Silver Metal plans cover an estimated 70% of your medical and prescription drug costs. They limit your annual out-of-pocket expenses.
Individual Deductible: | $3,800 |
Individual Out of Pocket Maximum: | $7,000 |
Office Visit Copay: | $15* |
Out of Network Coinsurance: | 50%* |
Preferred Generics: | $15* |
Preferred Brand Name: | $40* |
Non-Preferred Brand Name: | $70* |
Individual Rx Deductible: | Integrated |
Preferred Specialty: | $160* |
Non-Preferred Specialty: | $210* |
OON Individual Deductible: | $7,600 |
OON Family Deductible: | $22,800 |
OON OOP Individual Deductible: | Unlimited |
OON OOP Family Deductible: | Unlimited |
OON Office Visit Copay: | 50%* |
Specialist Copay: | $30* |
OON Specialist Copay: | 50%* |
Coinsurance: | 20%* |
All health plans in the exchanges are required to provide a minimum set of benefits which are termed essential benefits. These benefits include: