Sendero Health Pure Silver 87 / $20 PCP (1 Free PCP Visit) / $40 Specialist / $8 Gen Rx / $800 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
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 | $3,000 per person $6,000 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 | $800 copay |
| Ambulance | $350 copay after deductible |
| Hospital stay (facility) | $1500 copay per Stay after deductible |
| Hospital stay (physician) | 20% coinsurance after deductible |
| Outpatient procedure (facility) | $40 copay |
| Outpatient procedure (physician) | $40 copay |
| Physical rehabilitation | $45 copay |
Maternitowny and Pregnancy
| Well baby care | No data available |
| Labor, delivery, hospital stay | $1,500 copay |
Pharmacy, Drugs, and Medication
| Generic | $8 copay |
| Brand | $20 copay |
| Non-preferred Brand | $140 copay |
| Specialty | 20% coinsurance |
Lab Tests and Diagnostic Procedures
| X-rays | $100 copay |
| Imaging (CT/PET/MRI) | 20% coinsurance after deductible |
| Blood work | $22 copay |
Mental and Psychiatric Health Care
| Mental Health outpatient services | $40 copay |
| Psychiatric hospital stay | $1500 copay per Stay after deductible |
Health Plan Provider Information
| Health Plan Benefits | http://senderohealth.com/files/2024/71837TX001002105.pdf |
| Drug and medication plan formulary | https://senderohealth.com/files/2024/Formulary.pdf |
| Search doctor list | https://www.senderohealth.com/dbsearch/menu_new |
