Gold Metal plans cover an estimated 80% of your medical and prescription drug costs. They also limit your annual out-of-pocket expenses.
Individual Deductible: | $2,000 |
Individual Out of Pocket Maximum: | $8,500 |
Office Visit Copay: | $25 |
Out of Network Coinsurance: | 50%* |
Preferred Generics: | $15 |
Preferred Brand Name: | $40 |
Non-Preferred Brand Name: | $70 |
Individual Rx Deductible: | None |
Preferred Specialty: | $160 |
Non-Preferred Specialty: | $210 |
OON Individual Deductible: | $4,000 |
OON Family Deductible: | $12,000 |
OON OOP Individual Deductible: | Unlimited |
OON OOP Family Deductible: | Unlimited |
OON Office Visit Copay: | 50%* |
Specialist Copay: | $35 |
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: