NFP | Plan overview – Responsive Auto Insurance HDHPQ OAPIN

This document summarizes the 2026 HDHPQ OAPIN plan offered by The Responsive Auto Insurance Company. It describes in-network coverage, key costs such as the deductible and out-of-pocket maximum, and outlines the benefits you receive for common care needs. Premium details are provided separately.

01. At a glance

Deductible (Individual)

$2,000

Out-of-Pocket Max (Individual)

$6,900

Primary Care Visit

$25 copay / office

Emergency Room Visit

$300 copay / visit

02. What you'll pay

ServiceIn-NetworkOut-of-Network
Specialist visit$75 copay per office visitNot covered
Urgent care$50 copay per visitNot covered
Generic drugs (Tier 1)$10–$25 copay per prescriptionNot covered
Preferred brand drugs (Tier 2)$35–$88 copay per prescriptionNot covered
Specialty drugs (Tier 4)$150 copayNot covered
Diagnostic & ImagingNo chargeNot covered
Inpatient hospitalNo chargeNot covered
Home health careNo charge (40 visits/year)Not covered
Rehabilitation therapy$75 copay per visit, limits applyNot covered
Habilitation services$75 copay per visit, limits applyNot covered

03. Key observations

No cost for preventive services

Preventive care and immunizations are covered in-network before meeting the deductible.

Virtual visits included

MDLIVE telehealth visits have no charge—offering convenient access for routine care or specialists.

Out-of-network services excluded

All out-of-network care is not covered, except certain emergency or air ambulance services billed in-network.

Combined deductible and out-of-pocket limit

Medical, behavioral, and pharmacy services apply to the same deductible and annual limit.