Plata

More benefits and greater flexibility

The plata Plan offers solid coverage, affordable copayments, and full access to the provider network.

Hospitals with lower copays

Greater vision coverage

Enhanced life insurance

Higher annual medical coverage

Summary of Benefits:

Click any category to see detailed copays and coverage.

Benefit / Service Category

Emergency Services

Immediate emergency care

Red Preferida / Otras Facilidades

Accident

$0

Illness

$50

Hospitalization

Hospital stays and inpatient care

Total, including Mental Health

$0 Preferred Network
$100 Other Facilities

Partial Mental Health

$0 Preferred Network
$75 Other Facilities

Outpatient Services

Consultations and treatments without hospitalization

Primary Care Physician

$8

Specialist

$12

Sub-specialist

$18

Siquiatría

$12

Psychologist

$12

Qiropráctico

$12 Copay Limited to 20 sessions per year
(Combined with physical therapies)

Nutritionist

$12 Copay, Limited to 12 visits per year

Laboratorios y Rayos X

0% Preferred Network
30% Other Facilities

Specialized Studies

Diagnostic tests and medical studies

CT Scan

40%

Ultrasounds

0% Preferred Network
40% Other Facilities

STRESS Test, Electrocardiograma, Estudios Neurológicos

40%

MRI, MRA

40%
Limited to 1 per contract year

Rehabilitation and Habilitation Services

Therapies and necessary medical equipment

Physical therapy

$7 Copay, limited to 20 sessions (Combined with chiropractic manipulations)

Respiratory therapy

$7 Copay

Major Medical Expenses

Major medical care and specialized equipment

Durable medical equipment

A 20% coinsurance applies. Pre-authorization required.

Pharmacy

Covered prescription medications

Beneficio Anual $1,750
Luego aplica un 40%

Annual Benefit $1,750
then 40% applies

Bioequivalent Generic

Preferred Pharmacy $5
Non-Preferred Pharmacy $10

Preferred Brand

15% min $15 Preferred Pharmacy 20% min $20 Non-Preferred Pharmacy

Non-Preferred Brand

25% min $25 Preferred Pharmacy 30% min $30 Non-Preferred Pharmacy

Specialized Products

50%

Preventive Services

Preventive care and ongoing management

Preventive Services (Including Women's Services)

0%

Preventive Immunizations (Vaccines)

0% administration costs apply

Vision Services

Exams, lenses, and vision benefits

Eye Exam (Refraction)

Covered 100% of contracted rates
after a $10 copay

Frame and Prescription

Covered 1 pair per subscriber,
hup to $150 per contract year.
Covered by reimbursement

Dental Coverage

Diagnosis, prevention, and dental treatments

Periodic Oral Exam

Covered every 6 months

Restorative

30%

Endodontics

30%

Temporary Restorations (Crowns)

50%

Oral Surgery

30%

Note: This is a summary of benefits. Consult your plan documents for complete information. Copayments and coinsurance are subject to the annual maximum limit.

Benefit / Service Category

Emergency Services

Immediate emergency care

Red Preferida / Otras Facilidades

Accident $0
Illness $50
Hospitalization

Hospital stays and inpatient care

Total, including Mental Health $0 Preferred Network $100 Other Benefits
Partial Mental Health $0 Preferred Network
$75 Other Benefits
Outpatient Services

Consultations and treatments without hospitalization

Primary Care Physician $8
Specialist $12
Sub-Specialist $18
Psychiatry $12
Psychologist $12
Chiropractic $12 Copay, limited to 20 sessions per year.
(Combined with physical therapies)
Nutritionist $12 copay, up to 12 visits per contract
Laboratories and X-Rays 0% Preferred Network
30% Other Benefits
Specialized Studies

Diagnostic tests and medical studies

CT Scan 40%
Ultrasounds 0% Preferred Network
40% Other Benefits
Stress Test, Electrocardiogram, Neurological Studies 40%
MRI, MRA 40%
Limited to 1 per contract year
Rehabilitation and Habilitation Services

Therapies and necessary medical equipment

Physical Therapy $7 Copay, limited to 20 sessions
(Combined with chiropractic manipulations)
Respiratory Therapy $7 Copay
Major Medical Expenses

Major medical care and specialized equipment

Durable Medical Equipment 20% coinsurance applies. Pre-authorization required
Pharmacy

Covered prescription medications

Beneficio Anual $1,750
Luego aplica un 40%

Annual Benefit $1,750
Then 40% applies
Bioequivalent Generic Preferred Pharmacy $5
Non-Preferred Pharmacy $10
Preferred Brand 15% min $15 Preferred Pharmacy
20% min $20 Non-Preferred Pharmacy
Non-Preferred Brand 25% min $25 Preferred Pharmacy
30% min $30 Non-Preferred Pharmacy
Specialized Products 50%
Preventive Services

Preventive care and ongoing management

Preventive Services (Including Women's Services) 0%
Preventive Immunizations (Vaccines) 0% – administration costs apply
Vision Services

Exams, lenses, and vision benefits

Eye Exam (Refraction) Covered 100% of contracted rates
after a $10 copay
Frame and Prescription Covered 1 pair per subscriber
up to $150 per contract year.
Covered by reimbursement
Dental Coverage

Diagnosis, prevention, and dental treatments

Periodic Oral Exam Covered every 6 months
Restorative 30%
Endodontics 30%
Temporary Restorations (Crowns) 50%
Oral Surgery 30%

Note: This is a summary of benefits. Consult your plan documents for complete information. Copayments and coinsurance are subject to the annual maximum limit.

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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.


Thank you for contacting us!

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.


Do you need guidance?

Complete the form so we can help you with your questions.

Do you need guidance?

Complete the form and we’ll help you choose the best option.