Plan Details

CommunityCare Silver 220 HMO One

98905OK0320019-00
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:$7,000
Individual Out of Pocket Maximum:$9,100
Office Visit Copay:$35
Preferred Generics:$15
Preferred Brand Name:$45
Individual Rx Deductible:Integrated
Preferred Specialty:$50
Non-Preferred Specialty:$50
Specialist Copay:$60
Coinsurance:0%*
First 3 primary care visits have a $35 co-payment and are not subject to the deductible.
*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