Individual HMO and PPO Plans
Your Choice for Quality Coverage and Care.
Only Memorial Hermann Health Plan can offer coverage backed by Memorial Hermann, a
trusted name in health for more than 100 years. By combining care delivery, physicians and
health coverage, Memorial Hermann has built Houston’s first and only truly integrated health
system designed to deliver care that’s safer, smarter and more cost-effective.
Designed with Individuals and Families in Mind.
Individual and Family HMO and PPO coverage options from Memorial Hermann Health Plan
give you access to high-quality Memorial Hermann physicians and facilities at a price you can
afford. Plus, our plans offer something no other insurance provider can: a unique relationship
with Memorial Hermann, one of the largest and most respected health systems in the nation.
Our Freedom HMO Has You Covered.
Our HMO plans deliver significant savings while providing comprehensive, quality care by
Memorial Hermann providers and facilities. Memorial Hermann Health Plan HMO options are also
open access, which means you are not required to designate a PCP and no referrals are needed to
see specialists. Additionally, all Memorial Hermann hospital locations are in our network, along with
numerous Memorial Hermann Convenient Care Clinics, HEB RediClinics and Walgreens Take Care
Clinics located in and around the Greater Houston area.
To learn more about how Memorial Hermann Health Plan is
transforming health coverage and advancing care in our community,
visit healthplan.memorialhermann.org or call 866.471.5294 today.
Individual HMO and PPO Plans
Exclusions and Limitations:
The following Services, supplies and treatment for services that are not covered under this Certificate of Coverage and complications from services, supplies and treatment for
services that are not covered under this Certificate of Coverage. MHHIC will not pay for any charges incurred for or in connection with:
•Care or treatment by means of acupuncture except
when used as a substitute for other forms of
anesthesia.
•The amount of any charge which is greater than the
Allowed Charge.
•Services for Ambulance for transportation from a
Hospital or other health care Facility, unless the
Covered Person is being transferred to another
Inpatient health care Facility.
•Blood or blood plasma which is replaced by or for a
Covered Person.
•Services or supplies for which the Provider has
not obtained a certificate of need or such other
approvals as required by law.
•Care and or treatment by a Christian Science
Practitioner.
•Completion of claim forms.
•Services or supplies related to Cosmetic Surgery
except as otherwise stated in this Certificate of
Coverage; complications of Cosmetic Surgery;
drugs prescribed for cosmetic purposes.
•Services related to custodial or
domiciliary care.
•Dental care or treatment, including appliances
and dental implants, except as otherwise stated
in this Certificate of Coverage.
•Care or treatment by means of dose intensive
chemotherapy, except as otherwise stated in this
Certificate of Coverage.
•Services or supplies, the primary purpose of which
is educational, providing the Covered Person with
any of the following: training in the activities of
daily living; instruction in scholastic skills such as
reading and writing; preparation for an occupation;
or treatment for behavior problems or learning
disabilities except as otherwise stated in this
Certificate of Coverage.
•Experimental or Investigational treatments,
procedures, hospitalizations, drugs, biological
products or medical devices, except as otherwise
stated in this Certificate of Coverage.
•Extraction of teeth, except as otherwise stated in
this Certificate of Coverage.
•Services or supplies for or in connection with:
oExcept as otherwise stated in this Certificate of
Coverage for Covered Persons through the end
of the month in which he or she turns age 19,
exams to determine the need for (or changes of)
eyeglasses or lenses of any type;
oExcept as otherwise stated in this Certificate of
Coverage for Covered Persons through the end
of the month in which he or she turns age 19,
eyeglasses or lenses of any type; this exclusion
does not apply to initial replacements for loss of
the natural lens; or
oEye Surgery such as radial keratotomy or
Lasik Surgery, when the primary purpose is to
correct myopia (nearsightedness), hyperopia
(farsightedness) or astigmatism (blurring).
•Services or supplies provided by one of the
following members of Your family: spouse, child,
parent, in- law, brother, sister or grandparent.
•Services or supplies furnished in connection with
any procedures to enhance fertility which involve
harvesting, storage and/or manipulation of eggs
and sperm. This includes, but is not limited to the
following: a) procedures: embryo transfer; embryo
freezing; and Gamete Intra-fallopian Transfer (GIFT)
and Zygote Intra-fallopian Transfer (ZIFT); donor
sperm, surrogate motherhood; b) Prescription
Drugs not eligible under the Prescription Drugs
section of the Certificate of Coverage ; and c)
ovulation predictor kits. See also the separate
Exclusion addressing sterilization reversal.
•Except as stated in the Newborn Hearing
Screening and Hearing Aids provisions, Services or
supplies related to hearing aids and hearing exams
to determine the need for hearing aids or the need
to adjust them.
•Services or supplies related to herbal medicine.
•Services or supplies related to hypnotism.
•Services or supplies necessary because the
Covered Person engaged, or tried to engage, in an
illegal occupation or committed or tried to commit
an indictable offense in the jurisdiction in which it is
committed, or a felony.
•Except as stated below, Illness or Injury, including
a condition which is the result of disease or bodily
infirmity, which occurred on the job and which is
covered or could have been covered for benefits
provided under workers’ compensation, employer’s
liability, occupational disease or similar law.
•Exception: This exclusion does not apply to
the following persons for whom coverage
under workers’ compensation is optional unless
such persons are actually covered for workers’
compensation: a self-employed person or a
partner of a limited liability partnership, members
of a limited liability company or partners of a
partnership who actively perform services on
behalf of the self-employed business, the limited
liability partnership, limited liability company or
the partnership.
•Local anesthesia charges billed separately
if such charges are included in the fee for
the Surgery.
•Membership costs for health clubs, weight loss
clinics and similar programs.
•Services and supplies related to marriage, career or
financial counseling, sex therapy or family therapy,
nutritional counseling and related services, except
as otherwise stated in this Certificate of Coverage.
•Charges for missed appointments.
•Nicotine dependence treatments and
management drugs unless otherwise stated in
the Preventive Care section of this Certificate of
Coverage.
•Any charge identified as a Non-Covered Charge or
which are specifically limited or excluded elsewhere
in this Certificate of Coverage, or which are not
Medically Necessary and Appropriate, except as
otherwise stated in this Certificate of Coverage.
•Non-Prescription Drugs or supplies, except:
oInsulin needles and syringes and glucose test
strips and lancets;
oColostomy bags, belts and irrigators; and
oAs stated in this Certificate of Coverage for
food and food products for Inherited Metabolic
Diseases.
•Services provided by a pastoral counselor in the
course of his or her normal duties as a religious
person.
•Personal convenience or comfort items including,
but not limited to, such items as TVs, telephones,
first aid kits, exercise equipment, air conditioners,
humidifiers, saunas, hot tubs.
•The following exclusions apply specifically to
Outpatient coverage of Prescription Drugs.
oCharges to administer a Prescription Drug.
oCharges for:
•Immunization agents,
•[Allergens and allergy serums]
•Biological sera, blood or blood plasma, unless
they can be self-administered
oCharges for a Prescription Drug which is:
labeled “Caution — limited by Federal Law to
Investigational use”; or Experimental.
oCharges for refills in excess of that specified by
the prescribing Practitioner, or refilled too soon,
or in excess of therapeutic limits.
oCharges for refills dispensed after one year from
the original date of the prescription.
oCharges for Prescription Drugs as a replacement
for a previously dispensed Prescription Drug that
was lost, misused, stolen, broken or destroyed.
oCharges for drugs, except insulin, which can
be obtained legally without a Practitioner’s
prescription.
oCharges for a Prescription Drug which is to be
taken by or given to the Covered Person, in
whole or in part, while confined in:
–A Hospital
–A rest home
–A sanitarium
–An Extended Care Facility
–A Hospice
–A Substance Abuse Center
–An alcohol abuse or Mental Health Center
–A convalescent home
–A nursing home or similar institution
–A Provider’s office
oCharges for:
–Therapeutic devices or appliances
–Hypodermic needles or syringes, except
insulin syringes
–Support garments
–Other non-medical substances, regardless of
their intended use
oCharges for vitamins, except Legend Drug
vitamins.
oCharges for drugs for the management of
nicotine dependence.
oCharges for topical dental fluorides.
oCharges for any drug used in connection
with baldness.
oCharges for drugs needed due to conditions
caused, directly or indirectly, by a Covered
Person taking part in a riot or other civil disorder.
oCovered Person taking part in the commission of
a felony.
oCharges for drugs needed due to conditions
caused, directly or indirectly, by declared or
undeclared war or an act of war.
oCharges for drugs dispensed to a Covered
Person while on active duty in any armed force.
oCharges for drugs for which there is no charge.
This usually means drugs furnished by the
Covered Person’s employer, labor union or
similar group in its medical department or
clinic; a Hospital or clinic owned or run by any
government body; or any public program,
except Medicaid, paid for or sponsored by any
government body. But if a charge is made, and
We are legally required to pay it, We will.
oCharges for drugs covered under Home Health
Care or Hospice Care section of the Certificate
of Coverage.
oExcept as stated below, charges for drugs
needed due to an on-the-job or job-related Injury
or Illness; or conditions for which benefits are
payable by Workers’ Compensation, or similar
laws. Exception: this exclusion does not apply
to the following persons for whom coverage
under workers’ compensation is optional unless
such persons are actually covered for workers’
compensation: a self-employed person or a
partner of a limited liability partnership, members
of a limited liability company or partners of a
partnership who actively perform services on
behalf of the self-employed business, the limited
liability partnership, limited liability company or
the partnership.
oCompounded drugs that do not contain at least
one ingredient that requires a Prescription Order.
oPrescription Drugs or new dosage forms that
are used in conjunction with a treatment or
procedure that is determined not to be a
Covered Service.
oDrugs when used for cosmetic purposes. This
exclusion is not applicable to Covered Persons
with a medically diagnosed congenital defect
or birth abnormality who have been covered
under the Certificate of Coverage from the
moment of birth.
oDrugs used solely for the purpose of
weight loss.
oLife Enhancement Drugs for the treatment of
sexual dysfunction, (e.g. Viagra).
oPrescription Drugs dispensed outside of the
United States, except as required for Emergency
treatment.
•Services or supplies that are not furnished by an
eligible Provider.
•Services related to Private Duty Nursing care,
except as provided under the Home Health Care
section of this Certificate of Coverage.
•Services or supplies related to rest or convalescent
cures.
•Room and board charges for a Covered Person in
any Facility for any period of time during which he
or she was not physically present overnight in the
Facility.
•Except as stated in the Preventive Care section,
Routine examinations or Preventive Care, including
related x-rays and laboratory tests, except where a
specific Illness or Injury is revealed or where definite
symptomatic condition is present; premarital
or similar examinations or tests not required to
diagnose or treat Illness or Injury.
•Services or supplies related to Routine Foot
Care except:
oAn open cutting operation to treat weak,
strained, flat, unstable or unbalanced feet,
metatarsalgia or bunions;
oThe removal of nail roots; and
oTreatment or removal of corns, calluses or
toenails in conjunction with the treatment of
metabolic or peripheral vascular disease.
•Self-administered services such as: biofeedback,
patient-controlled analgesia on an Outpatient
basis, related diagnostic testing, self-care and self-
All HMO products are underwritten by Memorial Hermann Health Plan, Inc. All PPO
products are underwritten by Memorial Hermann Health Insurance Company.
Memorial Hermann Health Plan complies with applicable Federal civil rights laws and
does not discriminate on the basis of race, color, national origin, age, disability or sex.
ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia
lingüística. Llame al 888.594.0671 (TTY 711).
CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho
bạn. Gọi số 888.594.0671 (TTY 711).
Form # 10002COV(10/16)
Copyright © 2016 Memorial Hermann. All rights reserved.
help training.
•Services provided by a social worker, except as
otherwise stated in this Certificate of Coverage.
•Services or supplies:
oEligible for payment under either federal or state
programs (except Medicaid and Medicare). This
provision applies whether or not the Covered
Person asserts his or her rights to obtain this
coverage or payment for these services.
oFor which a charge is not usually made, such as
a Practitioner treating a professional or business
associate, or services at a public health fair.
oFor which a Covered Person would not have
been charged if he or she did not have health
care coverage.
oFor which the Covered Person has no legal
obligation to reimburse the Provider.
oProvided by or in a Government Hospital except
as stated below, or unless the services are for
treatment:
–Of a non-service Emergency; or
–By a Veterans’ Administration Hospital of a
non-service related Illness or Injury;
Exception: this exclusion does not apply to military
retirees, their Dependents and the Dependents of
active duty military personnel who are covered under
both this Certificate of Coverage and under military
health coverage and who receive care in facilities of
the Uniformed Services.
