If you receive a survey about your health care services, we hope you will take a few minutes to give us your feedback. Your opinion is important to us!
Important Note: For online premium payments, please only use CommunityCare verified payment portals to process transactions.
Attention: CommunityCare will be performing systems maintenance Friday, May 16th starting at 5 p.m. through midnight on Saturday, May 17th. Some online documents, tools and resources may be unavailable during this time. Thank you for your patience.

Plan Details

CommunityCare PPO Silver H23 Standard

87698OK0110044-00
Plan Year:
2024

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

Individual Deductible:$7,700
Individual Out of Pocket Maximum:$8,700
Office Visit Copay:$35
Out of Network Coinsurance:70%*
Preferred Generics:$15
Preferred Brand Name:$45*
Non-Preferred Brand Name:$95*
Individual Rx Deductible:$500
Preferred Specialty:$300*
Non-Preferred Specialty:$350*
OON Individual Deductible:$17,400
OON Family Deductible:$35,800
OON OOP Individual Deductible:Unlimited
OON OOP Family Deductible:Unlimited
OON Office Visit Copay:70%*
Specialist Copay:$65
OON Specialist Copay:70%*
Coinsurance:40%*
*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