Balance plans

Our Balance plans offer a harmonious mix of cost-saving features and coverage for the services your clients use the most. 

Balance plans offer:

  • A variety of deductible options and out-of-pocket maximums so you can select the plan and price point that fits within your client’s budget
  • Separate deductibles and out-of-pocket maximums, in and out of the network
  • Deductibles waived for doctor and specialist visits, urgent care, physical therapy and chiropractic manipulation and acupuncture
  • Deductibles waived in Gold and Silver plans for lab and X-ray, and all drug tiers except specialty
  • Fully covered Express Care Clinic and Express Care Virtual visits
  • Provider choice, in or out of the Providence Signature Network
  • Pediatric dental coverage
  • Adult vision coverage (exams and hardware)
  • Up to 10 combined chiropractic manipulation and acupuncture visits per year

Cost-sharing ranges for in-network benefits

PCP Copay*  $35 - $65 
Coinsurance 20% - 50%
OOP Maximum $5,500 - $7,900
Deductible $750 - $7,900
Rx Preferred Generic Copay* $15 - $35
Rx Non-Preferred Generic Copay* $20 - $60
Rx Preferred Brand Copay* Gold and Silver: $50 - $75*
Bronze: 50%**
Rx Non-Preferred Brand Gold and Silver: 50%*
Bronze: 50%**
Preferred Rx Specialty** 50% with a $200 per script cap
Non-Preferred Rx Specialty** 50%

*Deductible waived

**Deductible applies; on the Balance 7900 Bronze plan, the non-preferred brand name and non-preferred specialty benefit is covered in full after the deductible is paid.

Benefit highlights

View the plan details for all six Balance plan options.

For more information

Contact us to learn more about Providence medical plans.

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