Plan Details

98905OK0320019-00

Plan Year:

2023

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.

^†First 3 primary care visits have a $35 co-payment and are not subject to the deductible.

^*Subject to the deductible.

Benefit Details

All health plans in the exchanges are required to provide a minimum set of benefits which are termed essential benefits. These benefits include: