This overview summarizes the OAP HDHPQ Net Only plan offered by The Responsive Auto Insurance Company for the coverage period May 1, 2026 – April 30, 2027. It highlights key medical and prescription cost‑sharing provisions and important exclusions. The plan is an Open Access Plus (OAP) design that provides access to an in‑network provider network only and does not cover out‑of‑network services.
01 | At a glance
Deductible (Individual)
$2,000
Out‑of‑Pocket Maximum (Individual)
$6,900
Primary Care Visit
$25 copay
Emergency Room Visit
$300 copay per visit
02 | What you'll pay
| Service | In‑Network Cost | Notes |
|---|---|---|
| Specialist visit | $75 copay | MDLIVE virtual visits at no charge |
| Urgent care | $50 copay | Out‑of‑network urgent care not covered |
| Generic prescriptions (Tier 1) | $10 / $25 copay | 30‑ or 90‑day supply options |
| Preferred brand drugs (Tier 2) | $35 / $88 copay | Lower cost if in Cigna Assurance Program |
| Non‑preferred brand (Tier 3) | $70 / $175 copay | Not covered out‑of‑network |
| Specialty drugs (Tier 4) | $150 copay | Per 30‑day retail or home delivery |
| Preventive care | No charge | Deductible does not apply |
| Imaging (CT/MRI/PET) | No charge | Office or facility services covered |
| Hospital stay | No charge | Facility and physician fees included |
| Mental health outpatient | $75 copay | No charge for other MH/SA services |
| Rehabilitation / Habilitation | $75 copay | Visit limits apply (30‑60 per year) |
| Home health care | No charge | Limited to 40 visits per year |
| Durable medical equipment | No charge | Includes crutches and glucose meters |
03 | Key observations
Preventive care fully covered
All in‑network preventive screenings and immunizations are provided at no charge before the deductible.
Low in‑network cost sharing
After meeting the deductible, most major services—including hospital, diagnostic, and imaging—are covered at 0% coinsurance.
Out‑of‑network care excluded
Members pay 100% of costs for non‑network services, including routine dental or vision exams.
Combined medical & pharmacy limits
Deductible and out‑of‑pocket maximum include both medical and prescription expenses under one total.