2024 POS 7250 Silver Select

Health Insurance Plan Details (2024 Plan)

by Health Alliance Medical Plans, Inc.

Monthly Premium

POS
$ubsidy
Silver
Deductible
$7,250 /yr
Max Out-of-Pocket
$8,600 /yr

Details

Deductible (per individual) $7,250 /yr
Deductible (per family) $14,500 /yr
Max Out-of-Pocket (per individual) $8,600 /yr
Max Out-of-Pocket (per family) $17,200 /yr
Drug Deductible (per individual)
Drug Deductible (per family)
Drug Max Out-of-Pocket (per individual)
Drug Max Out-of-Pocket (per family)
Plan Type POS
Includes Child Dental? No
Includes Adult Dental? No
Medical Services
Preventive Care No Charge
Primary Care Visit $30 Copay
Specialist Visit $60 Copay
Emergency Room 15.00% Coinsurance after deductible
Inpatient Facility 15.00% Coinsurance after deductible
Inpatient Physician 15.00% Coinsurance after deductible
Drug Costs
Generic Drugs $30 Copay
Preferred Brand Drugs $60 Copay
Non-preferred Brand Drugs $100 Copay
Specialty Drugs $300 Copay

Plan Documents

Summary of Benefits and Coverage SBC doc
Provider Directory Doctor lookup
Drug Formulary List n/a

* Figures shown are only for in-network medical costs

** Please check with insurance company if Copay and Coinsurance rates are before or after the deductible


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