |
| Mandatoria | $10 |
| Chiropractor | |
| Rubí | $12 copay, limited to 15 sessions per year. (Combined with physical therapy) |
| Plata | $12 copay, limited to 20 sessions per year. (Combined with physical therapy) |
| Mandatoria | $10 copay, limited to 20 sessions per year. (Combined with physical therapy) |
| Nutritionist | |
| Rubí | $12 copay, up to 12 visits per contract. |
| Plata | $12 copay, up to 12 visits per contract. |
| Mandatoria | $10 copay, up to 12 visits per contract. |
| Laboratories and X-Rays | |
| Rubí | 0% Preferred Network 50% Other Facilities |
| Plata | 0% Preferred Network 30% Other Facilities |
| Mandatoria | 30% |
Diagnostic tests and medical studies
| CT Scan | |
|---|---|
| Rubí | 40% Preferred Network 50% Other Facilities |
| Plata | 40% |
| Mandatoria | 30% |
| Ultrasounds | |
| Rubí | 0% Preferred Network 50% Other Facilities |
| Plata | 0% Preferred Network 40% Other Facilities |
| Mandatoria | 30% |
| STRESS Test, Electrocardiogram, Neurological Studies | |
| Rubí | 50% |
| Plata | 40% |
| Mandatoria | 30% |
| MRI, MRA | |
| Rubí | 50% Limited to 1 per contract year |
| Plata | 40% Limited to 1 per contract year |
| Mandatoria | 30% Limited to 1 per contract year |
Therapies and necessary medical equipment
| Physical Therapy | |
|---|---|
| Rubí | $7 copay, limited to 15 sessions (Combined with chiropractic manipulations) |
| Plata | $7 copay, limited to 20 sessions (Combined with chiropractic manipulations) |
| Mandatoria | $7 copay, limited to 20 sessions (Combined with chiropractic manipulations) |
| Respiratory Therapy | |
| Rubí | $7 copay |
| Plata | $7 copay |
| Mandatoria | $7 copay |
Major medical care and specialized equipment
| Durable Medical Equipment | |
|---|---|
| Rubí | 20% coinsurance applies. Requires pre-authorization. |
| Plata | 20% coinsurance applies. Requires pre-authorization. |
| Mandatoria | 20% coinsurance applies after the initial deductible. |
Covered prescription medications
| Rubí | Annual Benefit $750 Then 80% applies |
| Plata | Annual Benefit $1,750 Then 40% applies |
| Mandatoria | Annual Benefit $2,000 Then 80% applies |
| Generic Bioequivalent | |
|---|---|
| Rubí | Preferred Pharmacy $10 Non-Preferred Pharmacy $15 |
| Plata | Preferred Pharmacy $5 Non-Preferred Pharmacy $10 |
| Mandatoria | 10% min $5 Preferred Pharmacy 15% min $10 Non-Preferred Pharmacy |
| Preferred Brand | |
| Rubí | 25% min $25 Preferred Pharmacy 30% min $30 Non-Preferred Pharmacy |
| Plata | 15% min $15 Preferred Pharmacy 20% min $20 Non-Preferred Pharmacy |
| Mandatoria | 10% min $12 Preferred Pharmacy 15% min $15 Non-Preferred Pharmacy |
| Non-Preferred Brand | |
| Rubí | 50% min $50 Preferred Pharmacy 55% min $55 Non-Preferred Pharmacy |
| Plata | 25% min $25 Preferred Pharmacy 30% min $30 Non-Preferred Pharmacy |
| Mandatoria | 15% min $20 Preferred Pharmacy 20% min $25 Non-Preferred Pharmacy |
| Specialty Products | |
| Rubí | 50% |
| Plata | 50% |
| Mandatoria | 30% up to a maximum of $200 |
Preventive care and ongoing management
| Preventive Services (Including Women's) | |
|---|---|
| Rubí | 0% |
| Plata | 0% |
| Mandatoria | 0% |
| Preventive Immunizations (Vaccines) | |
| Rubí | 0% administration fees apply |
| Plata | 0% administration fees apply |
| Mandatoria | 0% administration fees apply |
Exams, lenses, and vision benefits
| Eye Exam (Refraction) | |
|---|---|
| Rubí | Covered 100% of contracted rates after $10 copay |
| Plata | Covered 100% of contracted rates after $10 copay |
| Mandatoria | Covered 100% of contracted rates after $10 copay |
| Frames and Prescription | |
| Rubí | Covered 1 pair per subscriber up to $150 per contract year. Covered by reimbursement. |
| Plata | Covered 1 pair per subscriber up to $150 per contract year. Covered by reimbursement. |
| Mandatoria | Single Vision Lenses..$18 copay Bifocal Lenses......$20 copay Contact Lenses.....$36 copay Frames.................$18 copay |
Diagnosis, prevention, and dental treatments
| Periodic Oral Exam | |
|---|---|
| Rubí | Covered every 6 months |
| Plata | Covered every 6 months |
| Mandatoria | Covered every 6 months |
| Restorative | |
| Rubí | 50% |
| Plata | 30% |
| Mandatoria | 20% |
| Endodontics | |
| Rubí | 50% |
| Plata | 30% |
| Mandatoria | 20% |
| Temporary Restorations (Crowns) | |
| Rubí | 50% |
| Plata | 30% |
| Mandatoria | 20% |
| Oral Surgery | |
| Rubí | 50% |
| Plata | 30% |
| Mandatoria | 20% |
Complete the form so we can help you with your questions.
Complete the form so we can help you with your questions.
Complete the form and we’ll help you choose the best option.
We have received your information and appreciate
your interest in our health plans.
One of our Sales Representatives will be in touch with you to provide personalized guidance
and share details about the plan you are interested in.
Thank you for considering Plan de Salud Menonita as
your health insurance provider.
We have received your information and appreciate
your interest in our health plans.
One of our Sales Representatives will be in touch with you to provide personalized guidance
and share details about the plan you are interested in.
Thank you for considering Plan de Salud Menonita as
your health insurance provider.
Complete the form and we’ll help you choose the best option.