Sendero Health Austin512 Silver / $40 PCP / $15 Gen Rx / $75 Specialist / $0 Deductible – HMO
Network type: HMO
Coverage tier: Silver
Primary care visit: $40 copay
Specialist visit: $75 copay
Urgent care visit: $60 copay
Description
Health Care Plan Details
| Network type | HMO |
| Deductible | Success
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| Out-of-pocket max | $9,450 per person $18,900 per family |
| Metal tier | Silver |
Visit Copay
| Primary care visit | $40 copay |
| Specialist visit | $75 copay |
| Preventive care visit | No data available |
Urgent, Emergency Care, and Hospital Care
| Urgent care | $60 copay |
| Emergency room | $900 copay |
| Ambulance | $900 copay |
| Hospital stay (facility) | $3100 copay per Stay |
| Hospital stay (physician) | 20% coinsurance |
| Outpatient procedure (facility) | $400 copay |
| Outpatient procedure (physician) | $400 copay |
| Physical rehabilitation | $100 copay |
Maternitowny and Pregnancy
| Well baby care | No data available |
| Labor, delivery, hospital stay | $3,100 copay |
Pharmacy, Drugs, and Medication
| Generic | $15 copay |
| Brand | $75 copay |
| Non-preferred Brand | $150 copay |
| Specialty | $350 copay |
Lab Tests and Diagnostic Procedures
| X-rays | $125 copay |
| Imaging (CT/PET/MRI) | $350 copay |
| Blood work | $60 copay |
Mental and Psychiatric Health Care
| Mental Health outpatient services | $400 copay |
| Psychiatric hospital stay | $3100 copay per Stay |
Health Plan Provider Information
| Health Plan Benefits | http://senderohealth.com/files/2024/71837TX001002201.pdf |
| Drug and medication plan formulary | https://senderohealth.com/files/2024/Formulary.pdf |
| Search doctor list | https://www.senderohealth.com/dbsearch/menu_new |
