Sendero Health Original Silver 94 / $5 PCP / $5 Gen Rx / $0 Deductible / $10 Specialist – HMO
94% cost sharing reduction [Popular Plan]
Network type: HMO
Coverage tier: Silver
Primary care visit: $5 copay
Specialist visit: $10 copay
Urgent care visit: $30 copay
Description
This plan has 94% cost sharing reduction [Popular Plan]
Health Care Plan Details
| Network type | HMO |
| Deductible | Success
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| Out-of-pocket max | $1,700 per person $3,400 per family |
| Metal tier | Silver |
Visit Copay
| Primary care visit | $5 copay |
| Specialist visit | $10 copay |
| Preventive care visit | No data available |
Urgent, Emergency Care, and Hospital Care
| Urgent care | $30 copay |
| Emergency room | $350 copay |
| Ambulance | $350 copay |
| Hospital stay (facility) | $300 copay per Stay |
| Hospital stay (physician) | 10% coinsurance |
| Outpatient procedure (facility) | 10% coinsurance |
| Outpatient procedure (physician) | 10% coinsurance |
| Physical rehabilitation | $20 copay |
Maternitowny and Pregnancy
| Well baby care | No data available |
| Labor, delivery, hospital stay | $300 copay |
Pharmacy, Drugs, and Medication
| Generic | $5 copay |
| Brand | $8 copay |
| Non-preferred Brand | $50 copay |
| Specialty | 30% coinsurance |
Lab Tests and Diagnostic Procedures
| X-rays | $30 copay |
| Imaging (CT/PET/MRI) | 10% coinsurance |
| Blood work | 10% coinsurance |
Mental and Psychiatric Health Care
| Mental Health outpatient services | 10% coinsurance |
| Psychiatric hospital stay | $300 copay per Stay |
Health Plan Provider Information
| Health Plan Benefits | http://senderohealth.com/files/2024/71837TX001000106.pdf |
| Drug and medication plan formulary | https://senderohealth.com/files/2024/Formulary.pdf |
| Search doctor list | https://www.senderohealth.com/dbsearch/menu_new |
