Plan Details

CommunityCare Silver 4 Select

98905OK0170092-01

Plan Year:

2017

Silver Metal plans cover an estimated 70% of your medical and prescription drug costs. They limit your annual out-of-pocket expenses.

Individual Deductible:	$3,000
Individual Out of Pocket Maximum:	$4,500
Office Visit Copay:	$25*
Preferred Generics:	$15*
Preferred Brand Name:	$40*
Non-Preferred Brand Name:	$70*
Specialty:	$160*

^*Subject to the deductible

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