Constant Care Silver 1 – HMO
Network type: HMO
Coverage tier: Silver
Primary care visit: $30 copay
Specialist visit: $60 copay
Urgent care visit: $30 copay
Description
Health Care Plan Details
| Network type | HMO |
| Deductible | $0 per person $0 per person |
| Out-of-pocket max | $7,725 per person $15,450 per family |
| Metal tier | Silver |
Visit Copay
| Primary care visit | $30 copay |
| Specialist visit | $60 copay |
| Preventive care visit | No charge |
Urgent, Emergency Care, and Hospital Care
| Urgent care | $30 copay |
| Emergency room | 35% coinsurance |
| Ambulance | 50% coinsurance |
| Hospital stay (facility) | 35% coinsurance |
| Hospital stay (physician) | 35% coinsurance |
| Outpatient procedure (facility) | $1,500 copay |
| Outpatient procedure (physician) | $250 copay |
| Physical rehabilitation | $60 copay |
Maternitowny and Pregnancy
| Labor, delivery, hospital stay | 35% coinsurance |
Pharmacy, Drugs, and Medication
| Generic | $28 copay |
| Brand | $65 copay after deductible |
| Non-preferred Brand | 50% coinsurance after deductible |
| Specialty | 50% coinsurance after deductible |
Lab Tests and Diagnostic Procedures
| X-rays | $95 copay |
| Imaging (CT/PET/MRI) | $950 copay |
| Blood work | $60 copay |
Mental and Psychiatric Health Care
| Mental Health outpatient services | $30 copay |
| Psychiatric hospital stay | 35% coinsurance |
