Essential Plan 2025

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Senior rancher on the Essential Plan by Senior Care Plus
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Essential Plan

Available to residents of Washoe County, Storey County, and Carson City.

$0/mo

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 $30 per visit
ROUTINE LAB SERVICES $0 per visit
URGENTLY NEEDED CARE $20 / $65 per visit ($0 Teladoc)
OVER-THE-COUNTER BENEFIT $50 Quarterly
DENTAL COVERAGE Preventive Dental
Co-payments listed are for preferred facilities.

Plan Information

Doctors & Hospitals Amount You Will Pay
Maximum Out-of-Pocket$2,700 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 $30 per visit
Urgently Needed Care $20 / $65 per visit ($0 Teladoc)
Routine Lab Services$0 per visit
Diagnostic Tests (X-ray, CT, MRI) $35 / $65 / $100 per visit
Emergency Room Care$140 per visit
Ambulance Services$275 per trip
Inpatient HospitalPreferred: $250 Copay (1-4days) / Non-Preferred: $440 Copay (1-5days)
Outpatient Hospital ServicesPreferred: $250 per visit / Non-Preferred: $440 per visit
Prescription CoverageAmount You Will Pay for Preferred Medications
Coverage in the Gap N/A
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) 50% Coinsurance
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
Evidence of Coverage Updated (10/04/24)
Summary of Benefits Updated (09/24/24)
Annual Notice of Change Updated (09/24/24)
Over-the-Counter Catalog Updated (09/24/24)
Benefits at a Glance Updated (09/24/24)
Dental Benefits at a Glance Updated (09/26/24)
Amount you will pay is listed as “in-network / out-of-network”.

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Summary

The Essential Plan is the right option for you if your primary care physician is not a Renown Health 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 2025 with lower copays on the services members use most. NationsOTC® provides a $50 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