Geisinger Marketplace All-Access PPO 30/60/5500 (30/60/4300 .73) – PPO

73% cost sharing reduction [Popular Plan]
Network type: PPO
Coverage tier: Silver
Primary care visit: $30 copay
Specialist visit: $60 copay
Urgent care visit: $30 copay

SKU: 75729PA001267204 Category:

Description

This plan has 73% cost sharing reduction [Popular Plan]

Health Care Plan Details

Network type PPO
Deductible $4,300 per person $4,300 per person
Out-of-pocket max $7,250 per person $14,500 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 $300 copay after deductible
Ambulance No charge
Hospital stay (facility) 30% after deductible
Hospital stay (physician) 30% after deductible
Outpatient procedure (facility) 30% after deductible
Outpatient procedure (physician) 30% after deductible
Physical rehabilitation $60 copay

Maternitowny and Pregnancy

Labor, delivery, hospital stay 30% after deductible

Pharmacy, Drugs, and Medication

Generic $20 copay
Brand $50 copay after deductible
Non-preferred Brand $85 copay after deductible
Specialty 50% after deductible, up to $7,250 copay, 50% after deductible, up to $7,250

Lab Tests and Diagnostic Procedures

X-rays 30% after deductible
Imaging (CT/PET/MRI) 30% after deductible
Blood work 30% after deductible

Mental and Psychiatric Health Care

Mental Health outpatient services $30 copay
Psychiatric hospital stay 30% after deductible

Health Plan Provider Information