Comprehensive Healthcare
Coverage with Our Major Medical Plans
Prioritizing overall well-being is essential. Our Major Medical Plans are crafted to deliver extensive healthcare coverage, ensuring top-notch care without financial stress. These plans offer a wide range of benefits tailored to diverse needs, including comprehensive medical coverage, preventive care services, and flexible options to suit various budgets and requirements.
For Members Only
Benefits of Major Medical Plans
- Comprehensive Coverage: Our plans provide extensive coverage for medical services, including preventive care, chronic condition management, and emergency services, ensuring that all your healthcare needs are met.
- Financial Protection: With significant coverage for medical expenses, our plans protect you from the high costs associated with serious illnesses and injuries, providing peace of mind.
- Access to Specialists: Our network includes a wide range of specialists, ensuring that you receive expert care for specific health concerns. Whether you need a cardiologist, endocrinologist, or another specialist, our plans provide the necessary coverage.
- Flexibility: Our plans are customizable to fit your unique healthcare needs and financial situation, allowing you to choose from various deductibles, co-pays, and additional benefits to tailor the plan to your requirements.
Network
Our Major Medical Plans are available in all 50 states, offering a wide network of healthcare providers. Access to top-tier hospitals, specialists, and primary care physicians ensures you receive the best possible care.
- Nationwide Coverage: Available in all 50 states.
- Extensive Provider Network: Access to top-tier hospitals and specialists.
- Primary Care Physicians: Ensure you receive comprehensive and continuous care.
- Specialist Access: Easy referrals to specialists for specific health needs.
- Quality Care: High standards of care across the network to ensure optimal health outcomes.
Cost Options and Coverage Scenarios
Our Major Medical Plans offer programs that are good for your Wallet and better for your Well-being. We provide easy, simple, and professional options to suit your financial needs for maintaining a balanced Major Medical.
- Higher Deductibles, Lower Premiums: Lower monthly payments, higher out-of-pocket costs.
- Lower Deductibles, Higher Premiums: Minimize out-of-pocket expenses.
- Balanced Options: Moderate deductibles and premiums.
- Customizable Plans: Tailor plans for frequent specialist visits (Ultra 1000), basic coverage needs (Ultra 6000), chronic condition management, and preventive care.
Eligibility Criteria of Major Medical Plan
Open to individuals and families, our Major Medical Plans ensure that comprehensive support for your Major Medical needs is within reach.
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How to Apply
At The Harbor Group, getting the coverage you need is a straightforward process. Follow these simple steps to purchase your Major Medical plan.
Navigate our user-friendly website to explore the variety of plans we offer, choose the category
Complete the quick online form to submit your request for a customised plan quote
Receive expert advice from our agent and get a personalized quote tailored to your needs
Find the ideal fit for your budget with flexible pricing and enrolment options, supported by our agents
After selecting your subscription plan, complete a quick verification process to ensure eligibility
Receive prompt confirmation of your enrollment along with detailed plan information
Detailed Plan Descriptions
Ultra 6000
Ultra 3000
Ultra 1000
- Network: Available in all 50 states.
- Deductibles and Out-of-Pocket Costs: Individual deductible of $6,000, family deductible of $12,000. Individual max out of pocket $9,450, family max out of pocket $18,900.
- Coverage: Preventive care covered 100%, primary care copay $30, specialist care copay $60, urgent care $60, and so on.
- Prescription Drug Benefits: Generic $15, preferred brand $65, non-preferred brand $100.
- Additional details about laboratory, radiology services, emergency room, inpatient, and outpatient services.
- Network: Available in all 50 states.
- Deductibles and Out-of-Pocket Costs: Individual deductible of $3,000, family deductible of $6,000. Individual max out of pocket $9,450, family max out of pocket $18,900.
- Coverage: Preventive care covered 100%, primary care copay $30, specialist care copay $60, urgent care $60, and so on.
- Prescription Drug Benefits: Generic $15, preferred brand $65, non-preferred brand $100.
- Additional details about laboratory, radiology services, emergency room, inpatient, and outpatient services.
- Network: Available in all 50 states.
- Deductibles and Out-of-Pocket Costs: Individual deductible of $1,000 family deductible of $2,000. Individual max out of pocket $5,000, family max out of pocket $10,000.
- Coverage: Preventive care covered 100%, primary care copay $20, specialist care copay $40, urgent care $40, and so on.
- Prescription Drug Benefits: Generic $15, preferred brand $65, non-preferred brand $85.
- Additional details about laboratory, radiology services, emergency room, inpatient, and outpatient services.
Cigna Plans
| Major Medical Plans | Ultra 6000 | Ultra 3000 | Ultra 1000 |
|---|---|---|---|
| Network |  |
|
|
| Plan Availability | All 50 States | All 50 States | All 50 States |
| Benefits | |||
| Individual Deductible | $6,000 | $3,000 | $1,000 |
| Family Deductible | $12,000 | $6,000 | $2,000 |
| Individual Max Out of Pocket | $9,450 | $9,450 | $5,000 |
| Family Max Out of Pocket | $18,900 | $18,900 | $10,000 |
| Coinsurance | 70% | 70% | 80% |
| Preventive Care | Covered 100% | Covered 100% | Covered 100% |
| Lifetime Maximum | No Maximum | No Maximum | No Maximum |
| Primary Care Copay | $30 | $30 | $20 |
| Specialist Care Copay | $60 | $60 | $40 |
| Urgent Care | $60 | $60 | $40 |
| Laboratory | |||
| Diagnostic Test | $30 copay/visit | $30 copay/visit | Deductible then 20% |
| Radiology Services | |||
| Facility (CT, PET, MRI's) up to plan allowance | Facility: 30% of plan allowable, deductible does not apply. Professional Fees :30% after deductible |
Facility: 30% of plan allowable, deductible does not apply. Professional Fees :30% after deductible |
Deductible then 20% |
| Facility & Professional Services | |||
| Emergency Room - Professional Fee | 30% after deductible. Out of network is subject to plan allowable fee. | 30% after deductible. Out of network is subject to plan allowable fee. | Deductible then 20% |
| Emergency Room - Facility | 30% of plan allowable, deductible does not apply. | 30% of plan allowable, deductible does not apply. | Deductible then 20% |
| Inpatient Hospital - Physician Fees | Deductible then 30% | Deductible then 30% | Deductible then 20% |
| Inpatient - Facility | Deductible then 30% | Deductible then 30% | Deductible then 20% |
| Outpatient - Physician | 30% after deductible, subject to plan allowable | 30% after deductible, subject to plan allowable | Deductible then 20% |
| Outpatient Hospital - Facility | 30% of plan allowable, deductible does not apply | 30% of plan allowable, deductible does not apply | Deductible then 20% |
| Out of Network | |||
| Deductible | $12,000/$24,000 | $6,000/$12,000 | $2,000/$4,000 |
| MOOP | $18,900/$37,900 | $18,900/$37,900 | $10,000/$20,000 |
| Coinsurance | 40% | 40% | 60% |
| Reimbursement | Plans Allowable Fee | Plans Allowable Fee | Plans Allowable Fee |
| Prescription Drug Benefit | |||
| Generic | $15 | $15 | $15 |
| Preferred Brand | $65 | $65 | $65 |
| Non-Preferred Brand | $100 | $100 | $85 |
Detailed Plan Descriptions
Ultra 6000
Ultra 3000
Ultra 1000
- Network: Available in all 50 states.
- Deductibles and Out-of-Pocket Costs: Individual deductible of $6,000, family deductible of $12,000. Individual max out of pocket $9,450, family max out of pocket $18,900.
- Coverage: Preventive care covered 100%, primary care copay $30, specialist care copay $60, urgent care $60, and so on.
- Prescription Drug Benefits: Generic $15, preferred brand $65, non-preferred brand $100.
- Additional details about laboratory, radiology services, emergency room, inpatient, and outpatient services.
- Network: Available in all 50 states.
- Deductibles and Out-of-Pocket Costs: Individual deductible of $3,000, family deductible of $6,000. Individual max out of pocket $9,450, family max out of pocket $18,900.
- Coverage: Preventive care covered 100%, primary care copay $30, specialist care copay $60, urgent care $60, and so on.
- Prescription Drug Benefits: Generic $15, preferred brand $65, non-preferred brand $100.
- Additional details about laboratory, radiology services, emergency room, inpatient, and outpatient services.
- Network: Available in all 50 states.
- Deductibles and Out-of-Pocket Costs: Individual deductible of $1,000 family deductible of $2,000. Individual max out of pocket $5,000, family max out of pocket $10,000.
- Coverage: Preventive care covered 100%, primary care copay $20, specialist care copay $40, urgent care $90, and so on.
- Prescription Drug Benefits: Generic $15, preferred brand $65, non-preferred brand $85.
- Additional details about laboratory, radiology services, emergency room, inpatient, and outpatient services.
