NH Local Choice HMO Silver 2500 + $0 Rx list + $0 Virtual Urgent Care

Health Insurance Plan Details (2026 Plan)

HMO

Silver

Deductible (per individual)	$2,500 /yr
Deductible (per family)	$5,000 /yr
Max Out-of-Pocket (per individual)	$9,100 /yr
Max Out-of-Pocket (per family)	$18,200 /yr
Plan Type	HMO
Includes Child Dental?	Yes
Includes Adult Dental?	No

Medical Services
Preventive Care	No Charge
Primary Care Visit	$40 Copay
Specialist Visit	$80 Copay
Emergency Room	$500 Copay after deductible
Inpatient Facility	20.00% Coinsurance after deductible
Inpatient Physician	20.00% Coinsurance after deductible

Drug Costs
Generic Drugs	$10 Copay
Preferred Brand Drugs	$100 Copay after deductible
Non-preferred Brand Drugs	30.00% Coinsurance after deductible
Specialty Drugs	45.00% Coinsurance after deductible

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

Obamacare Plans

Off-Exchange Plans

Get advice from Licensed Insurance Agents

Looking for Other Options?

Short Term Health Insurance Plans

Call for a free quote & benefits review

Find the right short term coverage for your needs.