Individuals & Families

Affordable health coverage for individuals and families under 65 that puts preventive care first, with protection for medical, surgical, and emergency needs.

Is the VitalCover Health Plan right for you?

Whether you’re self-employed, changing jobs, or simply looking for more affordable healthcare options, the VitalCover Health Program is designed to provide preventive-focused care and cost-sharing support for individuals and families under 65.

Individuals seeking affordable health plans
Self-employed professionals and small business owners
Freelancers, gig workers, and 1099 contractors
Those needing a health plan after COBRA
Anyone looking for health plans between jobs
Designed to help with major medical expenses
Early retirees under 65 who aren't yet eligible for Medicare
Families looking for preventive-focused healthcare

Plan Highlights

Preventive Care

Covered at 100% per ACA guidelines

Prescription Savings

Save money on your prescriptions

Major Medical

Eligible major medical events via health share

Everyday Healthcare

Care when you need it

Important: VitalCover Health Program combines a Minimum Essential Coverage (MEC) plan which satisfies ACA preventive care requirements with a health-sharing arrangement for eligible major medical expenses like emergency, surgery, hospitalization, and maternity. The MEC portion is a limited benefit plan, not comprehensive major medical insurance. Major medical expenses are shared, not insured, and sharing is not guaranteed.

*This does not represent a complete summary of plan benefits. A full SBC document will be provided.
*Meets Affordable Care Act (ACA) Preventative Services Requirements
*Plan not available in WA, MA, 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.

Compare costs. Discover your savings!

See how a typical unsubsidized Silver PPO plan compares with VitalCover for a family of three.
While every situation is different, many families can significantly reduce their monthly healthcare costs with VitalCover.

Typical Silver PPO

Monthly premium – $2,300

Family deductible – $8,000

Total annual premium – $27,600 per year

VitalCover Health Program

Monthly membership – $1,466

$1,500 Unsharable Amount (UA)*

Total annual premium – $17,592

Illustrative comparison only. Actual premiums and deductibles vary. VitalCover combines PPO medical benefits, including ACA-compliant preventive care, with a health-sharing program for eligible major medical expenses. Benefits, eligibility, and cost-sharing differ from traditional ACA Marketplace plans.

*Similar to a deductible, the Unshared Amount, or UA, is the amount a member will pay per incident before medical expenses are shared. The lower your UA, the higher your monthly contribution will be.

Health Cost Calculator

Coverage Type

Age

Unshareable Amount*

Smoker (+$100)

*Similar to a deductible, the Unshared Amount, or UA, is the amount a member will pay per incident before medical expenses are shared. The lower your UA, the higher your monthly contribution will be.

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.