UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals)

Health Insurance Plan Details (2025 Plan)

Monthly Premium

HMO
$ubsidy
Silver
Deductible
$0 /yr
Max Out-of-Pocket
$9,200 /yr

Details

Deductible (per individual) $0 /yr
Deductible (per family) $0 /yr
Max Out-of-Pocket (per individual) $9,200 /yr
Max Out-of-Pocket (per family) $18,400 /yr
Drug Deductible (per individual) $3,500
Drug Deductible (per family) $7,000
Drug Max Out-of-Pocket (per individual) Included in Medical
Drug Max Out-of-Pocket (per family) Included in Medical
Plan Type HMO
Includes Child Dental? Yes
Includes Adult Dental? Yes
Medical Services
Preventive Care No Charge
Primary Care Visit $5 Copay
Specialist Visit $100 Copay
Emergency Room $1,500 Copay
Inpatient Facility $2500 Copay per Day
Inpatient Physician No Charge
Drug Costs
Generic Drugs $10 Copay
Preferred Brand Drugs $100 Copay after deductible
Non-preferred Brand Drugs 40% Coinsurance after deductible
Specialty Drugs 50% Coinsurance after deductible

Plan Documents

Summary of Benefits and Coverage SBC doc
Provider Directory Doctor lookup
Drug Formulary List drug list

* 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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