Meritus Meritus Community Network - Phoenix AZ

Plan Information
Company Meritus Health Partners
State AZ
Metal Tier Silver
Plan Type HMO

Cost Sharing Benefits

These details are for the standard Silver plan. For reduced Cost Sharing versions scroll down below

Policyholders are generally responsible for 100% of costs until the deductible amount is met. After the deductible has been met the policyholder is responsible for the coinsurance / copay until the out of pocket maximum is reached at which point the insurance company assumes 100% of all costs.

Deductibles and Cost Sharing In Network Out of Network
Deductible (Individual) $5,000 Data Not Available
Deductible (Family) $10,000 Data Not Available
Coinsurance $0 Data Not Available
Out of Pocket Maximum (Individual) $6,350 Data Not Available
Out of Pocket Maximum (Family) $12,700 Data Not Available
Services In Network Out of Network
Primary Care Visit No Charge Data Not Available
Specialist Visit $100 Data Not Available
In Patient Hospital Services $1000 Copay per Stay Data Not Available
Emergency Room Services $500 $500 copay
Mental / Behavioral Health Data Not Available Data Not Available
Imaging (CT/PET Scans, MRIs) $300 copay Data Not Available
Rehabilitative Speech Therapy Data Not Available Data Not Available
Rehabilitative Occupational & Physical Therapy Data Not Available Data Not Available
Preventative Care $0 Data Not Available
Laboratory Outpatient and Professional Services $100 copay Data Not Available
X-ray and Diagnostic Imaging $100 copay Data Not Available
Prescription Drugs In Network Out of Network
Generic Rx $20
Preferred Brand Rx $72
Non Preferred Brand Rx $150
Specialty Drugs 40%

73% Cost Sharing Benefits

Households with incomes between 200% to 250% of FPL qualify for the following cost sharing benefits for this silver plan.

Deductibles and Cost Sharing In Network Out of Network
Deductible (Individual) $2,200.00
Deductible (Family) $4,400.00
Out of Pocket Maximum (Individual) $5,200.00
Out of Pocket Maximum (Family) $10,400.00
Services In Network Out of Network
Primary Care Physician No Charge
Specialists $75
Emergency Room $500
Inpatient Facility $1000 Copay per Stay
Inpatient Physician No Charge
Prescription Drugs In Network Out of Network
Generic Rx $15.00
Preferred Brand Rx $65
Non Preferred Brand Rx $150
Specialty Drugs 40%

87% Cost Sharing Benefits

Households with incomes between 150% to 200% of FPL qualify for the following cost sharing benefits for this silver plan.

Deductibles and Cost Sharing In Network Out of Network
Deductible (Individual) $0.00
Deductible (Family) $0.00
Out of Pocket Maximum (Individual) $2,250.00
Out of Pocket Maximum (Family) $4,500.00
Services In Network Out of Network
Primary Care Physician No Charge
Specialists $50
Emergency Room $250
Inpatient Facility $500 Copay per Stay
Inpatient Physician No Charge
Prescription Drugs In Network Out of Network
Generic Rx $10.00
Preferred Brand Rx $35
Non Preferred Brand Rx $85
Specialty Drugs 40%

94% Cost Sharing Benefits

Households with incomes between 138% to 150% of FPL qualify for the following cost sharing benefits for this silver plan.

Deductibles and Cost Sharing In Network Out of Network
Deductible (Individual) $0.00
Deductible (Family) $0.00
Out of Pocket Maximum (Individual) $2,250.0
Out of Pocket Maximum (Family) $4,500.00
Services In Network Out of Network
Primary Care Physician No Charge
Specialists $15
Emergency Room $85
Inpatient Facility $150 Copay per Stay
Inpatient Physician No Charge
Prescription Drugs In Network Out of Network
Generic Rx $5.00
Preferred Brand Rx $10
Non Preferred Brand Rx $35
Specialty Drugs 40%

Other Plans

Other plans that are available in the state.

Plan Name
Meritus Community Network - Phoenix
Meritus Community Network - Pima
Meritus Cooperatively Silver
Meritus Cooperatively Together Gold
Meritus Healthy Together Gold
Meritus Healthy Together Silver
Meritus Neighborhood Network Maricopa Silver
Meritus Premium Saver Bronze
Meritus Affordable Silver
Meritus Clear Choice Gold
Meritus Confident Choice
Meritus Healthy Gold
Meritus Lifestyle Choice Bronze
Meritus Reliable Silver
Meritus Saver Choice Bronze
Meritus Secure Silver
Meritus Smart Choice Gold
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This tool is for research purposes only. The numbers shown are estimates based on the information you have provided and our best efforts to provide accurate data. We try to keep the information up to date however we cannot make warranties about the accuracy of our information. We advise that users confirm any research with the respective health insurance companies and health exchanges.