Plan overview
The Responsive Auto Insurance Company | OAP HDHPQ Net Only
This overview summarizes the key features of the Responsive Auto Insurance Company OAP HDHPQ Net Only plan for the coverage period May 1, 2026 – April 30, 2027. It highlights what you pay for common services, the main cost‑sharing limits, and important observations drawn from the Summary of Benefits and Coverage. Premium costs are provided separately by your employer.
01At a glance
$2,000
Individual deductible
$6,900
Individual out‑of‑pocket maximum
$25
Primary care visit copay
$300
Emergency room copay
02What you’ll pay (in‑network)
| Service | Your Cost |
|---|---|
| Specialist visit | $75 copay per visit |
| Urgent care | $50 copay per visit |
| Diagnostic test (x‑ray, blood work) | No charge |
| Imaging (CT, MRI, PET) | No charge at outpatient facility or office |
| Generic drugs (Tier 1) | $10 copay 30‑day / $25 copay 90‑day |
| Preferred brand (Tier 2) | $35 copay 30‑day / $88 copay 90‑day |
| Non‑preferred brand (Tier 3) | $70 copay 30‑day / $175 copay 90‑day |
| Specialty drugs (Tier 4) | $150 copay 30‑day |
| Inpatient hospital stay | No charge |
| Mental health / substance use inpatient | No charge per admission |
| Home health care | No charge (40 visits max per year) |
| Rehabilitation services | $75 copay per visit (30 visits max) |
| Habilitation services | $75 copay per visit (60 days max) |
| Skilled nursing care | No charge |
| Durable medical equipment | No charge |
| Hospice care | No charge (inpatient or outpatient) |
| Children’s eye exam, glasses, dental check‑up | Not covered |
03Key observations
Preventive care at no cost
All in‑network preventive screenings and immunizations are covered at no charge — the deductible does not apply.
Virtual visits at no cost
Telehealth (MDLIVE) visits for primary or specialist care are covered at no charge, helping you access care conveniently.
Out‑of‑network coverage excluded
This plan is network‑only. Services from out‑of‑network providers (except qualifying emergencies) are not covered and may result in full provider bills.
Comprehensive mental‑health support
Mental and behavioral health services share medical benefit levels — outpatient visits carry a $75 copay and inpatient stays are covered in full.