Sendero Health Real Gold / $350 Deductible – HMO

Description

Health Care Plan Details

Network type	HMO
Deductible	Success Your progress has been saved. We have sent an email to with a link to continue your application ×
Out-of-pocket max	$8,500 per person $17,000 per family
Metal tier	Gold

Visit Copay

Primary care visit	30% coinsurance after deductible
Specialist visit	40% coinsurance after deductible
Preventive care visit	No data available

Urgent, Emergency Care, and Hospital Care

Urgent care	30% coinsurance after deductible
Emergency room	35% coinsurance after deductible
Ambulance	35% coinsurance after deductible
Hospital stay (facility)	35% coinsurance after deductible
Hospital stay (physician)	35% coinsurance after deductible
Outpatient procedure (facility)	30% coinsurance after deductible
Outpatient procedure (physician)	30% coinsurance after deductible
Physical rehabilitation	$35 copay

Maternitowny and Pregnancy

Well baby care	No data available
Labor, delivery, hospital stay	35% coinsurance after deductible

Pharmacy, Drugs, and Medication

Generic	No charge after deductible
Brand	$40 copay after deductible
Non-preferred Brand	$80 copay after deductible
Specialty	35% coinsurance after deductible

Lab Tests and Diagnostic Procedures

X-rays	$20 copay
Imaging (CT/PET/MRI)	35% coinsurance after deductible
Blood work	20% coinsurance after deductible

Mental and Psychiatric Health Care

Mental Health outpatient services	30% coinsurance after deductible
Psychiatric hospital stay	35% coinsurance after deductible

Health Plan Provider Information

Health Plan Benefits	http://senderohealth.com/files/2024/71837TX001000201.pdf
Drug and medication plan formulary	https://senderohealth.com/files/2024/Formulary.pdf
Search doctor list	https://www.senderohealth.com/dbsearch/menu_new