MaxGuard $2,000
Budget-friendly basics: doctor visits, urgent care, ER, and telehealth up to plan limits. Not major medical.
Published monthly rates
The plan's published monthly contributions by age band. Membership and admin fees are added at enrollment.
| Age band | Member only | Member + spouse | Member + kids | Family |
|---|---|---|---|---|
| 18 – 29 | $249 | $539 | $403est. | $693est. |
| 30 – 44 | $279 | $579 | $452est. | $752est. |
| 45 – 54 | $319 | $629 | $517est. | $827est. |
| 55 – 64 | $369 | $639 | $598est. | $868est. |
Member-only and member + spouse rates are published; kids and family figures are our estimates (est.).
What you pay for care
Benefit limits on this plan
MaxGuard is a limited medical plan — each service has a fixed benefit, and care beyond these limits is your responsibility.
- Office visits: $50 copay after deductible, 10 combined visits per year (doctor + specialist + urgent care)
- Emergency room: $300 copay, max 3 visits per year
- Ambulance: $500 copay, once per year (ground + air combined)
- Outpatient surgery: $250 copay, max 3 per year — elective surgery not covered
- Hospital stay: $850 per admission, max 3 admissions per year, 10-day limit per stay
- Medical equipment: $100 per item, $500 max per year
- Outpatient mental health and dialysis: not covered
- Pre-certification required for hospital, imaging, surgery and more — skipping it costs a 50% penalty up to $2,500
Prescription coverage
Pharmacy through Ventegra on a Mini-MEC formulary: covered generics are $0 at retail. Home-delivery generics via ScriptCo. Brand-name drugs are only available through patient-assistance programs (ScriptAide). Specialty medications are not covered.
Worth knowing
- Not major medical — benefits are capped per service
- Office visits capped at 10 per year across all doctors
- Brand-name drugs only via assistance programs
- Outpatient mental health not covered
- Dialysis not covered
All plans require joining the Working Owners group: a 2-minute health survey each month that pays you $10/month.
These are self-funded association group plans, not ACA marketplace coverage. Eligibility depends on a short health questionnaire. Specialty medications are excluded on all plans. Rates shown exclude membership and admin fees, which are disclosed at enrollment.