Plan Details

CommunityCare PPO Platinum A Select

87698OK0090004-01

Plan Year:

2017

Individual Deductible:	$500
Individual Out of Pocket Maximum:	$1,700
Office Visit Copay:	$10
Out of Network Coinsurance:	50%*
Preferred Generics:	$15
Preferred Brand Name:	$40
Non-Preferred Brand Name:	$70
Specialty:	$160

^*Subject to the deductible.

Insure Oklahoma Qualified

Eligible for Small Business Health Care Tax Credits

Click here to visit HealthCare.gov for a Rate Quote

Essential Benefits

All health plans in the exchanges are required to provide a minimum set of benefits which are termed essential benefits. These benefits include:

• Ambulatory patient services
• Emergency services
• Hospitalization
• Maternity and newborn care
• Mental health services
• Substance use disorder services
• Prescription drug coverage
• Rehabilitative and habilitative services and devices
• Preventative and wellness services
• Pediatric Services