Individuals & Families

The Vital PPO plan offers individuals and families an affordable, all-inclusive pre-65 solution that blends the flexibility of a PPO network with tailored major medical, surgical, and emergency care.

3 Main Components of the Vital PPO Plan

Preventive &
Sick Care

ACA preventive care (immunizations, mammogram, check-ups, etc.) plus primary care, specialists, and $0 telehealth

Rx, Labs, & Imaging

Retail and mail order pharmacy,
$0 generics, labs, and imaging

Major Medical & Emergency Care

Surgery, hospitalization, maternity, and worldwide emergency care

Vital PPO Benefit Highlights

First Health PPO Network	Provider network by First Health PPO Network (wholly owned by Aetna). To locate a provider visit https://www.firsthealthlbp.com
Preventive / Wellness / Immunizations	Covered at 100% per ACA Guidelines
Primary Doctor & Pediatric-Sick Visits	$25 copay in-network
Specialist Doctor	$35 copay in-network (3)
Urgent Care	$50 copay in-network for in person (3), Unlimited $0 telehealth in HealthWallet
Diagnostic Tests (Labs, Xrays, Etc.)	$50 copay in-network - outpatient & basic diagnostic labs only (at lab Quest/LabCorp)
Virtual Urgent Care by Lyric, 24/7/365 with Licensed, Board- Certified Physicians	$0 copay unlimited
Mental Health & Wellness	Mental Health, Substance Abuse Consultation. Virtual Counseling - Consult with a Master-level Therapist/Counselor. Limitations apply.
Preventive Screenings - Mammography, Cervical, and Colorectal Cancer	Plan pays 100% for Preventive
Rx Program	Provides over 1,000 routinely prescribed ACUTE and CHRONIC generic drugs at no cost. Plus, access to thousands of other medications at the fraction of retail cost. Over 70,000 in-network retail pharmacies and mail-order available.
Emergency, Surgery, Diagnostic Imaging, Hospitalization, and Other Medical Expenses	Health Share covers your emergency, surgery, hospitalization, and other medical expenses. No annual caps or lifetime limits. Includes some holistic and alternative care options. There are some pre-existing condition benefit limitations. Further information available upon request.

*This does not represent a complete summary of plan benefits. A full SBC document will be provided.

*Meets Part A of the Affordable Care Act (ACA) Preventative Services Requirements

*Plan not available in WA or VT

*VitalCover reserves the right to update its vendor arrangements from time to time in order to maintain high-quality services and competitive pricing for members. Members will be provided advance notice of any material changes affecting their benefits or services.

Rates starting from:

*additional $100/mo for tobacco