Neighborhood VALUE – HMO
Network type: HMO
Coverage tier: Silver
Primary care visit: $35 copay
Specialist visit: $75 copay
Urgent care visit: $75 copay
Description
Health Care Plan Details
Network type | HMO |
Deductible | $4,750 per person $4,750 per person |
Out-of-pocket max | $9,000 per person $18,000 per family |
Metal tier | Silver |
Visit Copay
Primary care visit | $35 copay |
Specialist visit | $75 copay |
Preventive care visit | No charge |
Urgent, Emergency Care, and Hospital Care
Urgent care | $75 copay |
Emergency room | 40% after deductible |
Hospital stay (facility) | 40% after deductible |
Maternitowny and Pregnancy
Pharmacy, Drugs, and Medication
Generic | $10 copay |
Brand | $40 copay |
Non-preferred Brand | $55 copay |
Specialty | 50% after deductible |