•Provided outside the United States other than in
the case of Emergency and except as provided
below with respect to a full-time student.
Subject to Our Pre-Approval, eligibility for full-time
student status, provided the Covered Person is either
enrolled and attending an Accredited School in a
foreign country; or is participating in an academic
program in a foreign country, for which the institution
of higher learning at which the student matriculates in
the United States, grants academic credit. Charges in
connection with full-time students in a foreign country
for which eligibility as a full-time student has not been
Pre-Approved by Us are Non-Covered Charges.
Travel to obtain medical treatment, drugs or supplies
is not covered. In addition, We will not cover
treatment, drugs or supplies that are unavailable or
illegal in the United States.
•Stand-by services required by a Provider.
•Sterilization reversal - services and supplies
rendered for reversal of sterilization.
•Charges for third party requests for physical
examinations, Diagnostic Services and
immunizations in connection with: obtaining
or continuing employment; obtaining or
maintaining a license issued by a municipality,
state or federal government; obtaining benefits
coverage; foreign travel; school admissions; or
attendance including examinations required for
participation in athletic activities.
•Transplants, except as otherwise listed in this
Certificate of Coverage.
•Transportation, travel.
•Vision therapy.
•Vitamins and dietary supplements.
•Services or supplies received as a result of a war, or
an act of war, if the Illness or Injury occurs while the
Covered Person is serving in the military, naval or
air forces of any country, combination of countries
or international organization and Illness or Injury
suffered as a result of special hazards incident to
such service if the Illness or Injury occurs while the
Covered Person is serving in such forces and is
outside the home area.
•Weight reduction or control including surgical
procedures, medical treatments, weight control/
loss programs, dietary regimens and supplements,
food or food supplements, appetite suppressants or
other medications; exercise programs, exercise or
other equipment; and other services and supplies
that are primarily intended to control weight or treat
obesity, including morbid obesity, or for the purpose
of weight reduction, regardless of the existence of
comorbid conditions, except as otherwise provided
in the Surgical Treatment of Morbid Obesity section
of this Certificate of Coverage .
•Wigs, toupees, hair transplants, hair weaving or
any drug if such drug is used in connection with
baldness with the exception of hair loss following
chemotherapy/radiotherapy or for Syphilitic
alopecia up to 1 per lifetime or maximum dollar
amount of $350.
Individual HMO and PPO
2017 Plan Overview
Individual HMO and PPO Plans
Individual HMO and PPO Plans
GOLD
from Memorial Hermann Health Plan
GOLD
Gold 001 HMO
In-Network Deductible
Family Deductible
$0
$0
Gold 1000 HMO
$1,000
$2,000
SILVER
Gold 2500 HMO
$2,500
$5,000
Silver 4500 PPO
$4,500
$9,000
Silver 2850 HSA PPO
$2,850
$5,700
BRONZE
Silver 4500 HMO
$4,500
$9,000
Bronze 6550 HSA HMO
$6,550
$13,100
Bronze 6850 HMO
$6,850
$13,700
Out-of-Pocket Maximum (individual)
$7,150
$3,000
$3,000
$7,150
$6,550
$7,150
$6,550
$7,150
Out-of-Pocket Maximum (family)
$14,300
$6,000
$6,000
$14,300
$13,100
$14,300
$13,100
$14,300
Member Coinsurance
PCP
Specialist
Telemedicine/Telehealth
0%
$50
$100
No charge
20%
20% coinsurance
after deductible
20% coinsurance
after deductible
No charge
0%
