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Point-of-Service (POS) — Groups 51+

AmeriHealth Forms Online — New Jersey

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Option Copay Integrated Rx
POS $15/$30 $0 Day $15  
POS $15/$30 $200 Day $15  
POS $20/$40 $0 Day $20  
POS $20/$40 $300 Day $20  
POS $30/$50 $0 Day $30  
POS $30/$50 $400 Day $30  
POS Coinsurance $20/$40/90% $20  
POS Coinsurance $30/$50/70% $30  
POS Coinsurance $30/$50/80% $30