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All Plans · Plan Year 2026–2027

MEC, Dental & Vision Benefit Guide

Everything you need to understand, access, and get the most out of your Indie Healthcare coverage — medical, dental, vision, and the extras that come with it.

ACA Compliant · Minimum Essential Coverage

KeyCare MEC

Medical benefits

Wellness and PreventiveCovered at 100%
Primary Care Visits$25 Copay

Rx benefits

Tier 1
$15
Tier 2
$30
Tier 3
$50
Tier 4
$75

Look up your medication in the full drug formulary →

Virtual health benefits

Telemedicine$0 copay
Virtual Behavioral Health$0 copay

Recuro Health's Virtual Urgent Care & Behavioral Health give you 24/7 access to board-certified doctors and licensed counselors. Access via the HealthWallet app or call 1-855-6RECURO.

MEC companion discount card

DentalIncluded
VisionIncluded
Durable Medical EquipmentIncluded
Diabetic SuppliesIncluded
FitnessIncluded
X-RaysIncluded

See how to register your discount card →

Access your plan

The HealthWallet mobile app puts your coverage in the palm of your hand.

  1. Search "The HealthWallet" in your app store and download the app
  2. Log in with your social security number and date of birth
  3. Access your ID card(s), benefit information, and ancillary vendor services

Provider lookup

  1. Visit multiplan.com/sbmaspecificservices
  2. Enter provider type — Primary Care, OB-GYN, Lab, etc.
  3. Enter your zip code, search, and your directory will be provided

Present your medical card with your prescription at any of our 60,000+ retail pharmacies (PureRx). Additional information is on your medical ID card.

ACA Compliant · Minimum Essential Coverage

VitalCare MEC

Medical benefits

Wellness and PreventiveCovered at 100%
Primary Care Visits$25 Copay
Specialist Visits$25 Copay
Urgent Care Visits$50 Copay
Laboratory Services$50 Copay
X-Rays$50 Copay

Rx benefits

Tier 1
$15
Tier 2
$30
Tier 3
$50
Tier 4
$75

Look up your medication in the full drug formulary →

Virtual health benefits

Telemedicine$0 copay
Virtual Behavioral Health$0 copay

Recuro Health's Virtual Urgent Care & Behavioral Health give you 24/7 access to board-certified doctors and licensed counselors. Access via the HealthWallet app or call 1-855-6RECURO.

MEC companion discount card

DentalIncluded
VisionIncluded
Durable Medical EquipmentIncluded
Diabetic SuppliesIncluded
FitnessIncluded
X-RaysIncluded

See how to register your discount card →

Access your plan

The HealthWallet mobile app puts your coverage in the palm of your hand.

  1. Search "The HealthWallet" in your app store and download the app
  2. Log in with your social security number and date of birth
  3. Access your ID card(s), benefit information, and ancillary vendor services

Provider lookup

  1. Visit multiplan.com/sbmaspecificservices
  2. Enter provider type — Primary Care, OB-GYN, Lab, etc.
  3. Enter your zip code, search, and your directory will be provided

Present your medical card with your prescription at any of our 60,000+ retail pharmacies (PureRx). Additional information is on your medical ID card.

Wellness & Preventive Services

A full list of preventive benefits covered at no cost under your plan — for adults, women, and children. For the most up-to-date list, visit healthcare.gov/coverage/preventive-care-benefits.

For adults

  • Abdominal Aortic Aneurysm one-time screening for men who have ever smoked
  • Alcohol misuse screening and counseling
  • Aspirin use for cardiovascular & colorectal risk, ages 50–59
  • Blood pressure screening
  • Cholesterol screening for adults at higher risk
  • Colorectal cancer screening, ages 45–75
  • Depression screening
  • Diabetes (Type 2) screening for overweight adults 40–70
  • Diet counseling for adults at higher risk
  • Falls prevention for adults 65+ in community settings
  • Hepatitis B & C screening for higher-risk adults
  • HIV screening, ages 15–65 and other higher-risk ages
  • PrEP HIV prevention medication for high-risk adults
  • Immunizations for adults (varicella, flu, HPV, shingles, etc.)
  • Lung cancer screening for high-risk adults 55–80
  • Obesity screening and counseling
  • STI prevention counseling for higher-risk adults
  • Statin preventive medication, ages 40–75 at high risk
  • Syphilis & tobacco use screening for all adults
  • Tuberculosis screening for certain higher-risk adults

