HA Silver AH – POS
94% cost sharing reduction [Popular Plan]
Network type: POS
Coverage tier: Silver
Primary care visit: $4.70 copay
Specialist visit: $4.70 copay
Urgent care visit: $4.70 copay
Description
This plan has 94% cost sharing reduction [Popular Plan]
Health Care Plan Details
| Network type | POS |
| Deductible | $1,558 per person $1,558 per person |
| Out-of-pocket max | $2,210 per person $4,420 per family |
| Metal tier | Silver |
Visit Copay
| Primary care visit | $4.70 copay |
| Specialist visit | $4.70 copay |
| Preventive care visit | No charge |
Urgent, Emergency Care, and Hospital Care
| Urgent care | $4.70 copay |
| Emergency room | No charge |
| Ambulance | No charge after deductible |
| Hospital stay (facility) | No charge after deductible |
| Hospital stay (physician) | No charge after deductible |
| Outpatient procedure (facility) | $4.70 copay after deductible |
| Outpatient procedure (physician) | $4.70 copay |
| Physical rehabilitation | $4.70 copay |
Maternitowny and Pregnancy
| Well baby care | No charge |
| Labor, delivery, hospital stay | No charge after deductible |
Pharmacy, Drugs, and Medication
| Generic | $4.70 copay |
| Brand | $4.70 copay |
| Non-preferred Brand | $9.40 copay |
| Specialty | $9.40 copay |
Lab Tests and Diagnostic Procedures
| X-rays | $4.70 copay |
| Imaging (CT/PET/MRI) | $4.70 copay |
| Blood work | $4.70 copay |
Mental and Psychiatric Health Care
| Mental Health outpatient services | $4.70 copay |
| Psychiatric hospital stay | No charge after deductible |
Health Plan Provider Information
| Health Plan Benefits | https://secure.healthadvantage-hmo.com/members/ViewSbc.aspx?id=60009&year=2024 |
| Drug and medication plan formulary | http://www.healthadvantage-hmo.com/ha-formulary-2024 |
| Search doctor list | https://secure.healthadvantage-hmo.com/providerdirectory/trueblueppo.aspx |