PHCS Plans
| Major Medical Plans | Ultra 6000 | Ultra 3000 | Ultra 1000 |
|---|---|---|---|
| Network |  |
|
|
| Plan Availability | 49 States (Not available in New Jersey) | 49 States (Not available in New Jersey) | 49 States (Not available in New Jersey) |
| Benefits | |||
| Individual Deductible | $6,000 | $3,000 | $1,000 |
| Family Deductible | $12,000 | $6,000 | $2,000 |
| Individual Max Out of Pocket | $9,450 | $9,450 | $5,000 |
| Family Max Out of Pocket | $18,900 | $18,900 | $10,000 |
| Coinsurance | 70% | 70% | 80% |
| Preventive Care | Covered 100% | Covered 100% | Covered 100% |
| Lifetime Maximum | No Maximum | No Maximum | No Maximum |
| Primary Care Copay | $30 | $30 | $20 |
| Specialist Care Copay | $60 | $60 | $40 |
| Urgent Care | $60 | $60 | $40 |
| Laboratory | |||
| Diagnostic Test | $30 copay/visit | $30 copay/visit | Deductible then 20% |
| Radiology Services | |||
| Facility (CT, PET, MRI's) up to plan allowance | Facility: 30% of plan allowable, deductible does not apply. Professional Fees: 30% after deductible |
Facility: 30% of plan allowable, deductible does not apply. Professional Fees: 30% after deductible |
Deductible then 20% |
| Facility & Professional Services | |||
| Emergency Room - Professional Fee | 30% after deductible. | 30% after deductible. | Deductible then 20% |
| Emergency Room - Facility | 30% of plan allowable, deductible does not apply. | 30% of plan allowable, deductible does not apply. | Deductible then 20% |
| Inpatient Hospital - Physician Fees | Deductible then 30% | Deductible then 30% | Deductible then 20% |
| Inpatient - Facility | 30% of plan allowable, deductible does not apply. | 30% of plan allowable, deductible does not apply. | Deductible then 20% |
| Outpatient - Physician | 30% after deductible, subject to plan allowable | 30% after deductible, subject to plan allowable | Deductible then 20% |
| Outpatient Hospital - Facility | 30% of plan allowable, deductible does not apply | Deductible then 30% | Deductible then 20% |
| Out of Network | |||
| Deductible | $12,000/$24,000 | $6,000/$12,000 | $2,000/$4,000 |
| MOOP | $18,900/$37,900 | $18,900/$37,900 | $10,000/$20,000 |
| Coinsurance | 40% | 40% | 60% |
| Reimbursement | Subject to plan allowable | Subject to plan allowable | Subject to plan allowable |
| Prescription Drug Benefit | |||
| Generic | $15 | $15 | $15 |
| Preferred Brand | $65 | $65 | $65 |
| Non-Preferred Brand | $100 | $100 | $85 |
Detailed Plan Descriptions
Ultra 6000
Ultra 3000
Ultra 1000
- Network: Available in all 50 states.
- Deductibles and Out-of-Pocket Costs: Individual deductible of $6,000, family deductible of $12,000. Individual max out of pocket $9,450, family max out of pocket $18,900.
- Coverage: Preventive care covered 100%, primary care copay $30, specialist care copay $60, urgent care $60, and so on.
- Prescription Drug Benefits: Generic $15, preferred brand $65, non-preferred brand $100.
- Additional details about laboratory, radiology services, emergency room, inpatient, and outpatient services.
- Network: Available in all 50 states.
- Deductibles and Out-of-Pocket Costs: Individual deductible of $3,000, family deductible of $6,000. Individual max out of pocket $9,450, family max out of pocket $18,900.
- Coverage: Preventive care covered 100%, primary care copay $30, specialist care copay $60, urgent care $60, and so on.
- Prescription Drug Benefits: Generic $15, preferred brand $65, non-preferred brand $100.
- Additional details about laboratory, radiology services, emergency room, inpatient, and outpatient services.
- Network: Available in all 50 states.
- Deductibles and Out-of-Pocket Costs: Individual deductible of $1,000 family deductible of $2,000. Individual max out of pocket $5,000, family max out of pocket $10,000.
- Coverage: Preventive care covered 100%, primary care copay $20, specialist care copay $40, urgent care $90, and so on.
- Prescription Drug Benefits: Generic $15, preferred brand $65, non-preferred brand $85.
- Additional details about laboratory, radiology services, emergency room, inpatient, and outpatient services.