For women

  • Bone density screening for women 65+ or postmenopausal
  • BRCA genetic test counseling for higher-risk women
  • Mammography screening every 2 years, 50+ (or as advised 40–49)
  • Breast cancer chemoprevention counseling
  • Breastfeeding support, counseling & supplies
  • FDA-approved birth control & sterilization procedures
  • Cervical cancer (Pap) screening, ages 21–65
  • Chlamydia screening for higher-risk women
  • Diabetes screening after gestational diabetes
  • Domestic & interpersonal violence screening
  • Folic acid supplements for women who may become pregnant
  • Gestational diabetes screening, 24+ weeks pregnant
  • Gonorrhea & Hepatitis B screening for pregnant women
  • Maternal depression screening at well-baby visits
  • Preeclampsia prevention & screening
  • Rh incompatibility screening for pregnant women
  • STI counseling for sexually active women
  • Tobacco intervention for pregnant tobacco users
  • Urinary incontinence & UTI screening
  • Well-woman visits

For children

  • Alcohol, tobacco & drug use assessments for adolescents
  • Autism screening at 18 & 24 months
  • Behavioral assessments, ages 0–17
  • Bilirubin & blood screening for newborns
  • Blood pressure screening, ages 0–17
  • Depression screening from age 12
  • Developmental screening under age 3
  • Dyslipidemia screening for higher-risk children
  • Fluoride supplements & varnish
  • Gonorrhea preventive medication for newborns
  • Hearing & vision screening for all children
  • Height, weight & BMI tracking
  • Hemoglobinopathies / sickle cell screening for newborns
  • Hepatitis B & HIV screening for higher-risk adolescents
  • PrEP for high-risk HIV-negative adolescents
  • Immunizations from birth to age 18
  • Lead screening for at-risk children
  • Obesity screening and counseling
  • Oral health risk assessment, 6 months–6 years
  • PKU screening for newborns
  • STI prevention counseling for higher-risk adolescents
  • Tuberculin testing for higher-risk children
  • Well-baby & well-child visits

Exclusions & Plan Info

These exclusions and limitations apply only to the MEC plans and are standard with plans found on the Marketplace. This list isn't intended to be complete — additional exclusions or limitations may apply. Only services listed under the summary of benefits are covered; an omission from this list does not imply a service is covered. Members and providers should confirm coverage before services are rendered.

Exclusions

  • Abortion
  • Acupuncture / spinal manipulation & chiropractic care
  • Allergy testing
  • Biofeedback
  • Biopsies
  • Cardiovascular studies
  • Chemical dependency treatment
  • Chemotherapy / radiation
  • Childbirth & delivery facility / professional services
  • Cochlear implants
  • Cosmetic surgery
  • Dental care
  • Diabetic supplies including insulin injectors and pumps
  • Diagnostic colonoscopies
  • Diagnostic imaging incl. CT / PET scans, MRIs & ultrasounds
  • Diagnostic mammograms (preventive covered)
  • Dialysis
  • Drug testing
  • Durable medical equipment (boots, canes, crutches, splints, prosthetics, orthotics, hospital beds, oxygen equipment, sleep apnea machines, walkers, wheelchairs, scooters)
  • Electrocardiogram / electrocardiography
  • Emergency room care & transportation incl. ambulance
  • Endoscopies
  • Experimental drugs, procedures or studies incl. sleep studies
  • Eye care
  • Foot care
  • Genetic testing incl. breast cancer (BRCA)
  • Habilitation services
  • Hearing aids
  • Home health care incl. hospice, private duty nursing, skilled nursing, long-term care
  • Hospitalization incl. facility & physician/surgeon fees
  • Infertility treatment
  • Mental health / behavioral health services
  • Naturopathic services
  • Nutritional supplies, vitamins or supplements
  • Observation stays
  • Occupational / physical therapy incl. speech therapy
  • Out-of-network services incl. care outside the United States
  • Outpatient laboratory services in hospital setting
  • Pathology
  • Rehabilitation services incl. substance abuse & physical therapy
  • Services for sexual dysfunction incl. drugs, supplies & therapy
  • Sex change services incl. drugs, supplies, therapy & surgical procedures
  • Sleep studies
  • Specialty prescription drugs
  • Strength and performance services incl. devices & drugs
  • Stress tests
  • Supplementation (IV therapy)
  • Surgical procedures incl. transplants, outpatient surgery, facility fees, physician/surgeon fees & anesthesia
  • TMJ and orthognathic services
  • Weight loss drugs, procedures (incl. gastric bypass & lap banding), programs & supplies

Limitations

  • Birth control implants incl. IUD insertion/removal — limit 1 per plan year unless medically necessary
  • Breast cancer genetic testing (BRCA) — counseling only, no testing
  • COVID-19 testing limited to FFCRA / CDC guidelines or medical necessity, outpatient settings only
  • Prescription drugs limited to formulary — visit sbmabenefits.com/purerx/standard for the full list
  • Preventive breast cancer mammography screening — limit 1 per plan year
  • Routine preventive/wellness visits (men, women, children) — limit 1 per plan year

Delta Dental PPO

Dental

Indie Healthcare offers two Delta Dental PPO tiers — Preventive and Comprehensive. Both use the same nationwide network and Carryover Max℠ benefit; Comprehensive adds coverage for basic and major services.

