WellSense Clarity ConnectorCare 1 – HMO

94% cost sharing reduction [Popular Plan]
Network type: HMO
Coverage tier: Silver
Primary care visit: No charge
Specialist visit: No charge
Urgent care visit: No charge

SKU: 82569MA045000106 Category:

Description

This plan has 94% cost sharing reduction [Popular Plan]

Health Care Plan Details

Network type HMO
Deductible $0 per person $0 per person
Out-of-pocket max $0 per person $0 per family
Metal tier Silver

Visit Copay

Primary care visit No charge
Specialist visit No charge
Preventive care visit No charge

Urgent, Emergency Care, and Hospital Care

Urgent care No charge
Emergency room No charge
Ambulance No charge
Hospital stay (facility) No charge
Hospital stay (physician) No charge
Outpatient procedure (facility) No charge
Outpatient procedure (physician) No charge
Physical rehabilitation No charge

Maternitowny and Pregnancy

Labor, delivery, hospital stay No charge

Pharmacy, Drugs, and Medication

Generic $1 copay
Brand $3.65 copay
Non-preferred Brand $3.65 copay
Specialty $3.65 copay

Lab Tests and Diagnostic Procedures

X-rays No charge
Imaging (CT/PET/MRI) No charge
Blood work No charge

Mental and Psychiatric Health Care

Mental Health outpatient services No charge
Psychiatric hospital stay No charge

Health Plan Provider Information