Attention Members: If you have a Hillcrest HealthCare System primary care physician or have utilized services at a Hillcrest facility, please click here for an important update.
Call CommunityCare at 1-877-321-0022 for more information and rate quotes.

Plan Details

CommunityCare PPO Bronze A Standard

87698OK0110015-00
Plan Year:
2017
Individual Deductible:$6,000
Individual Out of Pocket Maximum:$6,550
Office Visit Copay:$10*
Out of Network Coinsurance:30%*
Preferred Generics:$10*
Preferred Brand Name:$40*
Non-Preferred Brand Name:$70*
Specialty:$160*
*Subject to the deductible

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