$30
$50
No charge
30%
$30
$75
No charge
15%
15% coinsurance
after deductible
15% coinsurance
after deductible
$40 applies to deductible
30%
$30
$75
No charge
0%
No charge after deductible
No charge after deductible
$40 applies to deductible
50%
50% coinsurance
after deductible
50% coinsurance
after deductible
No charge
SILVER
BRONZE
Age
Gold
001 HMO
Gold
1000 HMO
Gold
2500 HMO
Silver
4500 PPO
Silver
2850 HSA PPO
Silver
4500 HMO
Bronze
6550 HSA HMO
Bronze
6850 HMO
0-20
$294.15
$277.82
$264.28
$268.23
$260.57
$213.18
$173.41
$162.22
21
$463.24
$437.52
$416.20
$422.42
$410.36
$335.72
$273.10
$255.48
22
$463.24
$437.52
$416.20
$422.42
$410.36
$335.72
$273.10
$255.48
23
$463.24
$437.52
$416.20
$422.42
$410.36
$335.72
$273.10
$255.48
24
$463.24
$437.52
$416.20
$422.42
$410.36
$335.72
$273.10
$255.48
25
$465.08
$439.26
$417.85
$424.10
$411.99
$337.05
$274.18
$256.49
26
$474.35
$448.01
$426.18
$432.55
$420.20
$343.77
$279.64
$261.60
27
$485.47
$458.51
$436.17
$442.69
$430.05
$351.82
$286.20
$267.73
28
$503.53
$475.57
$452.40
$459.16
$446.05
$364.92
$296.85
$277.70
29
$518.35
$489.57
$465.72
$472.68
$459.18
$375.66
$305.59
$285.87
30
$525.77
$496.57
$472.38
$479.44
$465.75
$381.03
$309.96
$289.96
31
$536.88
$507.07
$482.36
$489.57
$475.60
$389.09
$316.51
$296.09
32
$548.00
$517.57
$492.35
$499.71
$485.44
$397.14
$323.07
$302.22
33
$554.95
$524.14
$498.60
$506.05
$491.60
$402.18
$327.16
$306.05
34
$562.36
$531.14
$505.25
$512.81
$498.16
$407.55
$331.53
$310.14
35
$566.07
$534.64
$508.58
$516.19
$501.45
$410.24
$333.72
$312.18
36
$569.77
$538.14
$511.91
$519.56
$504.73
$412.92
$335.90
$314.23
37
$573.48
$541.64
$515.24
$522.94
$508.01
$415.61
$338.09
$316.27
38
$577.18
$545.14
$518.57
$526.32
$511.30
$418.29
$340.27
$318.32
39
$584.60
$552.14
$525.23
$533.08
$517.86
$423.67
$344.64
$322.40
40
$592.01
$559.14
$531.89
$539.84
$524.43
$429.04
$349.01
$326.49
41
$603.13
$569.64
$541.88
$549.98
$534.28
$437.09
$355.56
$332.62
42
$613.78
$579.70
$551.45
$559.69
$543.71
$444.82
$361.84
$338.50
43
$628.60
$593.70
$564.77
$573.21
$556.84
$455.56
$370.58
$346.67
44
$647.13
$611.20
$581.42
$590.11
$573.26
$468.99
$381.51
$356.89
45
$668.90
$631.76
$600.98
$609.96
$592.55
$484.77
$394.34
$368.90
46
$694.85
$656.27
$624.29
$633.62
$615.53
$503.57
$409.64
$383.21
Urgent Care
$100
20% coinsurance
after deductible
$50
$75
15% coinsurance
after deductible
$80
No charge after deductible
50% coinsurance
after deductible
Emergency Room
$750
20% coinsurance
after deductible
$500 then deductible
$500
15% coinsurance
after deductible
$500
No charge after deductible
50% coinsurance
after deductible
47
$724.03
$683.83
$650.50
$660.23
$641.38
$524.71
$426.84
$399.30
$70
15% coinsurance
after deductible
$70
No charge after deductible
50% coinsurance
after deductible
48
$757.38
$715.33
$680.47
$690.64
$670.92
$548.89
$446.50
$417.69
49
$790.27
$746.39
$710.02
$720.63
$700.06
$572.72
$465.89
$435.83
15% coinsurance
after deductible
30% coinsurance
after deductible
50% coinsurance
after deductible
50
$827.33
$781.39
$743.32
$754.42
$732.89
$599.58
$487.74
$456.27
51
$863.92
$815.96
$776.19
$787.79
$765.30
$626.10
$509.31
$476.45
52
$904.22
$854.02
$812.40
$824.54
$801.00
$655.31
$533.07
$498.68
53
$944.99
$892.52
$849.03
$861.72
$837.11
$684.85
$557.10
$521.16
54
$989.00
$934.08
$888.57
$901.85
$876.10
$716.74
$583.05
$545.43
50% coinsurance
after deductible
55
$1,033.00
$975.65
$928.10
$941.97
$915.08
$748.63
$608.99
$569.70
56
$1,080.72
$1,020.71
$970.97
$985.48
$957.35
$783.21
$637.12
$596.01
50% coinsurance
after deductible
57
$1,128.89
$1,066.21
$1,014.26
$1,029.41
$1,000.02
$818.13
