Silver Metal plans cover an estimated 70% of your medical and prescription drug costs. They limit your annual out-of-pocket expenses.
Individual Deductible: | $5,000 |
Individual Out of Pocket Maximum: | $9,000 |
Office Visit Copay: | $30 |
Out of Network Coinsurance: | 60%* |
Preferred Generics: | $15 |
Preferred Brand Name: | $45 |
Non-Preferred Brand Name: | 50% |
Individual Rx Deductible: | None |
Preferred Specialty: | 50% |
Non-Preferred Specialty: | 50% |
OON Individual Deductible: | $10,000 |
OON Family Deductible: | $30,000 |
OON OOP Individual Deductible: | Unlimited |
OON OOP Family Deductible: | Unlimited |
OON Office Visit Copay: | 60%* |
Specialist Copay: | $65 |
OON Specialist Copay: | 60%* |
Coinsurance: | 30%* |
All health plans in the exchanges are required to provide a minimum set of benefits which are termed essential benefits. These benefits include: