Sanford Individual TRUE Enhanced $3,700 – HMO

87% cost sharing reduction [Popular Plan]
Network type: HMO
Coverage tier: Silver
Primary care visit: 10% coinsurance after deductible
Specialist visit: 10% coinsurance after deductible
Urgent care visit: 10% coinsurance after deductible

SKU: 31195SD008002305 Category:

Description

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

Health Care Plan Details

Network type HMO
Deductible $1,200 per person $1,200 per person
Out-of-pocket max $1,950 per person $3,900 per family
Metal tier Silver

Visit Copay

Primary care visit 10% coinsurance after deductible
Specialist visit 10% coinsurance after deductible
Preventive care visit No charge

Urgent, Emergency Care, and Hospital Care

Urgent care 10% coinsurance after deductible
Emergency room 10% coinsurance after deductible
Ambulance 10% coinsurance after deductible
Hospital stay (facility) 10% coinsurance after deductible
Hospital stay (physician) 10% coinsurance after deductible
Outpatient procedure (facility) 10% coinsurance after deductible
Outpatient procedure (physician) 10% coinsurance after deductible
Physical rehabilitation 10% coinsurance after deductible

Maternitowny and Pregnancy

Well baby care No charge
Labor, delivery, hospital stay 10% coinsurance after deductible

Pharmacy, Drugs, and Medication

Generic 10% coinsurance after deductible
Brand This is the amount you will pay for a generic drug prescription.
Non-preferred Brand 10% coinsurance after deductible
Specialty 10% coinsurance after deductible

Lab Tests and Diagnostic Procedures

X-rays 10% coinsurance after deductible
Imaging (CT/PET/MRI) 10% coinsurance after deductible
Blood work 10% coinsurance after deductible

Mental and Psychiatric Health Care

Mental Health outpatient services 10% coinsurance after deductible
Psychiatric hospital stay 10% coinsurance after deductible

Health Plan Provider Information

Health Plan Benefits https://www.sanfordhealthplan.com/-/media/plan-documents/2024/_ind_true_sd_3700_87_enhanced_hp5357.pdf
Drug and medication plan formulary https://www.sanfordhealthplan.com/-/media/files/documents/members/hp6911-simplicity-and-true-for-individual-and-small-groups-1124.pdf
Search doctor list https://www3.viiad.com/shp/public/default.asp?SelectedPlan=SHPISTP