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Network Health Go PPO

Customer Service: 800-378-5234

EyeMed link: EyeDocLocator.com

EyeMed Phone: 833-279-4359

Dental Network link: Say Cheese

Dental Network Phone: 888-454-4127

TruHearing: 877-759-8131

Find A Doc: NetworkHealth.com

New Gym Membership Link: YourOnePass.com

Mail Order with Express Scripts: 800-316-3107

For a full listing of the Network Health GO PPO, please click here.

2026

2027

Go

In Network / Out of Network

Go

In Network / Out of Network

Premium

$0

$0

Deductible: $270

Primary Doctor

$0 / $30

$0 / $30

Specialist

$50 / $100

$50 / $100

Physical Therapy

$50 / $100

$50 / $100

Urgent Care

$50

$50

Hospital

$295 days 1-6

$350 days 1-6

Out Of Network

$800 days 1-7

$800 days 1-7

Maximum Out Of Pocket

$4,500 / $7,400

$5,000 / $7,900

Outpatient Surgery

$275 / $225 ASC / $550

$300 / $250 ASC / $600

Ambulance

$275

$300

Emergency

$130

$130

Lab Services

$0-$20 / $40

$0-$20 / $40

X-Rays

$35 / $70

$35 / $70

Complex Diagnostic

$275 / $550

$275 / $600

Part D (Tiers 1-4)

$0 /$8 / 23% / 25%

$0 /$8 / 22% / 31%

90 Day Mail-Order

$0 / $0 / 23%/ 25%

$0 / $0 / 22%/ 31%

Part D Deductible

$340

(applies to tiers 2,3,4,5)

$340

(applies to tiers 2,3,4,5)

Hearing Aid

$495 – $1,695

$495-$1,695

OTC

Pick your Perks ($1,155)

Pick your Perks ($750)

Gym Membership

OnePass

OnePass

Dental

Pick your Perks ($1,155)

Pick your Perks ($750)

Dental Rider

Dental Network

$49/mo $1,000

SayCheese

$39/mo $1,000

SayCheese

Vision

Pick your Perks ($1,155)

Pick your Perks ($750)

For a full listing of benefits, please request the Summary of Benefits via email, info@fhkinsurance.com

Network Health Go PPO

2026

2027

Go

In Network / Out of Network

Go

In Network / Out of Network

Premium

$0

$0

Deductible: $270

Primary Doctor

$0 / $30

$0 / $30

Specialist

$50 / $100

$50 / $100

Physical Therapy

$50 / $100

$50 / $100

Urgent Care

$50

$50

Hospital

$295 days 1-6

$350 days 1-6

Out of Network

$800 days 1-7

$800 days 1-7

MOOP Cap

$4,500 / $7,400

$5,000 / $7,900

Outpatient Surg

$275 / $225 ASC / $550

$300 / $250 ASC / $600

Ambulance

$275

$300

Emergency

$130

$130

Lab Services

$0-$20 / $40

$0-$20 / $40

X-Rays

$35 / $70

$35 / $70

Complex Diag

$275 / $550

$300 / $600

Part D

$0 / $8 / 23% / 25%

$0 / $8 / 22% / 31%

90 Day- Mailorder

$0 / $0 / 23% / 25%

$0 / $0 / 22% / 31%

Part D Ded

$340

(applies to tiers 2,3,4,5)

$340

(applies to tiers 2,3,4,5)

Hearing Aid

$495-$1,695

$495-$1,695

OTC

Pick your Perks($1,155)

Pick your Perks ($750)

Gym Membership

One Pass

One Pass

Dental

Pick your Perks($1,155)

Pick your Perks ($750)

Dental Rider

Dental Network

$45/mo $1,000

SayCheese

$39/mo $1,000

SayCheese

Vision

Pick your Perks($1,155)

Pick your Perks ($750)

For a full listing of benefits, please request the Summary of Benefits via email, info@fhkinsurance.com

Customer Service: 800-378-5234

EyeMed link: EyeDocLocator.com

EyeMed Phone: 833-279-4359

Dental Network link: Say Cheese

Dental Network Phone: 888-454-4127

TruHearing: 877-759-8131

Find A Doc: NetworkHealth.com

New Gym Membership Link: YourOnePass.com

Mail Order with Express Scripts: 800-316-3107

For a full listing of the Network Health GO PPO, please click here.

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