Essential Plan 2024

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Senior rancher

Essential Plan

Available to residents of Washoe County and Carson City.


The Essential Plan offers residents of Washoe County, Storey County and Carson City access to our widest provider network, with a $0 monthly premium. Essential Plan members are can select a community provider as their Primary Care Provider while still enjoying priority access to Renown Health providers and facilities.

Questions?  Call us at 775-982-3158

Benefits IncludedPricing
PRIMARY CARE VISIT$0 per visit (preferred PCP) / $10 per visit (non preferred PCP) / $10 per visit (convenient care facilities)
SPECIALIST VISIT $40 per visit
URGENTLY NEEDED CARE $20 / $65 per visit ($0 Teladoc)
DENTAL COVERAGE Preventive Dental
Co-payments listed are for preferred facilities.

Plan Information

Doctors & Hospitals Amount You Will Pay
Maximum Out-of-Pocket$3,200 per year
Primary Care Office Visit$0 per visit (preferred PCP) / $10 per visit (non preferred PCP) / $10 per visit (convenient care facilities)
Specialist Office Visits $40 per visit
Urgently Needed Care $20 / $65 per visit ($0 Teladoc)
Routine Lab Services$0 per visit
Diagnostic Tests (X-ray, CT, MRI) $70 / $100 / $135 per visit
Emergency Room Care$135 per visit
Ambulance Services$325 per trip
Inpatient HospitalPreferred: $300 Copay (1-4days) / Non-Preferred: $440 Copay (1-5days)
Outpatient Hospital ServicesPreferred: $300 per visit / Non-Preferred: $440 per visit
Prescription CoverageAmount You Will Pay for Preferred Medications
Coverage in the Gap Tier1 $5 Tier 6 $0
Rx DeductibleN/A
Preferred Generic (Tier 1) $5 Per Prescription
Non-Preferred Generic (Tier 2) $12 Per Prescription
Preferred Brand (Tier 3) $47 Per Prescription
Non-Preferred Brand (Tier 4) $100 Per Prescription
Specialty Drugs (Tier 5)33% coinsurance
Select Drug (Tier 6)$0 Per Prescription
90-day Retail / 90-day Mail Order2.5 times 30-day / 2 times 30 day
Summary of Benefits Updated (12/13/23)
Evidence of Coverage Updated (11/22/23)
Annual Notice of Change Updated (09/29/23)
Over-the-Counter Catalog Updated (09/29/23)
Amount you will pay is listed as “in-network / out-of-network”.
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The Essential Plan is the right option for you if your primary care physician is not a Renown provider. The Essential Plan includes the entire Senior Care Plus network of doctors and specialists, including priority access to Renown Health facilities. The Essential Plan has been enhanced in 2023 with an updated hearing benefit from NationsHearing® that includes a $0 hearing exam and a generous hearing aid benefit. NationsOTC® provides a $25 quarterly Over-the-Counter benefit with free two-day shipping. The plan also has a Preventive Dental benefit from Liberty Dental. The prescription drug coverage included in the Essential Plan is extensive, and includes select insulins at the $35. Personal Assistants, who can help schedule appointments and navigate the healthcare system are included when you select a Renown Primary Care Provider (PCP). Above is a partial list of benefits and should not be construed as a complete list. Please refer to the Evidence of Coverage in the plan documents section above for a complete list of benefits. Out-Of-Network Providers: If you use an out-of-network provider, your share of the costs for your covered services may be higher. Out-of-network providers are under no obligation to treat members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost sharing that applies to out-of-network services.

Enroll Today

Enroll Today