Mass General Brigham Health Plan Complete ConnectorCare 2 – HMO

87% cost sharing reduction [Popular Plan]
Network type: HMO
Coverage tier: Silver
Primary care visit: No charge
Specialist visit: $18 copay
Urgent care visit: $18 copay

SKU: 41304MA002205405 Category:

Description

This plan has 87% cost sharing reduction [Popular Plan]

Health Care Plan Details

Network type HMO
Deductible $0 per person $0 per person
Out-of-pocket max $750 per person $1,500 per family
Metal tier Silver

Visit Copay

Primary care visit No charge
Specialist visit $18 copay
Preventive care visit No charge

Urgent, Emergency Care, and Hospital Care

Urgent care $18 copay
Emergency room $50 copay
Ambulance No charge
Hospital stay (facility) $50 copay
Hospital stay (physician) No charge
Outpatient procedure (facility) $50 copay
Outpatient procedure (physician) No charge
Physical rehabilitation $10 copay

Maternitowny and Pregnancy

Labor, delivery, hospital stay $50 copay

Pharmacy, Drugs, and Medication

Generic $10 copay
Brand $20 copay
Non-preferred Brand $40 copay
Specialty $40 copay

Lab Tests and Diagnostic Procedures

X-rays No charge
Imaging (CT/PET/MRI) $30 copay
Blood work No charge

Mental and Psychiatric Health Care

Mental Health outpatient services No charge
Psychiatric hospital stay $50 copay

Health Plan Provider Information