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Pennsylvania
2026 Vista Plan
2026 Plan Highlights
Vista (PPO)
Monthly Plan Premium
$0
Maximum Annual Out-of-Pocket
Healthcare Expenses
$5,900
Hospital and Medical Benefits
Inpatient Hospital (Physical)
$450 per stay
Primary Care Provider Visit
$0 copay
Specialist Visit
$25 copay ($50 OON)
Occupational, Physical, & Speech Therapy
$30 copay
Emergency Room/Urgent Care
$125/$45 copay
Routine Foot Care
$25 copay
Outpatient Surgery
$250 copay
Outpatient Lab Work
$25 copay
X-rays
$25 copay
Prescription Drug Benefits
Part D Prescription Drug Coverage
$0 deductible
$0 copay (Tier 1)
at preferred pharmacies
More Great Benefits
$0 Premium Plan
$0 Medical and Rx deductibles
$0 Primary care provider copay
$340 Flexible Spending Card
Up to $4500 Dental Allowance
Vision, hearing, and fitness
And More
Want to learn more about Peak Advantage Vista (PPO) Plan?
Check out all the details in our Summary of Benefits.