Shop and Save with Standard Plans

standard plans

Many DC Health Link Individual & Family plans are designed to make shopping easier and health care more affordable. These plans are called standard plans.

Standard plans help you in 2 ways:
Covering Services Before You Meet Your Deductible

Deductibles can be a struggle. DC Health Link’s standard plans make it easier to get needed medical care when you need it. Standard plans cover many in-network medical services without you having to meet the deductible first. These services include:

  • Primary care
  • Specialist visits
  • Generic drugs
  • Urgent care
  • Outpatient mental and behavior health
  • Outpatient substance abuse treatment
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To see what services a standard plan covers before the deductible, look at the plan’s Summary of Benefits and Coverage. In the “What You Will Pay Plan Provider” column, you don’t have to meet the deductible first for a service if it says “deductible does not apply.” For example, a standard plan with a $3,500 deductible might list the cost for an in-network primary care provider as “$40/visit, deductible does not apply.” This means that your cost to see a primary care provider for this plan would be $40, even if you haven’t met your deductible.

Important: There is one exception. If you choose a high deductible health plan eligible for a Health Savings Account (HSA), you’ll still need to meet the deductible first because of Internal Revenue Service rules.

Save Time Shopping

Each health insurance company in DC Health Link’s Individual & Family market offers a standard plan at each metal level. These plans have the same out-of-pocket costs for an in-network provider. For example, a primary care visit will have a $40 copay for any silver standard plan, whether you choose CareFirst BlueCross BlueShield or Kaiser Permanente. The major differences between standard plans at the same metal level are monthly premiums and provider networks. Comparing standard plans side-by-side makes it faster and easier to find the right plan that meets your needs and budget.