HAP individual and family plans

HAP offers a variety of HMO and PPO plans to fit your budget. All of our plan types focus on preventive care and reducing your health care costs.

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HAP creates health plans that work harder for individuals and families

HAP Individual/Family Gold plans


HAP Individual Gold plans	HMO HSA D3 HMO HSA D3 HFC HMO HSA D3 GC PPO HSA D3
Deductible (individual/ family)	$3,000/$6,000
Coinsurance	0%
Out-of-pocket limit	$3,000/$6,000
Telehealth/ PCP/ specialty visit	Telehealth: covered after deductible PCP: covered after deductible Specialist: covered after deductible
Emergency room/ urgent care	Covered after deductible
Prescription copay (generic drug purchased at a preferred pharmacy)	Covered after deductible

HAP Individual/Family Silver plans


HAP Individual Silver Plans	HMO D35 HMO D35 HFC HMO D35 GC PPO D35	HMO F55 HMO F55 HFC HMO F55 GC PPO F55
Deductible (individual/family)	$3,500/$7,000	$5,500/$11,000
Coinsurance	30%	40%
Out-of-pocket limit	$9,200/$18,400	$9,200/$18,400
Telehealth/ PCP/ specialty visit	$0/$40/$55	$0/$40/$65
Emergency room/ urgent care	ER:30% coinsurance after deductible UC:$65	ER:40% coinsurance after deductible UC:$75
Prescription copay (generic drug purchased at a preferred pharmacy)	$10	$5

HAP Individual/Family Bronze plans


HAP Individual Bronze plans	HMO H7 HMO H7 HFC HMO H7 GC PPO H7	HMO HSA H705 EMB HMO HSA H705 EMB HFC HMO HSA H705 EMB GC PPO HSA H705 EMB	HMO K92 HMO K92 HFC HMO K92 GC PPO K92
Deductible (individual/ family)	$7,000/$14,000	$7,050/$14,100	$9,200/$18,400
Coinsurance	40%	0%	0%
Out-of-pocket limit	$9,200/$18,400	$7,050/$14,100	$9,200/$18,400
Telehealth/ PCP/ specialty visit	$0/$55/$85	Covered after deductible	$0/$50/ covered after deductible
Emergency room/ urgent care	40% coinsurance after deductible	Covered after deductible	Covered after deductible
Prescription copay (generic drug purchased at a preferred pharmacy)	$10	Covered after deductible	$10

HAP Catastrophic plans (individual under 30)


HAP Catastrophic plans *Plans are available only to individuals under the age of 30, unless they qualify for a hardship exemption.	HMO Catastrophic K92 HMO Catastrophic K92 HFC HMO Catastrophic K92 GC PPO Catastrophic K92
Deductible (individual/ family)	$9,200/$18,400
Coinsurance	0%
Out-of-pocket limit	$9,200/$18,400
Telehealth/ PCP/ specialty visit	Telehealth: covered after deductible PCP: Fully covered for first three visits, all other visits covered after deductible Specialist: covered after deductible
Emergency room/ urgent care	Covered after deductible
Prescription copay (generic drug purchased at a preferred pharmacy)	Covered after deductible

Individual/Family HMO and PPO plan sales and network coverage areas
HMO Network Coverage Area:

Oakland

Oceana

Ogemaw

Osceola

Ottawa

Roscommon

Saginaw

Sanilac

Shiawassee

St. Clair

Tuscola

Washtenaw

Wayne

Kent

Lapeer

Lenawee

Livingston

Macomb

Mason

Mecosta

Midland

Missaukee

Monroe

Montcalm

Muskegon

Newaygo

Allegan

Arenac

Barry

Bay

Branch

Clare

Clinton

Crawford

Eaton

Genesee

Gladwin

Gratiot

Hillsdale

Huron

Ingham

Iosco

Ionia

Isabella

Jackson

HMO network – you must reside and seek care in the counties above

PPO Network Coverage Area:

Oceana

Ogemaw

Osceola

Ostego

Ottawa

Roscommon

Saginaw

Sanilac

Shiawassee

St. Clair

Tuscola

Washtenaw

Wayne

Kalamazoo

Kalkaska

Kent

Lake

Lapeer

Lenawee

Livingston

Macomb

Mason

Mecosta

Midland

Missaukee

Monroe

Montcalm

Muskegon

Newaygo

Oakland

Allegan

Arenac

Barry

Bay

Branch

Calhoun

Clare

Clinton

Crawford

Eaton

Genesee

Gladwin

Gratiot

Hillsdale

Huron

Ingham

Ionia

Iosco

Isabella

Jackson

PPO network – Members with a HAP PPO Individual plan can seek care through our statewide PPO network in Michigan and northwest Ohio** or use the Aetna Signature Administrator® Network when outside of that network.

**Seven counties in northwest Ohio: Defiance, Fulton, Henry, Lucas, Ottawa, Williams and Wood.

Henry Ford Choice network – you must reside and seek care in Macomb, Oakland and Wayne counties

Learn more about HFC

Genesys Choice network – you must reside and seek care in Genesee county

Learn more about GC

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HAP individual and family plans

HAP creates health plans that work harder for individuals and families

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