$665.52
$622.58
58
$1,180.31
$1,114.78
$1,060.45
$1,076.30
$1,045.57
$855.39
$695.83
$650.94
59
$1,205.79
$1,138.84
$1,083.34
$1,099.53
$1,068.14
$873.85
$710.85
$664.99
60
$1,257.21
$1,187.40
$1,129.54
$1,146.42
$1,113.69
$911.12
$741.17
$693.35
Hearing & Speech Exams
Independent & Outpatient Lab/
Pathology
Radiology/X-rays
MRI/Scans/Nuclear Medicine
Inpatient Hospital
PT/OT/Chiro
Retail Generic Rx
$80
$40
$80
$350
$750/day for the
first 3 days of admission
$80
$4
$50
20% coinsurance
after deductible
20% coinsurance
after deductible
20% coinsurance
after deductible
20% coinsurance
after deductible
20% coinsurance
after deductible
$4
No charge after deductible
No charge after deductible
No charge after deductible
No charge after deductible
$600/day
No charge after deductible
$4
30% coinsurance
after deductible
30% coinsurance
after deductible
30% coinsurance
after deductible
30% coinsurance
after deductible
30% coinsurance
after deductible
$4
15% coinsurance
after deductible
15% coinsurance
after deductible
15% coinsurance
after deductible
15% coinsurance
after deductible
$4 after deductible
30% coinsurance
after deductible
30% coinsurance
after deductible
30% coinsurance
after deductible
30% coinsurance
after deductible
$4
No charge after deductible
No charge after deductible
No charge after deductible
No charge after deductible
No charge after deductible
No charge after deductible
50% coinsurance
after deductible
50% coinsurance
after deductible
$4
Retail Brand Rx
$50
$50
$30
$50
$50 after deductible
$50
No charge after deductible
50% coinsurance
after deductible
Retail Non-Formulary Brand Rx
$100
$100
$60
$100
$100 after deductible
$100
No charge after deductible
50% coinsurance
after deductible
50% coinsurance
50% coinsurance
after deductible
50% coinsurance
after deductible
50% coinsurance
after deductible
50% coinsurance
after deductible
50% coinsurance
after deductible
No charge after deductible
50% coinsurance
after deductible
Retail Specialty Rx
61
$1,301.68
$1,229.40
$1,169.49
$1,186.97
$1,153.08
$943.35
$767.38
$717.87
62
$1,330.86
$1,256.97
$1,195.71
$1,213.58
$1,178.94
$964.49
$784.59
$733.97
63
$1,367.45
$1,291.53
$1,228.59
$1,246.95
$1,211.35
$991.02
$806.16
$754.15
64
$1,389.69
$1,312.53
$1,248.57
$1,267.23
$1,231.05
$1,007.13
$819.27
$766.41
65+
$1,389.69
$1,312.53
$1,248.57
$1,267.23
$1,231.05
$1,007.13
$819.27
$766.41
*The following notice is required upon enrollment if selecting an HMO Consumer Choice Health Benefit Plan you have the option to choose this Consumer Choice of Benefits Health Maintenance
Organization health care plan that, either in whole or in part, does not provide state-mandated health benefits normally required in evidences of coverage in Texas. This standard health benefit plan may
provide a more affordable health plan for you although, at the same time, it may provide you with fewer health plan benefits than those normally included as state-mandated health benefits in Texas. If
you choose this standard health benefit plan, please consult with your insurance agent to discover which state-mandated health benefits are excluded in this evidence of coverage.
Rates are valid from 1/1/2017–12/31/2017. The above rates do not include the premium surcharge for tobacco use.
HMO Service Area: Harris, Fort Bend and Montgomery counties
For individuals, find the rate that matches your age for the plan you’re interested in.
For families, find the rate that matches the age for all members of your family and add them together. If you have more than three (3) children, only add the rate for the three (3) oldest up to age 26.