Gold Plans

Plans offered at the gold level include Healthy NY Gold, iDirect Gold, iDirect Gold Coinsurance, NY/PA Gold, Passport Plan Gold, Choice Plus Gold and Prime Access Gold. These plans provide a variety of options including out-of-network coverage and provider choice, while still providing lower out-of-pocket costs as compared to other metal tiers.

From a deductible plan like iDirect Gold, to our innovative tailored provider network plans including Choice Plus Gold and Prime Access Gold, most plans offer a $250 primary care office visit allowance, as well as the NY Standard Gym Benefit, or the choice between our nutrition benefit and our personalBest! health and wellness benefit.

Coming Soon for 2015! Choice Plus® will now offer the advantage of an expanded, high-performing physician network – with physicians from The Primary Connection®. Learn more

The summary below provides you with a brief overview of benefits available through our Gold plan options. Click on the “Learn More” link at the bottom of each column to view a plan’s detailed Summary of Benefits and Coverage.


 iDirect Gold iDirect Gold Coinsurance NY/PA Gold Passport Plan Gold Choice Plus Gold Prime Access Gold
Product Attributes:
Unique Benefits personalBest! or Nutrition Benefit personalBest! or Nutrition Benefit personalBest! or Nutrition Benefit NY Standard Gym Benefit personalBest! or Nutrition Benefit personalBest! or Nutrition Benefit
$250 Primary Care Office Visit Allowance Yes Yes Yes Yes Yes Yes
$0 Preventive Care Services Yes Yes Yes Yes Yes Yes
Primary Care Office Visit Deductible then $25 Deductible then 20% Deductible then 20% Deductible then 20% Deductible then: Network A: $30 Network B: 40% Deductible then $30
Specialist Office Visit Deductible then $45 Deductible then 20% Deductible then 20% Deductible then 20% Deductible then: Network A: $50 Network B: 40% Deductible then: $50 with referral; $70 without referral
Emergency Room Deductible then $150 Deductible then 20% Deductible then 20% Deductible then 20% Deductible then: Network A: $150 Network B: $150 Deductible then $200
Urgent Care Yes Yes Yes Yes Yes Yes
Inpatient Hospitalization (per admission) Deductible then $1,000 Deductible then 20% Deductible then 20% Deductible then 20% Deductible then: Network A: $500 Network B: 40% Deductible then $1,000
Pharmacy $4/$30/50% $4/$30/50% $4/$30/50% $4/$30/50% $4/$30/50% $4/$30/50%
In-Network Deductible $750/$1,500 $1,000/$2,000 $1,000/$2,000 $1,000/$2,000 Network A: $1,000/$2,000 Network B: $2,000/ $4,000 $1,000/$2,000
In-Network Coinsurance 0% 20% 20% 20% Network A: 0%; Network B: 40% 0%
HSA Qualified plan No No No No No No
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