What's included in Benefi coverage
Virtual care, $0 generics, mental health, preventive, and more.
Benefi MEC plans provide healthcare coverage designed for hourly workforces. Here's what your employees get with each plan tier, from virtual doctor visits to preventive care.
Essential Plan ($59/month per employee)
The Essential tier covers the fundamentals of day-to-day healthcare:
Virtual Primary Care — Members connect with U.S.-based doctors 24/7 through text, phone, or video in the Benefi app. No appointment needed, no copays. Doctors can diagnose common conditions, prescribe medications, and provide care guidance.
$0 Generic Prescriptions — Over 500 common generic medications cost nothing at the pharmacy. The formulary includes treatments for diabetes, high blood pressure, infections, and other chronic conditions. Members show their Benefi card at any participating pharmacy nationwide.
Mental Health Therapy — Six therapy sessions per year at no cost. Members schedule appointments with licensed therapists, counselors, or psychologists through the app. First sessions run about 45 minutes.
Preventive Care — Annual physicals, immunizations, and screenings are covered 100% when members visit in-network providers through the First Health network.
Plus Plan ($129/month per employee)
The Plus tier includes everything in Essential, plus expanded coverage:
Additional Plus benefits
- 1,000+ generic medications at $0 (double the Essential formulary)
- 10 mental health sessions per year (instead of 6)
- 5 primary care visits per year with in-person doctors (copay applies)
- 1 specialist visit per year (copay applies)
- 2 urgent care visits per year (copay applies)
What's not covered
MEC plans provide essential coverage, not comprehensive insurance. Neither tier covers hospitalization, surgery, emergency room visits, or specialty treatments like cancer care. Members pay cash price or use other coverage for services outside the plan scope.
How members access care
Members download the Benefi app after enrollment. Virtual care starts immediately. For mental health appointments or in-person visits, members schedule through the app. The member ID card works at pharmacies nationwide for $0 prescriptions on the formulary.
Both plans help employers meet ACA requirements while keeping coverage affordable for variable-hour workforces. The mix of virtual and in-person options means members can get care when and how they need it.
Frequently Asked Questions
Can I see any doctor for the in-person visits on the Plus plan?
In-person visits must be with providers in the First Health network. You can search for participating doctors through the Benefi app or website. Going out-of-network means you'll pay the full cash price rather than just the copay amount.
What happens if I need a prescription that's not on the $0 formulary?
You'll pay the regular pharmacy price for medications not covered by the Benefi formulary. The Essential plan covers 500+ generics at $0, while Plus covers 1,000+ generics. Your Benefi doctor can often suggest covered alternatives that treat the same condition.
Are my family members covered under these plans?
Benefi plans can include spouse and dependent coverage, but family members aren't automatically included in the employee rate. Dependent pricing varies by employer and is shared during the enrollment process. Each covered family member gets the same benefits as the employee.
How quickly can I start using Virtual Primary Care after enrolling?
Virtual Primary Care is available immediately after you complete enrollment and download the Benefi app. You can text, call, or video chat with doctors 24/7 without waiting for approval or activation periods. Other services like mental health therapy require scheduling appointments through the app.
What's the difference between urgent care visits and Virtual Primary Care?
Virtual Primary Care connects you with doctors through the app for common conditions and is unlimited on both plans. Urgent care visits are in-person appointments at urgent care facilities, limited to 2 visits per year on the Plus plan with copays. Virtual care handles most non-emergency needs without visit limits.