Focused Silver – HMO
73% cost sharing reduction [Popular Plan]
Network type: HMO
Coverage tier: Silver
Primary care visit: $35 copay
Specialist visit: $85 copay
Urgent care visit: $50 copay
Description
This plan has 73% cost sharing reduction [Popular Plan]
Health Care Plan Details
Network type | HMO |
Deductible | $5,100 per person $5,100 per person |
Out-of-pocket max | $6,950 per person $13,900 per family |
Metal tier | Silver |
Visit Copay
Primary care visit | $35 copay |
Specialist visit | $85 copay |
Preventive care visit | No charge |
Urgent, Emergency Care, and Hospital Care
Urgent care | $50 copay |
Emergency room | 50% after deductible |
Ambulance | 50% after deductible |
Hospital stay (facility) | 50% after deductible |
Hospital stay (physician) | 50% after deductible |
Outpatient procedure (facility) | 50% after deductible |
Outpatient procedure (physician) | 50% after deductible |
Physical rehabilitation | $35 copay |
Maternitowny and Pregnancy
Labor, delivery, hospital stay | 50% after deductible |
Pharmacy, Drugs, and Medication
Generic | $3 copay |
Brand | $70 copay |
Non-preferred Brand | 50% after deductible |
Specialty | 50% after deductible |
Lab Tests and Diagnostic Procedures
X-rays | 50% after deductible |
Imaging (CT/PET/MRI) | 50% after deductible |
Blood work | $40 copay |
Mental and Psychiatric Health Care
Mental Health outpatient services | No charge |
Psychiatric hospital stay | No charge |
Health Plan Provider Information
Health Plan Benefits | https://d2ed110nmrd591.cloudfront.net/blobs/TJYrN3ENFpKbzwmaX3g919e8.pdf |
Search doctor list | https://ambetter.westernskycommunitycare.com/findadoc |