Qualcare Plans
| Major Medical Plans | Ultra 6000 | Ultra 3000 | Ultra 1000 |
|---|---|---|---|
| Network |  |
|
|
| Plan Availability | New Jersey Residents Only | New Jersey Residents Only | New Jersey Residents Only |
| Benefits | |||
| Individual Deductible | $6,000 | $3,000 | $1,000 |
| Family Deductible | $12,000 | $6,000 | $2,000 |
| Individual Max Out of Pocket | $9,450 | $9,450 | $5,000 |
| Family Max Out of Pocket | $18,900 | $18,900 | $10,000 |
| Coinsurance | 70% | 70% | 80% |
| Preventive Care | Covered 100% | Covered 100% | Covered 100% |
| Lifetime Maximum | No Maximum | No Maximum | No Maximum |
| Primary Care Copay | $30 | $30 | $20 |
| Specialist Care Copay | $60 | $60 | $40 |
| Urgent Care | $60 | $60 | $90 |
| Laboratory | |||
| Diagnostic Test | $30 copay/visit | $30 copay/visit | Deductible then 20% |
| Radiology Services | |||
| Facility (CT, PET, MRI's) up to plan allowance | Facility: 30% of plan allowable, deductible does not apply. Professional Fees: 30% after deductible |
Facility: 30% of plan allowable, deductible does not apply. Professional Fees: 30% after deductible |
Deductible then 20% |
| Facility & Professional Services | |||
| Emergency Room - Professional Fee | 30% after deductible. Out of network is subject to plan allowable fee. | 30% after deductible. Out of network is subject to plan allowable fee. | Deductible then 20% |
| Emergency Room - Facility | 30% of plan allowable, deductible does not apply. | 30% of plan allowable, deductible does not apply. | Deductible then 20% |
| Inpatient Hospital - Physician Fees | Deductible then 30% | Deductible then 30% | Deductible then 20% |
| Inpatient - Facility | Deductible then 30% | Deductible then 30% | Deductible then 20% |
| Outpatient - Physician | 30% after deductible, subject to plan allowable | 30% after deductible, subject to plan allowable | Deductible then 20% |
| Outpatient Hospital - Facility | 30% of plan allowable, deductible does not apply | 30% of plan allowable, deductible does not apply | Deductible then 20% |
| Out of Network | |||
| Deductible | $12,000/$24,000 | $6,000/$12,000 | $2,000/$4,000 |
| MOOP | $18,900/$37,900 | $18,900/$37,900 | $10,000/$20,000 |
| Coinsurance | 40% | 40% | 60% |
| Reimbursement | Subject to plan allowable | Subject to plan allowable | Subject to plan allowable |
| Prescription Drug Benefit | |||
| Generic | $15 | $15 | $15 |
| Preferred Brand | $65 | $65 | $65 |
| Non-Preferred Brand | $100 | $100 | $85 |
FAQs
What is the difference between the Ultra 6000, Ultra 3000, and Ultra 1000 plans?
The main differences are the deductibles, out-of-pocket costs, and premiums. Ultra 1000 offers the most comprehensive coverage with lower deductibles, while Ultra 6000 has higher deductibles but lower premiums. Ultra 3000 provides a balanced option.
Are preventive services covered?
Yes, all our plans cover preventive care services at 100%. This includes routine check-ups, vaccinations, and screenings, ensuring early detection and management of potential health issues.
Can I customize my plan?
Yes, our plans offer customizable options to fit your specific healthcare needs and financial situation. You can choose from various levels of deductibles, co-pays, and additional benefits to tailor the plan to your requirements.
What types of chronic conditions are covered?
Our plans cover a wide range of chronic conditions, including diabetes, hypertension, heart disease, and more. We provide comprehensive management, including specialist visits, medication, and regular monitoring.
Is family coverage available?
Yes, our plans are designed to cover not just individuals but also families, providing comprehensive health benefits for your loved ones. Family coverage includes spouse and children, ensuring that all family members are protected.
How can I access the network of providers?
Our plans provide access to a wide network of healthcare providers, including top-tier hospitals, specialists, and primary care physicians across all 50 states. You can easily find and choose providers within the network for quality care.
How do I enroll in a plan?
Enrolling in a plan is simple. You can contact our team for guidance, visit our website for more information, or schedule a consultation to discuss the best options for you and your family. We are here to assist you every step of the way.
What happens in case of an emergency?
All our plans cover emergency services, including ambulance transportation, emergency room visits, and urgent care. This ensures that you receive the necessary care without worrying about the cost during emergencies.
Let's get started with Major Medical plans
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