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Sendero Health Austin512 Silver / $40 PCP / $75 Specialist / $15 Generic Drugs / $0 Deductible
Health Insurance Plan Details (2026 Plan)
by Sendero Health Plans, inc.
Monthly Premium
HMO
$ubsidy
Silver
- Deductible
- N/A /yr
- Max Out-of-Pocket
- N/A /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) | Included in Medical |
| Drug Deductible (per family) | Included in Medical |
| 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? | No |
Out-of-Pocket Costs
| Preventive Care | No Charge |
| Primary Care Visit | $40 Copay |
| Specialist Visit | $75 Copay |
| Emergency Room | $900 Copay |
| Inpatient Facility | $3,100 Copay per Stay |
| Inpatient Physician | 20% Coinsurance |
| Generic Drugs | $15 Copay |
| Preferred Brand Drugs | $75 Copay |
| Non-preferred Brand Drugs | $150 Copay |
| Specialty Drugs | $350 Copay |
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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