Preventive Dental

BenefitIn NetworkOut of Network
Preventive & Diagnostic — exams, cleanings, bitewing & full mouth X-rays, fluoride treatments, space maintainers100%100%
Basic — fillings, extractions, oral surgery, periodontics, root canals, sealants——
Major — crowns, gold restorations, bridgework, dentures, implants——
Annual Maximum (per person)
$1,000
Annual Deductible
None

Comprehensive Dental

BenefitIn NetworkOut of Network
Preventive & Diagnostic — exams, cleanings, bitewing & full mouth X-rays, fluoride treatments, space maintainers100%100%
Basic — fillings, extractions, oral surgery, periodontics, root canals, sealants80%50%
Major — crowns, gold restorations, bridgework, dentures, implants50%50%
Annual Maximum (per person)
$1,500
Annual Deductible — Per Person
$50 in-network
$100 out of network
Annual Deductible — Family Max
$150 in-network
$300 out of network

Dental provider lookup

  1. Visit deltadental.com/us/en/member/find-a-dentist.html
  2. Specialty: choose one, or choose any · Plan: Delta Dental PPO
  3. Search by current location, or enter your zip code, and find dentists

Plan notes

Carryover Max℠ from Delta Dental lets you carry over a portion of your unused annual maximum into future years — useful for bigger procedures like bridges, crowns, and root canals.

VSP · Powered by Delta Vision

Vision

Exam / lens / frame frequency: 12 / 12 / 24 months · Contacts in lieu of glasses: every 12 months.

In-network coverage

Eye Exam Copay$10
Materials Copay$25
Frame Allowance$130 ($70 Walmart / Sam's Club / Costco)
Elective Contact Lens Allowance$130
Necessary Contact LensesCovered in full after copay
Contact Lens Fit/Evaluation Copay$60
Frames + Contacts Same YearNo — contacts in lieu of frames

Out-of-network coverage (reimbursement up to)

Examination, up to$45
Single Vision Lenses, up to$30
Bifocal Lenses, up to$50
Trifocal Lenses, up to$65
Progressive Lenses, up to$50
Lenticular Lenses, up to$100
Frames, up to$70
Elective Contact Lenses, up to$105
Necessary Contact Lenses, up to$210

Lens enhancements (member cost)

Anti-Glare Coating$41 single / $41 multifocal
Impact-Resistant Lenses (Adult)$31 single / $35 multifocal (covered for children)
Progressive LensesStandard progressives covered
Light-Reactive Lenses$75 single / $75 multifocal
Scratch Resistant Coating$17 single / $17 multifocal

Prices shown reflect the standard plastic price for each category. Premium lens enhancement prices may vary, are valid only through the VSP Choice Network, and are subject to change without notice.

Vision provider lookup

  1. Visit vsp.com/eye-doctor
  2. Search by location, office name, or doctor name

MEC Companion Discount Card

This is not insurance — it's a discount medical program that stacks with your MEC plan for everyday savings.

How to register

  1. Visit WellCardSavings.com
  2. Click "Click Here to Register"
  3. Enter Group ID: MECPLUS
  4. Fill out your information
  5. Save, text, or email your card, or print it to use at participating providers
1

Dental

Accepted at over 80,000 provider locations nationwide, covering all dental services and specialties, including orthodontia. Savings up to 50%, no limit on services or use.

2

Vision

Accepted by over 11,000 Outlook vision providers. Cardholders receive up to 50% savings on lenses, frames, and other vision needs.

3

Hearing Aids

Members receive a free hearing test and up to 70% discount on hearing aids at 2,200 providers nationwide.

4

Lab Services

Save up to 50% using the online search tool to locate a lab and order tests. Results available within 48–96 hours.

5

MRI & Imaging

Concierge appointment service with savings up to 75%+ on MRI, PET, and CT scans at over 4,000 locations nationwide.

6

Vitamins

A wide range of vitamin and mineral supplements delivered directly to the member's home at discounted rates.

7

Diabetic Supplies

A full line of diabetes testing supplies delivered directly to the member's home, and more.

This is NOT insurance. It is a discount medical program. It does not replace COBRA or any other medical insurance program, nor is it a Medicare Part D prescription drug plan. Cardholders are responsible for paying the discounted cost at time of service from participating providers. WellCard Savings will not share or sell your personal information. The discount plan organization is Access One Consumer Health, Inc., 84 Villa Road, Greenville, SC 29615. Not available to residents of Montana, though it may be used at participating Montana providers. Other state residents: visit WellCardSavings.com for full disclosure.

Questions about this benefit? An Indie Healthcare benefits specialist can walk you through it — no phone tree.