Prime Care Connect Requirements
Prime Care Connect is medical coverage designed for those with a limited household income. It is intended to reduce some of the financial barriers that may prevent employees from getting appropriate and timely health care.
This option provides the same quality health care and comprehensive coverage as other Ohio State medical plans, and you’ll pay less when you seek medical care or fill a prescription.
You’re eligible to apply for Prime Care Connect if:
- You are a full-time Ohio State faculty or staff employee (75% – 100%) in a regular, term, or seasonal position and eligible for the full-time medical contribution rate, and
- Your household income is not greater than the following amounts (as reported on your tax return, IRS Form 1040):
Note: You must meet both requirements above. Affiliated Group members and Graduate Associates participating in Ohio State’s medical benefits are not eligible for this coverage.
Persons in Family | Maximum Household Income |
---|---|
1 | $32,805 |
2 | $44,370 |
3 | $55,935 |
4 | $67,500 |
5 | $79,065 |
6 | $90,630 |
7 | $102,195 |
8 | $113,760 |
9 and up | add $11,565 per additional person |
Your Costs
The employee contribution for Prime Care Connect is the same as for Prime Care Advantage, but Prime Care Connect members pay less for medical care. Benefit details can be found in the Faculty and Staff Health Plans’ Specific Plan Details document.
Benefit Component | Premier Network | Standard Network |
---|---|---|
Annual Deductible | Individual: $150 Family: $300 |
|
Coinsurance | You pay 15% | You pay 25% |
Annual Out-of-Pocket Maximum | Individual: $1,500 Family: $3,000 |
|
Preventive Care | You pay $0 | You pay $0 |
Office Visit: Primary Care Provider (PCP)1 | You pay $0 | You pay $20 copay |
Office Visit: Specialist | You pay $20 copay | You pay $30 copay |
Urgent Care | You pay $35 copay | You pay $35 copay |
Emergency Room (waived if admitted) | You pay $100 copay | You pay $100 copay |
Inpatient Hospitalization | You pay $200 copay | You pay $300 copay |
Outpatient Surgery | You pay $100 copay | You pay $150 copay |