Sendero Health Austin512 Silver 87 / $20 PCP (2 Free PCP Visits) / $10 Gen Rx / $40 Specialist / $0 Deductible – HMO

87% cost sharing reduction [Popular Plan]
Network type: HMO
Coverage tier: Silver
Primary care visit: $20 copay
Specialist visit: $40 copay
Urgent care visit: $25 copay

SKU: 71837TX001002205 Category:

Description

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

Health Care Plan Details

Network type HMO
Deductible Success

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Out-of-pocket max $2,500 per person $5,000 per family
Metal tier Silver

Visit Copay

Primary care visit $20 copay
Specialist visit $40 copay
Preventive care visit No data available

Urgent, Emergency Care, and Hospital Care

Urgent care $25 copay
Emergency room $700 copay
Ambulance $700 copay
Hospital stay (facility) $1700 copay per Stay
Hospital stay (physician) 20% coinsurance
Outpatient procedure (facility) $300 copay
Outpatient procedure (physician) $300 copay
Physical rehabilitation $50 copay

Maternitowny and Pregnancy

Well baby care No data available
Labor, delivery, hospital stay $2,500 copay

Pharmacy, Drugs, and Medication

Generic $10 copay
Brand $25 copay
Non-preferred Brand $35 copay
Specialty $40 copay

Lab Tests and Diagnostic Procedures

X-rays $100 copay
Imaging (CT/PET/MRI) $250 copay
Blood work $20 copay

Mental and Psychiatric Health Care

Mental Health outpatient services $20 copay
Psychiatric hospital stay $1700 copay per Stay

Health Plan Provider Information

Health Plan Benefits http://senderohealth.com/files/2024/71837TX001002205.pdf
Drug and medication plan formulary https://senderohealth.com/files/2024/Formulary.pdf
Search doctor list https://www.senderohealth.com/dbsearch/menu_new