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Pennsylvania
2026 Summit Plan
2026 Plan Highlights
Summit (PPO)
Monthly Plan Premium
$20
Maximum Annual Out-of-Pocket
Healthcare Expenses
$5,500
Hospital and Medical Benefits
Inpatient Hospital (Physical)
$325 per stay
Primary Care Provider Visit
$0 copay
Specialist Visit
$20 copay ($40 OON)
Occupational, Physical, & Speech Therapy
$20 copay
Emergency Room/Urgent Care
$100/$30 copay
Routine Foot Care
$20 copay
Outpatient Surgery
$200 copay
Outpatient Lab Work
$20 copay
X-rays
$15 copay
Prescription Drug Benefits
Part D Prescription Drug Coverage
$0 deductible
$0 copay (Tier 1)
at preferred pharmacies
More Great Benefits
$20 Premium Plan
$0 Medical and Rx deductibles
$0 Primary care provider copay
$440 Flexible Spending Card
Up to $5000 Dental Allowance
Vision, hearing, and fitness
And More
Want to learn more about Peak Advantage Summit (PPO) Plan?
Check out all the details in our Summary of Benefits.