Neighborhood INNOVATION – HMO
Network type: HMO
Coverage tier: Expanded Bronze
Primary care visit: $25 copay
Specialist visit: 30% after deductible
Urgent care visit: 30% after deductible
Description
Health Care Plan Details
| Network type | HMO |
| Deductible | $7,050 per person $7,050 per person |
| Out-of-pocket max | $8,975 per person $17,950 per family |
| Metal tier | Expanded Bronze |
Visit Copay
| Primary care visit | $25 copay |
| Specialist visit | 30% after deductible |
| Preventive care visit | No charge |
Urgent, Emergency Care, and Hospital Care
| Urgent care | 30% after deductible |
| Emergency room | 30% after deductible |
| Hospital stay (facility) | 30% after deductible |
Maternitowny and Pregnancy
Pharmacy, Drugs, and Medication
| Generic | $10 copay after deductible |
| Brand | $40 copay after deductible |
| Non-preferred Brand | $55 copay after deductible |
| Specialty | 30% after deductible |
