Any employee waiving medical coverage will receive a $3,600 annual ($300/month) medical waiver payment. Please note, this only applies if you’re not enrolled on the plan. If your spouse is also a METRO RTA employee and you waive but enroll as EE+SP this benefit will not apply.
| In-Network | Out-of-Network | |
| Annual Deductible (Individual/Family) |
$0 / $0 | $0 / $0 |
| Maximum Out-of-Pocket (Individual/Family) |
$0 / $0 | $0 / $0 |
| Primary Care Visits | $15 | Not Covered |
| Preventive Care | $15 | Not Covered |
| Specialist Office Visit | $15 | Not Covered |
| Emergency Room | $100 | $100 |
| Urgent Care | $25 | Not Covered |
| Services | In-Network | Out-of-Network |
| Rx Retail | ||
| Generic | $10 | Not Covered |
| Preferred Brand | $15 | Not Covered |
| Non-Preferred Brand | $30 | Not Covered |
| Rx Mail Order | ||
| Rx Retail | $20 | Not Covered |
| Preferred Brand | $30 | Not Covered |
| Non-Preferred Brand | $50 | Not Covered |
| In-Network | Out-of-Network | |
| Annual Deductible (Individual/Family) |
$200 / $400 | $200 / $400 |
| Maximum Out-of-Pocket (Individual/Family) |
$200 / $400 | $1,300 / $2,600 |
| Primary Care Visits | $15 | 50% |
| Preventive Care | $0 | 50% |
| Specialist Office Visit | $15 | 50% |
| Emergency Room | $100 | $100 |
| Urgent Care | $25 | $50 |
| Services | In-Network | Out-of-Network |
| Rx Retail | ||
| Generic | $10 | Not Covered |
| Preferred Brand | $15 | Not Covered |
| Non-Preferred Brand | $30 | Not Covered |
| Rx Mail Order | ||
| Rx Retail | $20 | Not Covered |
| Preferred Brand | $30 | Not Covered |
| Non-Preferred Brand | $50 | Not Covered |
| In-Network | Out-of-Network | |
| Annual Deductible (Individual/Family) |
$200 / $400 | $275 / $550 |
| Maximum Out-of-Pocket (Individual/Family) |
$200 / $400 | $1,800 / $3,600 |
| Primary Care Visits | $15 | $20 |
| Preventive Care | $0 | 50% |
| Specialist Office Visit | $15 | $20 |
| Emergency Room | $125 | $125 |
| Urgent Care | $25 | $60 |
| Services | In-Network | Out-of-Network |
| Rx Retail | ||
| Generic | $10 | Not Covered |
| Preferred Brand | $15 | Not Covered |
| Non-Preferred Brand | $30 | Not Covered |
| Rx Mail Order | ||
| Rx Retail | $20 | Not Covered |
| Preferred Brand | $30 | Not Covered |
| Non-Preferred Brand | $50 | Not Covered |
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