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Plan Details

CommunityCare PPO Silver 5000 Select

87698OK0090010-00
Plan Year:
2016

Silver Metal plans cover an estimated 70% of your medical and prescription drug costs. They limit your annual out-of-pocket expenses at a maximum level in case you have some very large claims. The Silver plans are likely to be the most popular for individuals whose income is between 100%-400% of the Federal Poverty Level. You may be eligible for lower premiums through advanced tax credits and/or enhanced benefits, for example, lower deductibles and copayments.

  • Covers approximately 70% of your covered medical and prescription drug costs.
  • The standard plan in terms of tax credit eligibility

Individual Deductible:$5,000
Individual Out of Pocket Maximum:$6,600
Office Visit Copay:$20
Out of Network Coinsurance:60%*
*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