PSM Reference-Based Pricing · No network · pays Medicare-based rates

PSM Reference-Based Pricing $500

Open network (RBP)

See any provider. Typically the lowest premium of the major-style plans.

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Published monthly rates

Rate calculated at enrollment

This plan's rates are computed from your date of birth on the enrollment page — it takes about a minute and doesn't require an account. Rates are set by age band and by who you cover.

What you pay for care

Deductible (in-network)$500 / $1,000 family

Out-of-pocket max$7,350 / $14,700 family

Doctor office visit$25

Specialist visit$40

Urgent care$60

Emergency roomDeductible + coinsurance

Telehealth$0 with the plan's telemedicine provider

How reference-based pricing works

This plan has no provider network. Instead of negotiating rates with specific doctors and hospitals, it pays providers a multiple of what Medicare pays for the same service — which is why its premiums typically run lowest among the full-coverage options.

Most providers accept this payment. If one bills you for the difference (called balance billing), the plan administrator, Detego Health, negotiates with the provider on your behalf.

Prescription coverage

Prescriptions run through the Medalist Rx program — see the Medalist document below for tiers and pricing. Specialty medications are not covered.

Worth knowing

No network means providers may balance-bill; the administrator negotiates on your behalf

Network & finding your doctor

PSM of TN · PHCS/MultiPlan wrap

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Where it's available

Available in 39 states. Not yet available in: California, Connecticut, Hawaii, Maryland, Minnesota, New Hampshire, Oregon, Pennsylvania, Vermont, Washington, Wisconsin.

Eligibility & membership

These are group plans for members of the PSM Working Owners association — built for the self-employed, 1099 contractors, freelancers, and gig workers
Enrollment includes a short health questionnaire; significant pre-existing or chronic conditions may not qualify
Membership means a 2-minute health survey each month — and you earn $10/month for completing it
Coverage starts the 1st of the month after enrollment; final rate and fees are confirmed at checkout

Plan documents

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.