Catastrophic Plan
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Catastrophic Plan

Together with CCHP offers plan options across four different levels to our members. Plan benefits described below are for in-network services only.

Click on the buttons below to see benefits for each plan level. After November 1, get a quote and enroll with our Online Quote Tool. You can also call our Sales Support team directly for help at 844-708-3837.

  Catastrophic
Individual medical and prescription deductible $8,550
Individual medical and prescription maximum out-of-pocket1 $8,550
 
Family medical and prescription maximum deductible $17,100
Family medical and prescription out-of-pocket maximum1 $17,100
 
Primary care office visit 3 free visits then 0% after deductible
Speciality/specialist office visit 0% after deductible
Inpatient and outpatient services 0% after deductible
Outpatient lab services 0% after deductible
Urgent care 0% after deductible
Emergency room 0% after deductible
 
Prescription Drugs2
Tier 1: Generic 0% after deductible
Tier 2: Preferred brand 0% after deductible
Tier 3: Non-preferred brand 0% after deductible
Tier 4: Specialty prescriptions3 0% after deductible
Tier 5: ACA preventive prescriptions $0
Tier 6: Select generics, including select Insulin $0
 
Health management programs
CCHP on Call Nursline

1 The out-of-pocket maximum is the sum of the deductible amount, prescription drug deductible amount (if applicable), copayment amount and coinsurance percentage of covered expenses, as shown in your Evidence of Coverage.
2 For a list of covered preventive prescriptions, please review our 2021 Prescription Medication List.
3 Many specialty medications are paid according to medical plan benefits, not prescription drug benefits.

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Medicaid

Children's Community Health Plan

PO Box 56099
Madison, WI 53705
1-800-482-8010

Together with CCHP

Children's Community Health Plan

PO Box 1997, MS 6280
Milwaukee, WI 53201
1-844-201-4672

 

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